Shapely, perky breasts are the quintessential sign of youthful femininity. But as they age, many women find that their breasts have sagged and their breast volume has decreased. And having children can accelerate the undesired effects of aging on your breasts.

Breast lift, or mastopexy, can restore your breasts, giving them again a more youthful appearance. It can be performed, with or without breast augmentation (using implants), for women who have drooping, sagging, or flattened-out breasts.

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Recovery

The first two days after the surgery, you should plan on being home and relaxing. Depending on the extent of your lift, you may have a drain in place during this period. You will be in a comfortable surgery bra that has adjustable straps. Most people take some pain medication during this period of time but the breasts are usually only minimally achy and sore. After the first few days, most people are up and around, off all prescription pain medication, and usually have resumed basic activities. All exercise, heavy lifting, or other more strenuous activities should be avoided [***for the first three weeks*** I made that up -gmc]. If you go to work, expect to be more tired in the first week and sore by the end of the day. If your work involves a lot of moving of your upper body, take the whole first week off. Your breasts need more than a month to fully heal and take their final shape. Our team will discuss with you what kind of support and activity you will need for the first month.

Surgical Technique

The surgery works through at least a 2.6 cm incision in the lower breast, usually at the bottom edge of the areola. The skin of the lower breast is first separated from the breast tissue. This allows the breast to be lifted without cutting the skin. Depending on the degree of the lift, a central wedge of breast tissue is taken from the lower half of the breast and tucked under the central breast to create an "auto-augmentation" of the breast. This fills up the depleted upper half of the breast. Now, the lower half of the breast is brought together, creating a neat breast that is pulled up above the level of the natural crease under the breast. At that point in the surgery, the breast tissue itself is lifted and critical determinations need to be made: is the nipple high enough? Is the skin is too lax? In some patients, the one incision is adequate. In others, the nipple is too low, and since the nipple itself is part of the skin, the incision may need to be extended all the way around the areolae in order to remove some of the extra skin above the nipple and areola. This is called a "circumareolar" or "pursestring" mastopexy. Not all pursestring mastopexies are created equal, however, as many surgeons just cut some skin out to lift up the breast without performing the critical internal maneuvers, which creates an unattractive scar and a stretched-out areola. If the lower part of the breast skin is very loose or stretched out, then a vertical incision is made in addition to the incision around the areola. This is called a "lollipop" mastopexy. In rare cases, usually with extremely large lifts or breast that need reduction, a horizontal incision under the breast is also necessary. Dr. Cassileth uses sutures that do not need to be removed.

Risks

All surgical procedures have risk. As with other surgeries, the two most common risks are bleeding and infection. Scarring can be a problem with any surgery, and we insist that all our patients go on a six month scar treatment regimen after surgery to minimize all scars. During the healing period, the breasts often have tight or small lumpy areas where the internal sutures are located, and are most easy to feel under the breast in the center. This is common and is most prominent from weeks four to eight after the surgery. These sutures are absorbable and any lumps caused by the suture will resolve. Occasionally, the breasts are slightly asymmetric or heal differently. Small differences are always present going into the surgery and are expected afterwards. To resolve any of the above complications, a secondary procedure may be desired.

Some other procedures that might interest you:

• Breast Lift
• Breast Augmentation
• Breast Reduction
• Breast Asymmetry