Breast Lift Surgery
Glendale, Phoenix, Tempe, Scottsdale, Mesa, Surprise, & Peoria, AZ
Many Scottsdale, Glendale and Phoenix breast lift patients have benefited from the skill and experience of Dr. Angelchik. In the paragraphs below, he describes the breast lift procedure. Also visit the results section of the website to see the results of Phoenix breast lift patients.
Breast lift surgery, termed mastopexy in the plastic surgery lexicon, is a group of surgical techniques designed to lift sagging or drooping breasts. The goal is to create a lifted breast with an attractive shape and a proportionately sized and correctly positioned nipple areola complex. Breast lift patients seek treatment for sagging of the breast caused by pregnancy, aging, or congenital conditions. A lift is recommended when the problem cannot be corrected by implants alone or if the patient does not want implants. Some patients mainly want to reduce the size of an enlarged areola (the pigmented skin surrounding the nipple). All breast reductions involve lifting of the breast.
Sagging is called ptosis “toe-sis” and sagging breasts are called ptotic, “tot-ic” breasts. Ptosis of the breasts is a common complaint of patients seeking plastic surgery consultation for improvement of breast appearance. In this discussion, the terms ptosis and sagging will be used interchangeably.
Ptosis occurs when the connective tissue support structures in the breast, including the dermis (deeper layer of the skin) and Cooper’s ligaments, which attach the breast tissue and skin to the covering of muscle on the chest wall, become stretched and weakened. The elastic quality of the tissue is lost forever. This may happen with the loss of breast volume after pregnancy or weight loss, or increased skin laxity with aging and pregnancy. Basically as described by Handel, in his chapter from Surgery of the Breast, Principles and Art (1998), “In the broadest sense, ptosis stems from a discrepancy between volume of breast tissue and surface area of the surrounding skin envelope. Correction logically consists of increasing breast volume, reducing the skin envelope, or some combination, thereof….Inserting an implant augments breast volume while the mastopexy repositions the nipple and reduces the skin envelope”.
Breast Lift Options
Breast lifting can be done with a variety of techniques depending on the extent of sagging, amount of breast tissue, and patient preference regarding the type and extent of incisions used and the appearance of the resultant scars. In general, procedures which have more skin removal and tightening, have longer and more extensive incisions to produce greater lifting. This is of particular benefit in patients with moderate to severe sagging. Conversely procedures with more limited patterns of incisions will produce less lifting and at the same time less scarring. The tradeoff between scarring and lifting is one of the major considerations for patients seeking correction of sagging breasts. For patients with mild sagging who wish to avoid additional scarring, placement of a breast implant alone may provide an alternative to a lifting procedure as it fills up the excess skin envelope, provided the patient is willing to accept some remaining ptosis in the breasts.
Some important generalizations should be borne in mind by any woman considering breast lift surgery. While there are exceptions, the following statements in my experience are true:
- Surgery to correct a ptotic breast will rarely create a non-ptotic breast with a shape comparable to the breast of a young woman (who has not been pregnant) with no sagging. Many ptotic breasts sit lower on the chest wall to begin with, as measured by the distance of the upper pole of the breast from the clavicle.
- Breast lift surgery does not last forever. The propensity for the breasts to sag, as demonstrated by the appearance before surgery, necessarily indicates that the remaining connective tissue support structures of the breast are weak and inadequate to support the breast permanently even after repair. How long does surgery last? It’s hard to say as each patient’s tissues are different, but the benefit should be evident for years. We are not stopping time and gravity, merely setting back the clock. While adding an implant may significantly improve the appearance after surgery, the additional weight of the implant, even in the submuscular position, will inevitably push on the ptosis repair and contribute to sagging.
- Large implants and ptosis correction are somewhat at cross-purposes from each other, as the tightening and lifting of the mastopexy are pitted against the implant expansion of the breast volume and tension on the skin. A careful balance must be achieved to get the best possible result which usually means compromise in terms of the lift and the size. Patient preference must be based on detailed understanding of this issue when considering an augmentation with a lift. Staging the procedures separately is recommended in some situations.
Breast Lift: The Procedure
Mastopexy per se is not a particularly painful operation. More extensive incisions will lead to correspondingly greater discomfort, although skin incisions alone are not usually severely painful. When combined with an implant there will be more pain early on, particularly in the submuscular position, as muscle fibers to the ribs, sternum, and fascia (connective tissue) of the muscles are cut to make an adequate pocket. For more involved techniques, like a vertical lift or anchor mastopexy, drains are often used. These come out typically at 4-5 days. Patients are asked to refrain from heavy upper body exercise and lifting more than 10–15 pounds for 4 weeks, and may not drive a car or operate machinery while on narcotic pain medication. Currently typical patients are off narcotics in most cases within a week.
In cases where the lift is combined with an augmentation, muscle relaxants are prescribed, which have proven to be very helpful in reducing narcotic requirements and alleviating muscle spasm. Sutures (stitches) are typically buried and absorbable and thus do not need to be removed. Swelling will subside over several weeks and the breasts will inevitably relax into position as the tissue determines the “comfortable” tension at which it wants to live. Bruising may occur, is usually minor, and resolves after 2–3 weeks. Patients may shower after drain removal. In cases where drains are not used, patients may shower at 48 hours. Dressing changes are generally minimal for the patient and are reviewed in the office. For donut mastopexy patients, a transparent adhesive dressing on the incision is recommended for 12 weeks to splint the incision and reduce the risk of spreading of the scar. Implant massage and compression exercises are started at 2 weeks in patients with implants.
Click here for Frequently Asked Breast Lift Questions
In addition to breast lift, Dr. Angelchik also performs other breast procedures in his Phoenix plastic surgery practice. Visit these pages in the website to learn about how Dr. Angelchik treats Phoenix breast augmentation and breast reduction patients.