Breast Uplift (Mastopexy)

What is breast uplift?

Breast uplift is an operation whereby breasts are reshaped. It is a very similar operation to a breast reduction, only the skin is tightened and no breast tissue is removed.

Who will the operation help?

Often as a result of weight loss, having children, breast feeding or just with ageing, the breast skin stretches and the breasts sag.

This sagginess can be corrected by breast uplift, or if the breasts are very small and saggy they may be improved by inserting a breast implant

What are the limitations of a mastopexy?

Most women seeking a mastopexy want

It is important to appreciate from the outset that whilst breasts can be reshaped and uplifted, this does require significant scars to be placed on the breast. With time these scars will fade in colour from red to white but they are permanent. Also, the effect of gravity and time will continue to act on the breasts and eventually they will start to droop again. This can be lessened to some extent by wearing a well-fitted bra to support the breast tissue.

What size will my new breasts be?

As no breast tissue is usually removed, your breasts will stay the same size, but will be reshaped to appear firmer and more pert.

Is breast uplift available on the NHS?

Breast uplift is rarely available on the NHS.

Before and after photos

How is the operation done?

The operation is done under a general anaesthetic (with you asleep). The ideal position for a nipple is level with the crease under the breast. The first stage is to move the nipple upwards to its ideal position. The nipple has to be moved with a block of breast tissue in order to keep a blood vessel (and hopefully a nerve) with it, to keep it alive! Once this has been done, the skin is lifted off the lower half of the breast and the breast tissue is folded onto itself and reshaped. This is the key step in a mastopexy operation and once the breast tissue has been reshaped it is held in shape using buried, permanent stitches. You will then be sat upright on the operating table to ensure your breasts are of equal size and shape. At this stage the skin is redraped over the reshaped breast and any excess skin is carefully tailored and cut off. The skin wounds are closed using buried, dissolvable stitches. Your wounds are then dressed and surgical tapes are applied all around your new breasts. The tapes help to support your new wounds and shape your breasts until they have healed a little.

What shape will my scar be?

You will have a scar around your areola and a vertical scar running down from the centre of this areola scar to the crease under your breast (see picture). In the early weeks the skin under each breast will contain many wrinkles, which appear unsightly. Do not worry about this, it is normal. Over the next six weeks these wrinkles will disappear.

How long is the operation?

Mastopexy surgery usually takes about 2-3 hours

How many days in hospital?

Most women undergoing a mastopexy stay in hospital overnight and go home on the day after surgery.

Postoperative period in hospital

When you wake up you will have surgical tapes over your breasts. The operation causes a moderate amount of discomfort but you will receive regular painkillers, which should keep you comfortable. You should limit your arm movements and wear your sports bra before being discharged from hospital.

Postoperative Follow Up

After discharge you will be provided with written information to explain the postoperative course. An appointment will be made to see your surgeon one week after your operation. Your surgeon will remove your dressings and inspect your wounds, which may or may not have healed at this time. If they have, you will be given advice on wound care, bathing and exercise advice. If they have not quite healed by this one-week visit, your surgeon will reapply the dressings and arrange to see you again the following week. Once your wounds have healed you will be given an appointment to see your surgeon six weeks after your operation. At this appointment your surgeon will check on the early outcome of surgery; if all is settling satisfactorily your surgeon will arrange to see you for a final visit six months later.

What are the possible risks?

All surgery carries the potential for complications. The specific complications that may occur with a mastopexy are:
Infection; infection is not uncommon with mastopexy and can result in swelling, redness and tenderness at any time up to 4 weeks after surgery. This usually responds well to a course of antibiotics. Occasionally however, it can result in some opening of the wounds. This wound breakdown is not a disaster and is usually managed by regular wound dressing and usually heals in four to six weeks.
Bleeding: bleeding can occur at any time over the first ten days after surgery, and therefore it is wise to avoid any strenuous exercise over this time. Arm movements should be limited for the first week. Should a bleed occur into the breast, the breast can swell quite dramatically and you may develop visible bruising and tenderness. If this happens you usually need to return to theatre to have the blood removed and the bleeding stopped.
Ugly scarring: although most scars settle very nicely to leave a pale flat line, occasionally scars may become red, raised, or itchy. This is fairly uncommon in mastopexy, but any wound breakdown which occurs in the early postoperative period may result in a stretched flat scar.
Wrinkling: this is seen almost without exception; the skin under the breast is puckered and very wrinkly for the first six weeks after surgery. This is a necessary part of the operation and happens because we are trying to limit the size of the final scar. After six weeks, these wrinkles will have mostly disappeared to leave a fine scar. In about 5% of cases these wrinkles may persist up to 6-9 months after surgery. If they do not settle after this time, they can be simply cut out in a minor procedure under local anaesthetic.
Dog-ears: Dog-ears are small folds of skin, which occur at either end of the scar, caused by a natural folding of the skin when the wound is closed. Great care is taken during the operation to avoid producing dog-ears

Nipple loss: One of the worst complications of this procedure is complete or partial loss of a nipple. As mentioned above, the nipple is moved on a block of tissue, which preserves a blood vessel and nerve, but if this blood vessel becomes kinked or damaged, the blood supply to the nipple will fail and the nipple will die. If this happens, the nipple will become darker and darker and eventually blister and disappear. Fortunately this is a very rare occurrence and only happens approximately once in every 2000 mastopexies.

Asymmetry: no two breasts are almost ever the same, and some degree of asymmetry is common both before and after this procedure and cannot be avoided, it is one of the limitations of any given pair of breasts. Great care is taken to ensure that the two breasts are as symmetrical as possible, but occasionally an unacceptable asymmetry results. If this happens you will be advised to wait for 9 months for all scarring and swelling to settle fully before we reassess the final outcome. At this time you may have to return to theatre to have minor asymmetries of breast volume corrected by a small liposuction procedure or minor asymmetries of nipple position corrected by relocating the nipple under local anaesthetic.

Blood clots: occasionally a blood clot may form in the deep veins of the legs (deep vein thrombosis). These clots can have the potential to break off and travel inside the veins into the lungs (pulmonary embolism). Any surgery carries a small risk of causing a blood clot in the leg veins. To reduce the risk of this happening, you will be given surgical compression stockings to wear throughout the first 2 weeks after surgery, special inflating compression devices will be applied to your legs in theatre and worn for the first 24 hours in hospital, and you will be given a daily injection to slightly thin your blood.

Breast-feeding: It is usually not possible to breast feed after a mastopexy procedure because the milk ducts under the nipple have to be divided when relocating the nipple to its ideal position.

Recurrence of drooping: your breasts drooped before surgery because the skin and tissues became lax. The mastopexy operation tightens up the skin and tissues but there remains a possibility that, with time, these tissues may become lax again and the breasts may start to droop again. This is just a part of the natural aging of your own tissues but may be helped by wearing a well fitting bra to support your new breasts.

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