Breast lift

Overview

A breast lift is a surgical procedure to change the shape of the breasts. During a breast lift, a plastic surgeon removes extra skin and reshapes breast tissue. The goal is to raise the breasts. A breast lift also is known as mastopexy.

You might choose to have a breast lift if your breasts sag or the nipples point downward. A breast lift also might boost your self-image and self-confidence.

A breast lift won't change the size of the breasts. But some people may have a breast lift done at the same time as a surgery to increase breast size, called breast augmentation. Some people also may have a breast lift done at the same time as a surgery to lessen breast size, called breast reduction.

Why it's done

Breasts change with age. They often lose firmness. And the skin loses the ability to snap back into place after being stretched, called elasticity. There are many causes for these kinds of breast changes, including:

• Pregnancy. During pregnancy, the bands of tissue that support the breast, called ligaments, might stretch. This happens as the breasts get fuller and heavier. The stretching might cause sagging breasts after pregnancy. This may happen whether or not you breastfeed your baby.
• Weight changes. Changes in weight can cause the breast skin to stretch. They also can cause breast skin to become less elastic.
• Gravity. Over time, gravity causes ligaments in the breasts to stretch and sag.

A breast lift can lessen sagging and raise the position of the nipples. The surgery also can lift the darker areas surrounding the nipples, called the areolae. The areolae may be made smaller to keep them balanced with the newly shaped breasts.

You might think about a breast lift if:

• The breasts have lost shape and volume, or they've gotten flatter and longer.
• The nipples fall below the breast creases when the breasts aren't supported.
• The nipples and areolae point downward.
• The areolae have stretched out of proportion to the breasts.
• One of the breasts falls lower than the other.

A breast lift isn't for everyone. If you plan to become pregnant in the future, you might wait to get a breast lift. Breasts could stretch during pregnancy and offset the results of the breast lift.

Surgeons suggest waiting about six months to a year after stopping breastfeeding to get a breast lift. This allows for the breasts to return to a stable shape and size. Breastfeeding usually is possible after the procedure. But the breasts may look different after you stop breastfeeding.

While plastic surgeons can do breast lifts on breasts of any size, surgeries on smaller breasts may have longer lasting results. Larger breasts are heavier, which makes them more likely to sag again.

Risks

A breast lift has some risks, including:

• Scarring. While scars don't go away, they tend to soften and fade within 1 to 2 years. Scars from a breast lift usually can be hidden by bras and bathing suits. Rarely, poor healing can cause scars to become thick and wide.
• Changes in nipple or breast feeling. Feeling often comes back within a few weeks. But some loss of feeling might last. Erotic feeling usually isn't affected.
• An uneven shape and size of the breasts. This could happen because of changes during the healing process. Also, if the breasts were different sizes before the procedure, a breast lift usually doesn't change this.
• Partial or total loss of the nipples or areolae. Rarely, the blood supply to the nipple or areola briefly stops during a breast lift. This can damage breast tissue and lead to the partial or total loss of the nipple or areola.
• Trouble breastfeeding. While breastfeeding usually is possible after a breast lift, some people might have trouble making enough milk.

Like any major surgery, a breast lift has a risk of bleeding and infection. Some people have bad reactions to a medicine that puts you to sleep, called anesthetic. Also, it's possible to have an allergic reaction to the surgical tape or other materials used during or after the procedure.

How you prepare

Start by talking with a plastic surgeon. During your first visit, a plastic surgeon will likely:

• Review your medical history. Be ready to answer questions about current and past medical conditions. That includes whether you have a family history of breast cancer.

  Share the results of any mammograms or breast biopsies. Talk about any medicines you're taking or have taken recently. Also share information on any surgeries you've had.

• Do a physical exam. To guide your treatment options, a surgeon examines the breasts. This includes the position of the nipples and areolae.

  A surgeon also checks the quality of the skin tone. Breast skin that has good tone holds the breasts in a better position after surgery. The surgeon may take pictures of the breasts for your medical record.

• Talk about your expectations. Explain why you want a breast lift. Be clear about how you want your breasts to look after the procedure. Make sure you know the risks and benefits. Risks may include scarring and changes in nipple or breast feeling.

Before a breast lift, you also might need to:

• Schedule a mammogram. Your surgeon might recommend a baseline mammogram before the procedure. You also may need another mammogram a few months afterward. This can allow your medical team to see changes in your breast tissue and help the team interpret future mammograms.
• Stop smoking. Smoking lessens blood flow in the skin and can slow the healing process. If you smoke, it's important to stop smoking before surgery.
• Avoid certain medicines. You'll likely need to avoid taking aspirin, anti-inflammatory medicines and herbal supplements, which can increase bleeding.
• Arrange for help during recovery. Make plans for someone to drive you home after surgery and stay with you as you start to recover. You might need someone to help you with daily activities, such as washing your hair, during your early recovery.
• Be at a healthy weight. Think about making changes to help with weight loss if you've gained weight in the past year. For example, you might change your diet or join an exercise program.

What you can expect

A breast lift can be done in a hospital or as an outpatient procedure. Medicine is used to numb the body and prevent pain. Your surgeon might do the procedure with medicine that helps you relax and be less aware of your surroundings, called a local anesthetic. Or your surgeon may use medicine called general anesthetic that puts you into a deep sleep.

During the procedure

Techniques vary for removing breast skin and reshaping breast tissue. Your surgeon makes cuts during surgery based on the technique used. These cuts become scars as they heal. The cuts also are called incisions.

A surgeon might make cuts:

• Around the darker areas that surround the nipples, called the areolae.
• Going downward from the areolae to the breast creases.
• Straight across along the breast creases.

The surgeon might place stitches deep within the breasts to reshape the breast tissue. Stitches also may be used to make the size of the areolae smaller. The surgeon removes extra breast skin and moves the nipples to higher positions. Then the surgeon brings together the breast skin. The cuts are closed with stitches, surgical tape or skin glue.

The procedure typically takes about two hours. You often can go home on the same day.

After the procedure

After a breast lift, the breasts are usually covered with gauze and you wear a surgical support bra. Small tubes might be placed where the surgeon made cuts in the breasts. The tubes help drain any excess blood or fluid.

The breasts will likely be swollen and bruised for about two weeks. You'll likely feel pain and soreness around the cuts. These may look swollen and irritated, called inflamed, for a few months. Numbness in the nipples, areolae and breast skin might last for about six weeks.

Your healthcare team can guide you on what pain medicine to use for the first few days after a breast lift. Avoid straining, bending and lifting. Sleep on your back or your side to keep pressure off your breasts.

Avoid sexual activity for at least 1 to 2 weeks after the breast lift. Ask your healthcare team when it's OK to go back to doing daily activities, such as washing your hair or bathing.

Drainage tubes may be placed near where the surgeon made cuts in the breasts. These typically are removed within a few days. When the tubes are removed, your bandages will probably be changed or removed too.

Talk with your healthcare team about your stitches. Some stitches dissolve on their own. Other types of stitches need to be removed by a healthcare professional. These types of stitches often are removed 1 to 2 weeks after the procedure.

Keep wearing the surgical support bra 24 hours a day for 3 to 4 days. Then wear a soft support bra for 3 to 4 weeks. Your healthcare team might suggest using silicone tape or gel on your stitches to help the area heal.

Keep the breasts out of the sun to protect the skin as it heals.

Results

You'll see a change in the look of your breasts right away. Their shape will keep changing and settling over the next few months.

At first, scars will likely look hard and lumpy. While scars last forever, they soften and become thin within 1 to 2 years. Scars from a breast lift usually can be hidden by bras and bathing suits.

Breast lift results might not last forever. As you age, skin naturally becomes less elastic. Some sagging might happen, especially for women who have larger, heavier breasts. Keeping a stable, healthy weight can help you keep your results.