Breast lift (mastopexy) is a surgical procedure to raise and reshape sagging breasts. Sagging breasts are the results of many factors; pregnancy, nursing, ageing and the force of gravity, are just a few. During a breast lift procedure the plastic surgeon can also reduce the size of the areola, the darker skin surrounding the nipple, or insert a breast implants to increase the firmness and the size of the breast.
The average cost of the Breast Lift procedure in the UK is £3500 to £4000, depending on whether you have implants as well as the lift.
BEFORE THE SURGERY
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Breast lift is usually performed as an outpatient procedure, in an outpatient surgery centre, a surgeon’s office or a hospital. Occasionally it is done as an inpatient procedure in a hospital.
Breast lifts are usually performed under general anaesthesia. Some surgeons using a small incision may prefer local anaesthesia, combined with a sedative. Breast lift procedure usually takes one and a half to three and a half hours.
Several techniques are used, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.
The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.
Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the “doughnut (or concentric) mastopexy,” in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.
TYPES OF IMPLANTS
In the UK, there are several types of implants that can be used for the augmentation, the most common are: Soybean Oil filled implants (Trilucent), salt water filled implants known as saline implants and Silicone Implants.
The Soya-oil implants (Trilucent) have an outer shell of silicone and are filled with a soybean gel. They feel very similar to silicone implants. The advantage with soybean implants is that should the silicone shell rupture, the soybean gel filling is absorbed by the body and is naturally flushed out as it is not a toxin. The makers of the Trilucent soybean oil implants claim that their implants do not block the natural breast tissue on mammogram x-rays (they are radiolucent). Trilucent implants have been available in the United Kingdom since 1995 and we have not heard of any problems associated with them.
There is a very new type of implant called the Hydrogel. It is filled with solidified sugar, salt and water and it is said to feel just like natural breast tissue. It is too new to be able to access the safety and suitability at this time. These implants are between £250 to £1000 more expensive than the other types of implants.
The Saline implants are perhaps the safest type and the least expensive, but there have been complaints from women that they “slosh” and don’t feel very natural. The other major complaint is that they can deflate a bit over time.
Silicone implants are now available in the form of a cohesive gel (a thicker gel form that will not break down). The advantage of cohesive gel silicone over the older silicone gel is that if there was a rupture, in theory, the cohesive gel will stay in the same place and will not be able to travel around the body as was the case with the more liquid silicone implants.
The safety of Silicone implants is still under debate. They have been banned in the US since 1992 (also banned in France and Australia) because of ill effects women have suffered from the silicone that seeped from their implants. The UK has not concluded that they cause illness and thus they are still available. A British Medical Journal report on implant safety in February 1998, entitled “Do silicone breast implants cause connective tissue disease? There is still no clear evidence that they do”. This report goes over the research findings from numerous studies and concludes that there is no link between breast implants and connective tissue diease.
A UK medical panel reviewed silicone implants and their safety in June 1998. The panel concluded that they could not find evidence linking silicone implants with the types of illnesses women with implants said were caused by silicone leakage. Therefore, the silicone implants are still available in the UK and should be for the foreseeable future.
There are also different shapes of implants available. The most common type is the round shape, which is a flat, circular shape. The second and less common type is an “anatomical” shape, which is more like a tear drop. It is said that the anatomical shape gives a more natural ‘drooped’ appearance. This is probably more of a consideration if you have very little breast tissue and you are afraid of the “Pamela Anderson” look.
AFTER THE SURGERY
Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing. You’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your surgeon. Within several days, the gauze dressings will be removed and you may be given a surgical bra, if not, you should buy a bra (prior to your surgery) that will give you very firm support in your anticipated new breast size.
You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Your stitches will come out in a week to 10 days, but the swelling in your breasts may take three to five weeks to disappear. Follow your surgeon’s advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.
If you have had implants, routine mammograms should be continued for women who are in the appropriate age group, although the mammographic technician should use a special technique to assure that you get a reliable reading.
You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.
If you become pregnant, the operation should not affect your ability to breast-feed, if your milk ducts and nipples were left intact. However, you should understand that your breasts will probably enlarge and it may be wise to have the surgery after you have decided that your family is complete.
Please note that this information is offered freely to individuals considering cosmetic surgery. No rights are granted and it is not to be reprinted or copied without the prior written consent of Cosmetic Surgery Net – UK . Beware that although efforts have been made to assure accuracy, many of the issues discussed here are a matter of professional opinion. Consultation with a Qualified Plastic Surgeon should be obtained to answer more detailed questions and advise you based on your personal circumstances.