A breast lift is an extremely effective procedure for reversing the effects of pregnancy and aging on the breasts. Patients who have undergone breast lift are generally thrilled with the improvements because they have regained the youthful look and feel of their breasts.

A woman’s breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from:

• Pregnancy
• Breastfeeding
• Weight fluctuations
• Aging
• Gravity
• Heredity

Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

Sometimes the areola has become enlarged over time, and a breast lift can reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted.

Breast lift surgery does not significantly change the size of your breasts. If you want your breasts to look fuller or smaller, you might want to consider either breast augmentation or breast reduction surgery.

There are several important factors to choosing a surgeon, including recommendations from friends, personality, physician training and board certification, and experience.

Referral from Friends: Many prospective patients find confidence if they have a close friend or other trusted individual who has already undergone a successful procedure. This is often a good first step in making a decision. However, not all patients know someone who has had surgery. Most of our new patients are referred by their friends who are satisfied patients.

Personality: It is important to develop a good relationship with a surgeon, where communication is easy and trust can be developed. A patient needs to completely comfortable and intuitively conclude that they are in good hands. Bedside manner is important in creating a trusting relationship.

Training and Certification: In years past, only plastic surgeons performed Breast Lift. However, in recent years doctors from many different specialties are more commonly performing cosmetic surgery procedures, including Ear, Nose, and Throat doctors (also known as otolaryngologists and facial plastic surgeons), Dermatologists, Ophthalmologists, and Gynecologists. Only a surgeon who has completed residency training in an accredited training program can become certified by the American Board of Plastic Surgery. There are many Boards, and it is easy for patients to become confused, or assume that when a doctor says they are “Board Certified” it all means the same thing. BE CAREFUL! Learn more about the significance of Board Certification here.

Experience: Finally, consider the physician's experience, the most important factor in making a decision. As with all professions, expertise is directly proportional to experience, meaning the total number of procedures performed. Medical literature illustrates that biggest predictor of success in surgery is volume, in other words, the number of times that a doctor has performed a procedure.

If the doctor is recommending a specific procedure, how many has he performed? How often does the surgeon perform this procedure?

While board certifications and training are important, a surgeon's experience with the procedure itself is more important. Don't hesitate to ask pointed questions about recommended procedures.

A breast lift is a good option for you if:

• You are physically healthy and maintain a stable weight
• You do not smoke
• You have realistic expectations
• You are bothered by the feeling that your breasts sag, have lost shape and volume
• Your breasts have a flatter, elongated shape
• When unsupported, the nipples are lower than the crease below the breasts
• The nipples point downward
• You have stretched skin and enlarged areolas
• One breast is lower than the other

To ensure the most natural looking results, Dr. Alexander will recommend the procedure which most appropriately matches the your needs and to offer realistic expectations for post-surgery outcomes.

Breast size and shape are important, so be honest and open about your expectations when talking with your surgeon. Implant type and size will be determined not just on your desire but as importantly on your breast anatomy, skin elasticity and body type.

The success and safety of your breast augmentation procedure depends very much on your being completely candid during your consultation. We will ask you questions about your health, desires and lifestyle. Be prepared to discuss:

• Why you want breast augmentation surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• Family history of breast cancer and results of any mammograms or previous biopsies

We may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of the nipples
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of breast augmentation surgery and any risks or potential complications
• Discuss the use of anesthesia during your breast augmentation procedure

Prior to surgery, we will have you:

• Take certain medications or adjust your current medications
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
• Stop smoking well in advance of surgery
• Depending on your age get a baseline mammogram before surgery to help detect any future changes in your breast tissue

During a Pre Operative appointment, usually 1-2 weeks before surgery, we will:

• Get lab testing or a medical evaluation
• Tell you what to do on the night before and morning of surgery
• Discuss the use of anesthesia during your procedure
• Explain post-operative care and follow-up, and what help you will need after the procedure

Achieving excellent results with a breast lift requires the surgeon to have significant skill and experience. Your breast lift surgery can be achieved through a variety of incision patterns and techniques. The appropriate technique for you will be determined based on:

• Breast size and shape
• The size and position of your areolas
• The degree of breast sagging
• Skin quality and elasticity as well as the amount of extra skin

Medications are administered for your comfort during the surgical procedure. An anesthesiologist will administer general anesthesia , which is recommended for this procedure. Smaller lifts can be done with IV sedation or local anesthesia.

The procedure typically takes 2-3 hours depending on the individual and certain surgical variables.

There are five basic steps to a Breast Lift.

Step 1 – Marking
While you are sitting up, Dr. Alexander makes careful measurements and markings on the breast. This is arguably the most important part of the procedure, and requires skill, patience, experience, and a good eye for symmetry and detail.

Step 2 – The incisions
There are three common incision patterns, depending on how low the breast sits and how much skin needs to be removed:

A. Around the areola. This is called a ‘periareolar’ or ‘donut’ mastopexy.

B. Around the areola and vertically down from the areola to the breast crease, often referred to as a ‘vertical’ mastopexy, because it requires a vertical line. Patients often worry about this incision, but it actually heals extremely well.

C. Around the areola, vertically down from the breast crease and horizontally along the breast crease. This is often called an ‘anchor incision’ or ‘inverted T.’

Step 3 – Reshaping your breasts
If necessary, enlarged areolas are reduced by excising skin at the perimeter. The underlying breast tissue is lifted and reshaped to improve breast contour and firmness. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Often, the breast tissue is tacked to the muscle at a higher position, to support the breast and help the lift last. The nipple and areola are repositioned to a natural, more youthful height, and excess breast skin is removed to compensate for a loss of elasticity.

Step 4 – Closing the incisions
After your breasts are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed with sutures. No drains are needed. Some incision lines resulting from breast lift are concealed in the natural breast contours; however, others are visible on the breast surface. Incision lines are permanent, but in most cases will fade and significantly improve over time.

The results of your breast lift surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade.

Important facts about the safety and risks of Breast Lift surgery
The decision to have breast surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. In general, the overall risks are small with this procedure. Revisions may be required if the breasts settle a little with time.

Pain
Pain from a breast lift varies but is usually mild. Patients are given pain pills to alleviate the discomfort, but usually only need them for a few days.

We will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

The risks include:

• Scarring
• Bleeding (hematoma)
• Infection
• Changes in nipple or breast sensation, may be temporary or permanent
• Fluid accumulation
• Pain, which may persist
• Breast contour and shape irregularities
• Skin discoloration, permanent pigmentation changes, swelling and bruising
• Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
• Breast asymmetry
• Fatty tissue deep in the skin could die (fat necrosis)
• Excessive firmness of the breast
• Potential partial or total loss of nipple and areola
• Anesthesia risks
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

You should also know that:

• Breast lift surgery can interfere with diagnostic procedures
• Breast and nipple piercing can cause an infection
• Breast lift surgery does not normally interfere with pregnancy, but if you are planning to have a baby, your breast skin may stretch and offset the results of mastopexy and you may have more difficulty breastfeeding after this operation

.

After your procedure is completed, we will wrap your chest with a snug bandage. This may feel increasingly tight during the night because of swelling, but we will loosen it the next day. Usually you will remain wrapped for 48 hours, after which you can remove the wrap, take a cool shower, and place a soft bra, which we provide, for support.

You'll need help
You will need someone to drive you to and from surgery and to stay with you for at least the first night following surgery. If you experience shortness of breath, chest pains, or unusual heartbeats, you should call Dr. Alexander immediately.

You will likely need a recovery period of 24 to 48 hours and an additional reduced-activity period of a few days. You will experience soreness and swelling for a few weeks.

Exercise and normal activity can resume at approximately 2-3 weeks. Over time, post-surgical swelling will decrease and incision lines will fade.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Be careful Following our instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing.

Sutures are removed beginning at 3-4 days and finally at 10-14 days. Removable sutures are used to minimize scarring. Absorbable sutures can increase inflammation and increase scarring. The improved shape of the breasts will be visible immediately, but the lower part of the breast is often temporarily tight and flat. The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time.

The results of your breast lift surgery will be long lasting. You will find it easier to wear certain styles of clothing and swim suits. Like most women who have had a breast lift, you may also have a boost in self-confidence. Over time, your breasts can continue to change due to aging and gravity. But, you’ll be able to retain your new look longer if you maintain your weight and keep a healthy lifestyle.

Special note: While a breast lift does not usually affect breast function, if you are planning to become pregnant, discuss this with Dr. Alexander. Changes that occur in the breasts during pregnancy can minimize or reverse the improvement a breast lift provides. Likewise, plans for significant weight loss should also be discussed.

A quote will be provided to you after your consult with Dr. Alexander. Cost is always a consideration in elective surgery. We offer patient financing plans, so be sure to ask.

Costs include:

• Surgeon’s fee
• Operating Room and Supplies
• Prescriptions for medication
• Medical tests
• Anesthesia fees

• Anesthesia—General: The patient is asleep, requiring that the airway be protected, either by a standard breathing tube, or by a laryngeal mask (LMA), an inflatable mask that goes in the back of the throat but doesn’t go down the trachea. Through the airway, an anesthesiologist gives gases to put the patient asleep. Drugs may also be given through the iv.


• Anesthesia—Local: The surgical area is numbed up with an injection, but the patient is awake. Sometimes a patient will be given an oral medication, like Valium, to help with relaxation.


• Anesthesia— Sedation (Twilight): The patient is made sleepy with medications given through an iv. The level of sedation can be adjusted, from barely sleepy to very sleepy. Sometimes sedation is given by the surgeon, but most of the time it is administered by an M.D. Anesthesiologist.


• Areola: Pigmented skin surrounding the nipple.


• Breast augmentation: Also known as augmentation mammaplasty, breast enlargement by placement of breast implants.


• Breast lift: Also known as mastopexy; surgery to lift the breasts.


• Breast reduction: Also known as reduction mammaplasty, reduction of breast size by surgery.


• Excision: To remove the skin


• Mammogram: An x-ray image of the breast


• Mastopexy: Surgery to lift the breasts.

• Are you certified by the American Board of Plastic Surgery?
• Were you trained specifically in the field of plastic surgery?
• How many years of plastic surgery training have you had?
• Do you have hospital privileges to perform this procedure?
• Is the office-based surgical facility accredited by a nationally-or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for a breast lift?
• What surgical technique is recommended for me?
• What will be expected of me to get the best results?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• Do you have breast lift before-and-after photos I can look at for this procedure and what results are reasonable for me?
• How are complications handled?
• How can I expect my lifted breasts to look over time?