Mastopexy

Droopiness of the breasts is a common legacy of motherhood and the force of gravity taking its toll, and the effect of pregnancy. A distension of the breasts with milk causes the fibrous bands, which support the breasts in their youthful shape to break down and the skin to stretch.

With the subsequent shrinking, the unsupported breasts settle into the stretched skin and gravity pulls them down. Putting on weight and then losing it can have the same effect. So too does the ageing process, which is why women dislike the appearance of their droopy breasts.

What can be done?

Whilst it is not possible to recreate surgically the natural supporting structure of the breast, it is possible to reshape the breast into one which looks more youthful and feels more firm. The operation is called a Mastopexy. Pleats of surplus skin are removed from underneath the breast, the breast itself is remodelled into a tighter cone and the nipples are repositioned at a higher level so that they lie at the points of the tightened breasts. Mastopexy can also reduce the size of the areola (the darker skin surrounding the nipple). If the breasts are too small as well as droopy, their size can be increased during the operation by placing silicone breast implants underneath the tightened breasts. The best results are achieved in women with small sagging breasts although breasts of any size can be lifted. The results may not last as long with heavy breasts.Many women seek a Mastopexy when their families are complete, so if you are planning to have further children, it may be a good idea to put this procedure on hold until you have completed your family, as your breasts are likely to stretch again and reduce the overall effect of the procedure.

What you should do before the operation?

If you smoke you should stop now. If you are taking the contraceptive pill, change to an alternative method at least six weeks beforehand, and if you are overweight you should reduce your weight before surgery and be at a comfortable weight that you can manage, as weight gain can make the breasts droop again

What can you expect at the time of the operation?

The surgery is carried out under general anaesthetic and involves an overnight stay in hospital and will often involve an overnight stay in hospital. Your surgeon will need to mark the size and shape of the breast while you are standing.  Following the operation you may find that you have two small tubes emerging from each side of your breasts, this is so that any collection of blood can drain. These will remain in place for a short period of time. You will be given painkillers for the discomfort you experience in the first few days. Your surgeon may encourage you to wear a firm bra or dressing following surgery, which will continue until the sutures are removed, some 10 days to 2 weeks later. You should refrain from strenuous physical exercise including swimming, for approximately 6 weeks and you will probably require at least two weeks off work. Over the next 6 to 12 months the scars will gradually fade from red to pale. Your surgeon will make every effort to make your scars as inconspicuous as possible but it is important to remember that the scars are extensive and permanent. It is not possible to reshape droopy breasts without significant scarring.  Breast lift will not last for ever and the effects of gravity, pregnancy and weight gain will take their toll, as will time.

What Are The Consequences?

This is a good operation to improve the appearance of droopy breasts but you would be left with scars, possibly some numbness of your nipples and you may not be able to breast feed again. Mastopexy can be carried out by a number of different techniques and the scars will differ accordingly.  It may be possible for the operation to be performed with less scars and your surgeon will discuss this with you.Usually scars are narrow in width and pale but they are not invisible and will be noticeable when you are undressed.

What Are The Limitations?

Because it is not possible to recreate the natural attachment of the breast to the tissues underneath, a mastopexy alone will not greatly increase the fullness of the breast above the nipples. Fullness above the nipples can be achieved, however, by increasing the size of the breast with silicone implants. The extra weight of the silicone implants may accelerate the return of the droopiness of the breasts and in any event there is a tendency for the breast to sink downwards as time goes by. You can lessen the rate at which this happens by supporting your breasts in a good supporting bra as much as possible.

What Are The Risks?

As with any major operation under general anaesthetic, there is a small risk of chest problems, particularly if you are a smoker and a small risk of thrombosis of veins in your legs, particularly if you are taking a contraceptive pill. In addition there is a small risk of one of the following complications.

Rarely heavy bleeding from the broken blood vessels can occur after the operation, which requires treatment in theatre under a general anaesthetic. Occasionally, infection (usually from germs that are lying dormant in the ducts of the breast) can cause part of the wounds to break down, which prolongs the healing period and worsens the quality of the final scars.

Some people have an inborn tendency for scars to stretch and some people produce scars that remain thick, red and irritable for a long time.

If silicone implants are used you will need to refer to the leaflet on breast augmentation, which will discuss the issue of breast implants and the potential complications in much more detail.

ARNICA tablets will reduce swelling. They may be bought from a chemist. These should be started a few days before surgery and continued for several days afterwards.

The sutures you have may not all be dissolving and may need removing.  This will be at your two week appointment

You must keep your dressing as dry as possible until your follow up appointment.

Swelling and bruising may be severe.

You should have been measured for bra size preoperatively. Although it is difficult to be precise about your size after surgery, you should have an indication of the size of the sports bra you will need. As a general rule expect to keep your chest measurement (36, 38 etc) but you should increase your cup size. Immediately after surgery there will occasionally be dramatic swelling, which means you may be alarmed that your breasts appear too large.  Swelling will decrease over the next 6 – 12 months.

Please bear in mind that we will endeavor to give you the breast enlargement you desire, but it may be that your skin would not stretch to accept a larger implant. This will have been discussed with you at your initial consultation and in your preoperative discussion on the day of surgery. The operation we have performed is to ensure a SAFE and NATURAL result.

Scarring is always an issue and hopefully your scarring will be reasonable. If scarring is an issue we will endeavor to correct this. A facility fee may be charged for this. Any corrective surgery will only be undertaken when post operative swelling settles which may be after 9 – 12 months.

At your follow up appointment you will be given further advice regarding scar massage.

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