A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin's natural elasticity or simply the effects of gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and it can be combined with mammoplasty (breast augmentation) for added breast volume and firmness. Breasts of any size can be lifted, but results last longest when they are originally small and sagging.
Women planning to have children are advised to postpone surgery, since pregnancy and nursing can counteract its effects by stretching the skin. However, mastopexy should not affect your ability to breast-feed.
Mastopexy may be performed in a hospital, an outpatient surgery center or a surgeon's office-based facility. It is usually done on an outpatient basis under general anesthesia, and lasts from 1-½ to 3-½.
A number of pre-operative steps are typically taken such as a mammogram, measurement of the bustline, and discussion with the surgeon about the desired size and shape of the breast and placement of the nipple. During the procedure an anchor-shaped incision is made from the location of the new nipple down to and around the crease beneath the breast. The surgeon removes excess skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches.
Patients with small breasts and minimal sagging may be recommended for smaller-incision mastopexy. One such modified procedure is concentric ("doughnut") mastopexy, in which two concentric circular incisions are made around the areola and a doughnut-shaped swathe of skin is removed.
After surgery the breasts are wrapped with gauze dressings, over which an elastic bandage or a surgical bra is placed. After a few days this is replaced with a soft support bra which is worn 24 hours a day for about a month. Breasts will probably be bruised, swollen, and uncomfortable for a few days but this will pass. Numbness in the breasts and nipples should lessen as swelling subsides, although occasionally it lasts for months or even permanently. Stitches are removed after one to two weeks, and many patients return to work then.
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Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.
During the procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in some cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.
For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.
Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
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