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Mastopexy

My Dearest Patient,

In this leaflet I aim to explain your chosen procedure in a simple understandable way.

Breast lift or mastopexy is a surgical procedure to raise and reshape sagging breasts. There may be an associated reduction in the size of the breasts of less than 500g but the main aim is store youthfulness to the breasts.

Factors such as pregnancy, breast feeding, weight change, aging and gravity produce changes in the appearance of a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and sag.

Breast lift or mastopexy is a surgical procedure performed by a plastic surgeons to raise and reshape sagging breasts.  Thus we are lifting your breast to a better position. This operation can also reduce the size of the areola, the darker skin around the nipple making the nipple areolar complex look smaller.

If your breasts are small or have lost volume after pregnancy, breast implants inserted in conjunction with mastopexy can increase both firmness and size. An augmentation mastopexy i.e. lift and enlarging is associated with an increased complications rate.

The best candidates for a breast lift (mastopexy) are healthy, emotionally stable women who have realistic expectations about what this type of surgery can accomplish.

Breasts of any size can be lifted, but the results may not last as long in women with heavy, large breasts. Mastopexy does leave permanent, noticeable scars on the breasts. There are a variety of different surgical techniques used for the reshaping and lifting of the female breast.

There are different types of surgical incision that can be made for a breast lift procedure.

 

The type of incision used depends on:

  1. The amount that your nipple needs to be lifted
  2. The amount of excess skin that needs to be removed

 

Generally the procedure would either be:

Type 1        

Perioarolar

Incision around the nipple

Major advantage: Reduced scarring

Major disadvantage: Unequal stretching of the nipples over time with the left and right nipple-areolar complexes not being the same.

Type 2

“lollipop” cut or vertical

Around the nipple down the middle

Major advantage: Reduced scarring

Major disadvantage:

  1. May need revision operation to correct scar, i.e. dog ear at the inferior aspect
  2. The breast may have a very triangular shape that takes time to settle due to effects of gravity, initially very distressing to patients.

Type 3          

Wise pattern or Anchor incision

This incision is indicated for patients that require a dramatic lift or removal of a large amount of skin. This incision gives the most reliable, durable, aesthetically pleasing result over time. The cut around the nipple areolar complex does not pose a problem as you have a natural colour change there, the cut below is hidden in the fold and the vertical incision due to the distribution of forces lightens very well over time.

Major advantage: Good lasting results and no stretching of nipples

Disadvantage: Significantly more scarring than in the other procedures

The surgery will be performed in a theatre under general anaesthesia. You will be admitted on the day of surgery and discharged the following day unless specific alternative arrangements have been made.

The procedure takes approximately one to two hours, depending on the amount of alteration that needs to be done. After the surgery you may have drains in your breasts.

I would recommend that you wear a comfortable bra after the procedure.

The wounds should be kept clean and dry for two weeks after the procedure. Ideally you should have a dressing change weekly after the surgery in the dressing clinic until satisfactory wound healing have been achieved.

You will go home on pain medication and antibiotics which should be used as instructed. Drains remain until it drains less than 60 ml per drain in two consecutive days.

We recommend that you do not drive in the first two weeks after the operation. Movement and exercise should be limited during the first six weeks after surgery. As a rule of thumb you should not be doing anything that causes pain and discomfort.

Cosmetic surgery is an important and exciting decision.

It is important to understand that although the change following surgery is immediate the overall aesthetic improvement can only be appreciated at six months to a year following the surgery.

Below follows a list of the possible complications associated with cosmetic surgery. The aim of the list is not to scare you but rather to provide you with informed consent.

Risks of Mastopexy / Breast Lift Surgery

Every surgical procedure involves a certain amount of risk and it is important that you understand these risks and the possible complications associated with them. In addition, every procedure has limitations. An individual’s choice to undergo a surgical procedure is based on the comparison of the risk to potential benefit. Although the majority of patients do not experience these complications, you should make sure that you fully understand each of them.

Local Complications

  1. Change in Nipple and Skin Sensation: You may experience a diminished (or loss) of sensitivity of the nipples and the skin of your breast. Partial or permanent loss of nipple and skin sensation can occur after a mastopexy in one or both breasts and nipples.
  2. Breast Augmentation and Simultaneous Mastopexy:

Patients who choose to undergo breast implant augmentation and elect to have it at the same time as a breast lift (Mastopexy) may be at increased risk of complications. These risks may range from skin and nipple death and wound healing compilations and delays.

  1. Mastopexy Performed at the Time of Breast Implant Removal Surgery: Patients who choose to undergo simultaneous removal of breast implants and capsules and elect to have it at the same time as a breast lift (Mastopexy) may be at increased risk of necrosis of skin, nipples, and breast tissue due to decreased blood supply to the tissues from earlier surgery.
  2. Skin Contour Irregularities: Contour and shape irregularities may occur after mastopexy. Visible and palpable wrinkling may occur. One breast may be smaller than the other. Nipple position and shape will not be identical one side to the next. Residual skin irregularities at the ends of the incisions or “dog ears” are always a possibility

when there is excessive redundant skin. This may improve with time, or it can be surgically corrected.

  1. Delayed Healing: Wound disruption or delayed wound healing is possible. Some areas of the breast skin or nipple region may not heal normally and may take a long time to heal. Areas of skin or nipple tissue may die. This may require frequent dressing changes or further surgery to remove the non-healed tissue. Individuals who have decreased blood supply to breast tissue from past surgery, smoking or sugar diabetes may be at increased risk for delayed wound healing and poor surgical outcome.
  2. Complete nipple loss
  3. Fat Necrosis. Fat lumps in the breast from the scarring produced by breast tissue. Fat necrosis is the way the breast scars on the inside and will be perceived as hard lumps. Although it does get better with time it may never completely disappear. Fat necrosis is easily discernible on an ultrasound or mammogram.

Smokers have a greater risk of skin loss and wound healing complications.

Other complications,

-Haematoma formation (Bleeding)

-Seroma formation

-Delayed wound healing

-Infections

-Sensory changes in the nipples and breasts

Systemic Complications

-Fluid and electrolyte abnormalities

-Deep vein thrombosis

-Pulmonary Embolism

It is important to consider the complications. Although I have been lucky with a low complication rate I cannot predict which patient will develop a complication. I think that it is important that if you open yourself to an operation you also open yourself to the possibility of compilations. It is important to evaluate the complications and consider your course of action should you develop a complication.

A mastopexy is a necessary operation whom all of us will need to have sooner or later. The importance is to plan the operation so that you may benefit from it the most and to ensure longevity of the operation.

I WOULD LIKE TO ENQUIRE

CONTACT US

Please don’t hesitate to contact us if you have any questions, comments or messages. We’ll try to respond to everything.

011 482 2196
dr.mventer@gmail.com