Loss of skin elasticity, gravity and other factors such as weight loss, pregnancy and breast feeding ultimately affect the shape and firmness of your breasts. You may be quite happy with the size of your breasts but you could have a breast lift to raise and firm them, resulting in a more youthful breast contour.
However, if you are not happy with the size of your breasts and feel that they have diminished in size over time, a breast uplift and re-shaping can be combined with an augmentation to restore your natural volume.
Q. Am I a good candidate for breast uplift?
A. You may be a good candidate for a breast lift if you have one or more of the following conditions:
- Breasts that are pendulous but of satisfactory size
- Breasts that lack substance or firmness
- Nipples and areolas (the pigmented area around the nipple) that point down especially if they are positioned below the breast crease
Sometimes these conditions may be inherited, for example, breasts that have developed differently so that one breast is firmer and well positioned while the other is not. It is normal to have one breast that is slightly larger than the other but in some people this difference is quite marked. Breasts that are large and heavy can be uplifted but the results will not be as long lasting as when the procedure is done on smaller breasts. Breast lift can be performed at any age but we recommend waiting until the breast is fully developed. Since the milk ducts and nipples are left intact, breast lifting and re-shaping surgery usually will not affect your ability to breast feed; however, this will affect the longevity of your result. You can discuss this further at your consultation.
Q. How will my plastic surgeon evaluate me for breast lift surgery?
A. At your consultation you will be asked about your desired breast shape and size. You will be able to discuss your nipples and areolas and how they will be re-positioned. To help your surgeon understand your expectations in determining whether these goals are realistically achieved, you should mention all other aspects about your breasts you would like to see improved. Your breasts will be examined, looking carefully at the quality of your skin and the placement of the nipples and areolas. Measurements may be taken as will photographs. This is for the purposes of medical records. Your surgeon will also be interested in your full medical history, not only any previous operations to your breasts but also any medical conditions, drug allergies or regular medication. You should let your surgeon know if you plan to lose a significant amount of weight particularly if you have noticed that your breasts sag or become smaller with weight loss. It is recommended that you stabilise your weight before surgery.
Q. Where are the incisions placed?
A. Individual factors and personal preferences will determine the specific technique selected to lift your breast. The technique selected will determine the positions of the incisions and therefore the scars. You will be able to discuss with your surgeon the uplift you require and this, in turn, will determine the exact positioning of the scars.
For a small uplift, an incision encircling the areola (the pigmented area around the nipple) may be all that is required. In most instances, however, a vertical scar running from the areola to the natural skin fold under the breast will be required, and for a more extensive uplift a horizontal scar running in the breast fold will be required.
Your skin tone, breast firmness and size of uplift required will be factors determining which technique may best suit your requirements.
In all techniques, the nipples and the areolas remained attached to the underlying mounds of breast tissue and this usually allows for the preservation of sensation and the ability to breast feed. If you and your plastic surgeon decide that it is desirable to enlarge your breasts at the same time as the uplift, this will also require the insertion of a breast implant. A few people need this and you may discuss this at the consultation.
Q. I understand that every surgical procedure has risks or side effects. I want to learn more so that I can make an informed decision.
A. Every year many thousands of women undergo successful breast lift surgery and experience no major problems and are pleased with the results.
Anyone considering surgery, however, should be aware of both the benefits and the risks. Significant complications in breast lift surgery are infrequent. Some people find that the breasts are not perfectly symmetrical or the nipple height might vary slightly. Even prior to surgery most ladies are not perfectly symmetrical. Minor adjustments often can be made at a later time if this is a problem. Loss of sensation in the nipples or areas of breast skin may occur rarely. Some people have a tendency to develop thickened scars and if you have had this problem you should let your surgeon know.
Your breast lift surgery will have made your breasts firmer and more uplifted. The position of your areolas and nipples will be enhanced and the size of the areolas will be aesthetically pleasing. Unless you gain or lose significant amounts of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of ageing will eventually alter the size and shape of virtually every woman’s breasts and breast uplift surgery will not make you immune to this. If, over the course of years you again become dissatisfied with the appearance of your breasts, you may always choose to undergo a second breast uplift procedure to restore the more youthful contour and appearance.
Q. What will the day of surgery be like?
A. The goal of the plastic surgeon and the entire staff is to make your surgery experience as easy and comfortable for you as possible. Your operation will be performed under general anaesthetic as an inpatient at hospital. You will be asked to attend the hospital on the day of your hospital when you will get a further opportunity to meet with your surgeon. You will have a private room and your procedure will be carried out in the operating theatre. After the operation, you will be taken to the recovery suite where the specialist recovery nurses will monitor you closely as you wake up. You will then return to your private room and spend one night in hospital. When you leave the following morning, you will be able to shower from the waist down. You will be asked to keep your wounds dry until they are adequately healed. This is usually at five days. There will be no sutures to be removed as they will dissolve naturally.
Once your surgery is over and you are discharged from hospital, this is not the end of your relationship with your plastic surgeon and you will be expected to return for follow-up to ensure that you have a smooth postoperative recovery and good surgical result.
Q. How will I look and feel initially?
A.The day after surgery you will be able to get out of bed for short periods of time. After only a couple of days you should be able to move about more comfortably. Straining, bending and lifting must be avoided however since these activities might cause increased swelling or even bleeding. You will be asked to sleep on your back to avoid pressure on your breasts. You will also be asked to wear a good supporting bra of your choice until the swelling and discolouration of your breasts diminish. There will be no sutures to be removed since all sutures will dissolve naturally.
You may find that you have less sensation in the nipple and areola areas and some of the skin underlying the breast. This is usually temporary and sensory changes to the nipple in particular are most unusual. It may take weeks or months for sensation to return to normal.
The bra you choose will help your breasts maintain and assume a more natural shape. You will be encouraged to wear this for an extended period of time. The incisions will initially be red or pink in colour and they will slowly fade but not vanish over six to 12 months.
Q. When can I resume normal activities?
A. After breast lift surgery it is often possible to return to work within a week or so depending on your job. In most instances, you will be able to resume most of your normal activities, including some mild exercise after only three weeks. Strenuous activities, especially those of the upper limbs and torso are probably best avoided for up to six weeks. You may continue to experience some mild or intermittent discomfort during this time. Such things are normal. Severe pain should be reported to your doctor.
Any sexual activity should be avoided for a minimum of one week. After that care must be taken to be extremely gentle with your breasts for a further four weeks.