Breast Lift

BREAST LIFT

By nature, breasts can become ptotic during puberty and with aging all breasts will to some extend succumb to the force of gravity. Pregnancy and weight loss will speed up this proces. After removing breast implants the breasts may become deflated and ptotic. When breasts are excessively ptotic they may cause discomfort as the bra has to lift the entire breast which can result in back, shoulder and neck pain. Bra straps can cut and rub into the skin of the shoulders and sweating underneath the breast can cause irritations and fungus infections. Ptotic breasts can be experienced to be repulsive or shameful. In most women an asymmetry can be observed whereby one breast is larger, hanging lower or has a slightly different shape. When the asymmetry is significant finding the right size bra may become difficult. A breast lift elevates the volume of the breast and moves the nipple-areola complex towards the center of the breast. If a larger breast volume is desired, a breast augmentation using a prosthesis can be performed at the same time as the breast lift.

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DETAILS OF THE TREATMENT

THE FIRST CONSULTATION

During the first consultation your general health, length, weight and breasts will be assessed. A breast lift will result in scars and may affect the sensation of the nipples. The chances of being able to breastfeed after a lift decreases. These consequences depend on how much the breasts and the nipple-areolae need to be lifted. As with all elective procedures it is important that your weight and general health is acceptable. The surgery, the consequences thereof and the aftercare will be discussed. If a breast augmentation together with a breast lift is desired additional attention and information will be given during the first consultation (see breast augmentation).

THE PROCEDURE

A breast lift and a breast reduction are in fact the same procedure. During a large breast reduction, a large amount of breast tissue is removed and during a small breast reduction only little tissue is excised. During a breast lift a minimal amount of tissue is removed. In both a breast lift and a breast reduction the nipple-areola needs to be moved upwards and skin needs to be excised resulting in similar scars. Both will result in a scar around the areola, a vertical scar and a horizontal scar underneath the breast: the “anchor” scar. Depending on how much the breasts need to be lifted and quality of the skin the horizontal scar may be prevented resulting a “lollypop” scar. A breast lift procedure takes 1 ½ - 2 hours and together with an augmentation 2 ½ - 3 hours. The nipple-areolae will be positioned higher and the areolae will be made smaller when they are too large. If necessary, drains will be placed to drain any fluid or blood that may accumulate after the procedure. Simple dressings will be applied.

AFTER THE PROCEDURE

The procedure can take place as a day case and you can go home when you are fully awake from the anesthetic. The drains will be removed at the consulting room after 1 – 3 days. The stitches will all be dissolvable and do not have to be removed. A sports bra, without under wiring needs to be worn to protect the breasts and to allow the wound healing process to proceed undisturbed. It is important that the bra is supportive and comfortable as it needs to be worn day and night for six weeks. After the “lollypop” technique the skin underneath will initially be wrinkled and swollen. This will settle down and smoothen out in 4 – 8 weeks. During this time, you will be followed up for checkups. The final scar will depend mainly on your wound healing. After a breast reduction the aging process will continue and further changes can occur with fluctuations in body weight, pregnancies and menopause. It is advisable to always wear a well supporting bra during the day.

RESULTS

After a breast lift the breasts will be rounder and the nipple-areolae will be more centrally located on the breasts. As skin and some breast tissue needs to be excised to achieve the lift the volume will only reduce slightly. If an augmentation has been performed at the same time the volume will of course be increased. The nipples need to be in the right place and the breasts need to be similar in same shape and size. The result can be judged after 3 months when the wound healing is completed around 70 – 80 %. Wound healing takes about a year in total.

RISKS AND COMPLICATIONS

All operations run the risks of bleeding and infections. In general, these can to be treated well with little consequences for the final result. By mobilizing and moving the nipple upward, the sensation can change, decrease or disappear. In rare instances the circulation of the nipple-areola complex is inadequate resulting in partial or complete necrosis of the nipple/areola. The chances of breastfeeding after a breast lift depends on the amount of mobilization necessary to lift the nipple-areola complex. The wounds and scars may heal poorly requiring treatment or a scar revision. When a breast augmentation is performed together with a breast lift the specific risks and complications of an augmentation apply as well (see breast augmentation). After a breast lift the forces are inwards and after a breast augmentation the forces are outward. As these forces work against each other it may be possible that within a year the breasts have stretched and has lost some of their lift. A second breast lift may be necessary after a year to achieve the intended result.

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