Frequently asked questions about breast uplift / mastopexy surgery

 

What can be done by mastopexy / breast uplift?
Will there be scars after breast uplift surgery?
How do I prepare for breast uplift (mastopexy) surgery?
What does mastopexy / breast uplift surgery involve?
What should I expect in the recovery period after mastopexy surgery?
Is mastopexy / breast uplift surgery safe?
How do I arrange a consultation with Mr Hamilton regarding breast uplift in London, UK?

 

What can be achieved by mastopexy or breast uplift?

Mastopexy involves re-positioning of the nipple and surrounding areola in a higher, more youthful position, often with some re-shaping on the breast tissue itself and removal of some of the stretched, excess skin. In some patients, breast uplift is combined with breast augmentation (implants) to restore volume lost after pregnancy or breastfeeding.

Does the surgery usually involve breast implants?

In general, no. The desired correction is usually achieved without implants. Those patients desiring an increase or re-creation of breast vue, augmentation alone may be enough to achieve this without scars on the front of the breast. In other patients, where breast volume and a significant lift are needed, the mastopexy may be combined with breast augmentation to achieve the best possible shape (augmentation mastopexy).

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Will there be scars after breast uplift surgery?

Yes. A variety of surgical approaches are possible and the exact details of any scars will be discussed with you at consultation. Usually, the smallest incisions necessary will be used to minimise scarring. In some patients, where only a relatively minor correction in breast height is required, the scars can be limited to the edge of the areola (the darker area outside the nipple). Where a more significant lift is desired, the scar usually extends down from the nipple to the crease underneath and possibly along the crease itself. The extent of the scars depends on the shape of the breast and the degree of correction required.

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How do I prepare for breast lift / mastopexy surgery?

Where possible, it is important to avoid aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen (Brufen) and diclofenac (Voltarol) for two weeks pre-operatively. These drugs reduce the ability of the blood to clot and can make bleeding more of a problem during and after surgery.

Smoking can increase the likelihood of wound problems in this type of surgery and abstaining from smoking for at least 2 weeks preoperatively and postoperatively is a sensible precaution.

Patients taking the oral contraceptive pill should ideally use an alternative form of contraception for a full cycle prior to surgery since the pill can increase the risk of thrombosis (clot) forming in the veins of the leg.

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What does mastopexy / breast uplift surgery involve?

What happens when I come into hospital?

You will be admitted to hospital on the day of surgery and Mr Hamilton will come to re-discuss the procedure and to plan and to mark the exact extent of the surgery. You will be seen by our consultant anaesthetist who will discuss the anaesthetic with you and answer any questions you may have.

How long does the operation take?

The length of the procedure depends on the extent of correction required. Typically, the surgery takes about 2 to 2½ hours.

What does the surgery entail?

With you asleep under general anaesthetic, local anaesthetic is placed in the area to be treated to reduce any postoperative discomfort. Mr Hamilton will then remove any excess skin in the breast, repositioning the nipple at the new higher level and, where necessary, re-shaping the breast and removing any excess skin. If a breast implant is to be used, this is usually placed before any adjustment of the skin to ensure the correction can be precisely tailored to the new breast volume. Occasionally a small drain connected to a suction bottle is placed in the wound to remove any fluid which might collect and reduce bruising. Very often, however, Mr. Hamilton does not find surgical drains to be necessary, allowing for a more comfortable recovery period. A supportive dressing is placed over the breasts and our consultant anaesthetist will then gently wake you before you are returned to your room on the ward.

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What should I expect in the recovery period after mastopexy surgery?

What happens after the operation?

Usually, after a relaxed night in hospital, you will be able to go home the following day. If drains are used, they will be removed the morning after surgery in the ward prior to discharge. Occasionally patients wish to stay another night but the majority prefer to go home the morning after surgery. We usually recommend that you use a sports bra after surgery to give extra support and comfort. Our nursing staff will help you into your sports bra before you go home. Sports bras are usually used for 4-6 weeks.

Mr. Hamilton will usually see you back in the consultation room 7-10 days after surgery to check that all is well and to reduce the dressing. Usually, only dissolving sutures are used, though some of these may need trimming when you come back to the clinic. Typically, you will be seen again a week thereafter at which stage dressings usually be dispensed with. A further follow up visit is planned around 3 months after surgery.

Is it painful?

Breast uplift causes a degree of discomfort but this is usually well controlled with the painkillers provided by our experienced consultant anaesthetist. On discharge home, patients are generally comfortable using mild painkillers such as paracetamol and codeine. Most patients find they are able to resume normal activities over a 1-2 week period.

How quickly will I recover?

If all goes to plan, normal activities can be resumed by about 2 weeks and most patients are back at work by 2-3 weeks. Vigorous sporting activities and gym work are probably best left until 4-6 weeks after surgery.

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Safety and potential risks in breast uplift / mastopexy surgery

What are the risks?

The great majority of patients undergoing breast uplift in the hands of an experienced surgeon achieve good results with a rapid recovery. However, in a small proportion some complications are a possibility:

• Unfavourable scars – In some patients, especially those of Afro-Caribbean origin, scars can be thicker than expected or become raised. In the vast majority of cases, these settle spontaneously but occasionally other measures to improve the scar may be necessary. Most patients find that the scars settle well though all individuals are different and in some cases, scars can take many months to settle. Mr Hamilton will advise you on massage techniques to help speed up the rate at which the scars mature. Scars, of course, never disappear and some form of scar will always be present.

• Infection – fortunately, infection is rare in this type of surgery and the risk is minimised by careful surgical technique and the use of a dose of antibiotic before surgery commences.

• Nipple sensation – Most ladies find that there is some reduction in nipple sensation after breast uplift, though this tends to improve with time. Some loss of sensation is seen from time to time.

• Haematoma – Rarely, small blood vessels in the wound may bleed after the surgery leading to a collection of blood under the wound (a haematoma) which needs to be released and washed out before resuturing the wound. If this problem arises, it is typically on the day of surgery and does not affect the final result.

• Occasionally, wounds can be little slow to heal and small dressings are occasionally required after surgery. Usually these areas heal of their own accord but on very rare occasions it can be necessary to resuture or revise this portion of the scar. This problem is, fortunately, unusual and more commonly seen in smokers.

• Significant surgery such as this carried out under general anaesthetic carries a small risk of postoperative chest infection (particularly in smokers) and of thrombosis of the veins of the legs (DVT or deep venous thrombosis) and the concomitant risk of clot moving to the lung (embolism). Patients wear protective stockings during and after surgery to help minimise the risk of DVT and embolism. Early mobilisation after surgery is an excellent way of reducing the risk we also use a compressive massaging device on the calf muscles in theatre to further reduce the small risk of this complication.

Summary

Breast uplift surgery can be very effective in addressing the changes seen in the beast with age or after pregnancy. In some patients who desire more breast volume, a breast implant may be combined with the uplift to give the desired correction and postoperative shape. Mr Hamilton will be happy to discuss the surgical options at your consultation.

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