Breast-lift surgery is performed to address breast sagging and emptiness, usually evident after pregnancy and childbirth, or following extreme dieting and weight loss. The goal of this surgery is to restore aesthetic appearance and firmness to the breasts.
Furthermore, it helps improve the woman’s sense of self-image. During surgery, any excess breast skin is removed, and the overall shape and contents of the breast is rearranged, taking into account how high the breast is to be elevated and deciding on where the nipple and areola should best be relocated. In any case of volume deficiency in the breast, one may choose to have a silicone breast implant included as well. Breast-lift surgery is performed under general anesthesia. Duration of surgery is approximately two hours. At times, an overnight admission for the purpose of observation is necessary.
It is recommended that one arrive to surgery only after any outstanding medical test results are normalized, such as elevated blood pressure and sugar levels. Furthermore, one should refrain from smoking cigarettes at least 3 weeks prior to surgery, and stop taking any blood-thinners at least 2 weeks beforehand as well.
Given that breasts finalize their development only after sexual puberty, it is advised that one not have this surgery performed before the age of 17-18. One must take into consideration that if there are any plans to become pregnant and breast-feed after surgery, the breast shape may be affected and require an additional surgery at some point. Any change in weight exceeding 5kg after surgery can cause a distortion in the overall shape of the breasts.
During the pre-surgical consultation, any personal and family history regarding breast and ovary disease or cancer will be inquired about. Additionally, a breast examination will be performed. A current mammography examination will be required for any patient above the age of 35. If there is any relevant medical history, or if the results of any of the examinations are suspicious of breast disease, the patient will be referred to a breast surgeon for examination. During the breast exam, several parameters are checked, such as the overall quality and type of skin overlying the breasts, any signs of stretching, the diameter of the areola, and the severity of breast sagging.
Breast-lift surgery may leave scars several scars, among them one around the areola, and one extending from the lower edge of the areola and extending vertically downwards towards the inframammary fold. Rarely, only one scar around the areola is attainable. After breast-lift surgery, one may wear a bra or bathing suit without concern of any scars being visible to others.
Breast-lifting surgery enables the patient to achieve more symmetry between the breasts than that existing before surgery, given the appropriate measurements and planning are carried out. Note that some basic asymmetry between the breasts exists in every woman.
As stated before, during breast-lifting surgery excess skin is removed according to pre-surgical planning and marking. Furthermore, existing breast tissue is reorganized, the nipple and areola are relocated to a higher site, and, if needed, a silicone breast implant in positioned into a “pocket” created either above or below the breast muscle (before surgery, the patient will be consulted regarding the differences between implant placement above or below the chest muscle). It is recommended that one have the goal of reaching a breast size and shape that is natural in appearance and proportional to her chest dimensions and body structure. Closure of the surgical wounds is achieved via usage of absorbable sutures that obviate the need for their removal.
Silicone implants currently in the market possess an outer shell that is textured and made up of several layers, while the central filling is made up of non-liquid silicone that is available in different viscosities—from moderate to high. This elevated viscosity level prevents the silicone from oozing out in any case of rupture.
Two main kinds of implants exist, round and anatomical. The round comes in varying degrees of projection, and the anatomical (shaped like a teardrop) comes in varying lengths. Complete matching of the implant to the breast is possible only in the operating room. In most cases the round implants are chosen. The choice of implant type depends on the structure and shape of the existing breast, dimensions of the chest wall, and the woman’s personal desire. In cases of asymmetry, differently sized implants may be necessary for each breast.
Today, every breast implant manufacturer provides a product warranty for their implants. The company will provide a replacement implant in any case of spontaneous rupture after surgery. It is recommended that the patient plan for long-term check-ups to have the integrity of the implants assessed. There is an upper limit in terms of implant volume, and this limit is determined based on the elasticity of the breast tissue, chest wall dimensions, and size of “pocket”.
When surgery is concluded, the area is dressed with a sport’s bra that must be worn at least one month. The initial recovery period from breast-lift surgery is approximately 2 weeks. During this time, one may experience local tenderness, skin bruising, swelling and edema, and changes in sensation of the breast and nipple. Furthermore, there may be some opening of the suture line along the inframammary fold. In such a case, the area is treated conservatively. It is recommended that one avoid physical exertion for at least 2 weeks, and refrain from sleeping on the stomach side of the body for one month. Complete healing of the surgical wounds may take up to several weeks. Breast-lifting surgery may cause disruption in the ability to breastfeed.
Note that the final size and shape of the breast will become apparent only after several months, and patience is necessary until the results are complete.
At the appropriate age, every woman is advised to go for routine breast examinations and imaging (mammography). When performing these examinations, it is important to note if any breast surgery was undertaken. One should be aware of the fact that breast augmentation can mask part of the breast tissue that is assessed during breast imaging. To address this disadvantage, other imaging tests may become necessary.
The complications of this surgery are extremely rare, and may include:
1) Bleeding that may require drainage in the operating room
2) Infection – usually treated conservatively
3) Folding of the implant along the upper region
4) Hardening of the implant shell-capsular contraction
5) Hypertrophic or keloid scarring
6) Opening of the suture lines
8) Necessity for additional surgery for improvement or repair
9) Necrotic (ischemic) skin and/or nipple
10) Transient or permanent disruption in sensation of the breast and/or nipple
11) Disruption in the ability to breastfeed
Further information regarding this surgery will become available from the physician during the pre-surgical consultation.
Please take the time to look at “Before and After” pictures.