Introduction to the Breast Lift
The breast lift (mastopexy) is designed to do two things:
- Raise the position of the nipple – areola
- It can also be used to change the size of the areola if desired
- Raise the lower pole breast tissue that sits below the fold under the breast.
Every patient has basically three options when considering breast enhancement surgery:
- Breast Augmentation alone
- Breast Lift alone
- Or a combination Breast Lift and Augmentation
The option we use is determined by a combination of what the patient’s underlying anatomy is…
- No sagging
- Minimal sagging
- Moderate sagging
- More than moderate sagging
…and by what shaped breast the patient desires. Dr. Schneider has treated patients with severe sagging by breast augmentation alone, and he has lifted breasts with minimal sagging. The key is understanding the patient’s desires for breast shape and size, as well as what is required surgically to achieve the desired result.
Breast Ptosis (Toe-Sis) – Breast Sagging
Ptosis is derived from Greek meaning to fall. Ptosis of the breast means that the nipple and breast tissue are positioned below the fold under the breast. Ptosis may be the result of how the breasts naturally develop, or it may result from the changes that occur in the breast due to pregnancy, weight gain & loss, or aging. Regardless of the cause, breast sagging can be addressed with the mastopexy procedure.
Breast Lift Incisions
Lollipop, Anchor and Periareolar
One of three different incisions is typically used for the mastopexy: the periareolar (around the areola), the lollipop incision, and the anchor incision. Dr. Schneider uses a breast lift technique he developed that minimizes scarring and produces a full rounder breast. This incision technique is known as the lollipop incision.
The goal of the mastopexy is to elevate and reshape the breast the tissue as much as possible so that ideally, it stays above the inframammary fold. Dr. Schneider’s personal lollipop technique is a modification of the vertical mastopexy that creates a breast that is higher, fuller, more shapely and stands the test of time. The technique can be performed either with or without an implant.
Dr. Schneider stopped using the large anchor incision for the breast lift in the early 90’s. The lollipop incision allows him to create significantly less scarring, and in his opinion, a better shape to the breast.
The periareolar incision is a reasonable technique if the nipple-areola needs a small amount of elevation.
Breast Lift with Implants
The breast lift procedure by itself will not produce fullness in the upper pole of the breast. Thus, the breast lift operation results in a natural-appearing breast.
If the patient desires more fullness in the upper pole than a breast lift can accomplish on its own, and/or if the patient also desires a larger breast, then an implant is recommended at the same time that the breast lift is performed.
The implant is inserted through the same incisions and placed under the muscle. Based on the patient’s choice, either a saline, silicone, or a gummy bear implant can be utilized. Patients ultimately have the choice of having their breast size smaller, the same size, or larger.
The breast lift procedure takes Dr. Schneider about 2 hours to perform. The operation is performed in our AAAHC certified office surgery center while the patient is asleep with a deep twilight anesthesia. Once incisions are created, the breast tissue below the fold is reshaped into an internal brassiere. All stitching is performed with internal absorbable sutures so no stitches need to be removed. Usually, the procedure is performed without using a surgical drain.
At the conclusion of the procedure, antibiotic gauze is applied to the incisions, special tape is applied to support the lower pole of the breast, and then a light surgical bra is placed on the patient.
Breast Lift Recovery
The breast lift requires a longer recovery, in terms of limitation of physical activity, compared to the breast augmentation procedure alone. The day or two after the procedure, patients are asked to return to the office to check the dressings. Sometimes there can be a small amount of bleeding along the edges of the incisions. If there is no bleeding, the patients may shower. If there is a small amount of bleeding, they are asked to wait 24 hours after the bleeding has stopped before they get their breasts wet. This may take 2-3 days.
Most patients are able to return to school or work within 7 days. However, we ask patients not to lift anything more than about what a large purse holds (about 10 pounds), or reach with their arms for 6 weeks. We ask this because the breast tissue internal bra that Dr. Schneider creates with the operation takes about 6 weeks to become strong.
During that time we like patients to wear either a supportive bra or the special tape Dr. Schneider applies. Scar creams or ointments are not necessary to use or purchase. After six weeks, you may resume all normal activities and bra choices.