Procedures

Breast Lift / Mastopexy

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Introduction.  A breast lift, or mastopexy, is a plastic surgery procedure designed to elevate and reshape sagging breasts. Factors such as pregnancy, nursing, and the force of gravity influence sagging. As the skin loses elasticity, the breasts often lose their shape and firmness. Results of this procedure are not permanent, as no surgery can permanently delay the natural effects of gravity. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume, such as post-pregnancy, breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. If you're considering a breast lift, the below information will give you a basic understanding of the procedure and what you can expect. It will not answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask Dr. Shienbaum if there is anything about the procedure you don't understand.

Candidates for mastopexy.  Women who are in good general physical health, are nonsmokers, and who have realistic expectations and goals about the surgery are the best candidates. A breast lift can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Shienbaum. While mastopexy will elevate your breasts, factors that caused them to lose their shape will continue to have their effects and therefore some loss of shape and sagging may eventually recur.

Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you're planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure. There are several factors that deem some women as non-candidates for mastopexy. These include existing malignant or pre-malignant cancer of your breast without adequate treatment, patients with active infections anywhere in the body, and women who are pregnant or currently breast-feeding.

Surgical procedures. The technique used for your surgery is dependent on your specific anatomy and the desired results. The most common method of breast lift involves three incisions resembling an anchor-shape: one incision around the areola, one vertically from the bottom edge of the areola to the crease underneath the breast, and one horizontal incision beneath the breast that follows the natural curve of the breast crease.

These incisions outline the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Sutures are located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast. This procedure usually takes one and a half to three and a half hours.

There are several variations of this procedure and Dr. Shienbaum will determine the best technique for you based on the size and shape of your breast, the size of your areolas, and the extent of the sagging.

Planning your surgery.  Dr. Shienbaum and his staff at Brandon Plastic Surgery welcome you to a complementary initial consultation during which your desires will be discussed. In your initial consultation, you will visit with the professional staff that will take your medical history. The Doctor will evaluate your health, conduct an examination, and recommend which surgical technique is most appropriate for you. It is important for you to be frank with the Doctor and for you to know that the Doctor will be frank with you, describing his technique, alternatives, limitations, and risks. Dr. Shienbaum also will explain the anesthesia that will be used during your procedure. If you and Dr. Shienbaum decide that your breasts will be enlarged at the same time they are lifted, breast implants will be required. Please view the previous section on breast implants for additional information on augmentation. The staff will provide you with photos of previous patients so that you may better comprehend likely mastopexy results. The facility where your surgery will be performed will be explained, as will the expenses involved. Insurance carriers generally do not cover mastopexy (nor associated augmentation), since they generally deem it to not be medically necessary.

Upon your decision to proceed with mastopexy, the staff will work with you to arrange a surgery date, review consent forms, and take photographs. Dr. Shienbaum uses an advanced digital imagery camera and storage on an automated imagery filer to immediately record photographs.

The staff will also provide you with instructions in preparation for your surgery. These will include guidance on eating, drinking, smoking, and the taking or avoidance of certain medications and vitamins. You will need to arrange for transportation from the facility and should have some assistance to help or to provide care following your surgery.

Where your surgery will occur? Dr. Shienbaum will perform your breast augmentation in a local, fully accredited ambulatory surgical facility. While mastopexy surgery is typically conducted in an outpatient facility, Doctor Shienbaum has privileges at area hospitals where he is recognized as a board-certified Plastic Surgeon and Otolarnygologist.

Your surgery and anesthesia. Upon your arrival for your surgery, the anesthetist will initiate an intravenous (IV) line. The IV will be used to provide your anesthesia and appropriate medications and hydration during the surgery and your recovery period. Depending on your case and the facility, either general anesthesia or a shallower �sleep�, known as IV sedation, are usually employed.

This procedure usually takes one and a half to three and a half hours. As discussed above, the technique used for your surgery is dependent on your specific anatomy and the desired results. After completion of your surgery, you will be moved to a recovery room or area. While in recovery, a nurse will be constantly monitoring your vital signs and will ensure that you are comfortable. Recovery time is dependent on the anesthesia used and your individual physiology. A normal recovery stay of one to two hours should be expected. A member of Dr. Shienbaum�s nursing staff will contact you in the evening to check on your status. It is important that you provide the staff with a contact phone number.

After your surgery. You will likely feel light-headed the first 24 hours after your procedure and you should expect swelling and discomfort in your breasts. After surgery, your breasts will be wrapped in an ace bandage over gauze dressings. Your breasts will be bruised, swollen, and uncomfortable for a few days, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications that Dr. Shienbaum will prescribe. You will be seen in our office normally on the day following your surgery. During this visit you will be evaluated, your dressings changed, and provided with further post-operative instructions, as needed. The bandages will be replaced by a sports bra, which you will wear around the clock for approximately four weeks. The sutures will be removed after a week or two.

You should expect to be up and around in 24 to 48 hours following the surgery. Most discomfort that you experience will be controlled by medication, but should subside within 3 to 4 days. Any expected bruising and swelling from the procedure should disappear within 2 to 4 weeks. Any complications noted should be immediately brought to the attention of Dr. Shienbaum.

Follow-on examinations will be scheduled based on your personal progress.

You should be able to resume most non-physical activities within 1 week. Your breasts will likely be sensitive to direct stimulation for 2 to 3 weeks. Scars will be firm and pink for at least 6 weeks, may remain the same size for several months, and then will fade. Most patients are completely healed and back to full activities within 4 to 6 weeks. 

Frequently asked questions. This section provides information in response to questions or subjects routinely posed by our patients:

1. Nipple sensitivity/nipple numbness. Numbness may occur temporarily or permanently from traumatizing sensory nerves in the breast during the procedure. Tingling, burning, or shooting pains accompany regeneration of the sensory nerves. These sensations will disappear with time and are not alarming.

2. Scarring. Using the standard technique for mastopexy, you will have scars around the areola, in a vertical line from the areola to the crease below the breast, and horizontally in the crease. The scars usually flatten and fade with time, but thicker and heavier scars can persist and require subsequent treatment, including surgery. Redness of the scar will continue to fade for up to 2 years.

3. Asymmetry. Mastopexy operations involve very careful planning in order to achieve near symmetry and a natural look. Dr. Shienbaum diligently attempts to promote symmetry; however, it is not always possible to predict perfect and equal breast shapes. It should also be noted that very few women have natural symmetrical breasts.

4. Activities. You may take gentle walks within a few days. Do not resume aerobic or strenuous exercise for three to four weeks after surgery.

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