Project Description

For women with saggy breasts a mastopexy (breast lift) may suit you – either in combination with an augmentation or by itself. The procedure can improve the shape and contour of the breast without altering the size. Saggy breasts are very common following breast feeding and pregnancy. At times, following large weight losses, saggy breasts may develop.

Incision is made around the nipple extending vertically down to the mammary crease. The so-called “lollipop” incision allows the skin to be removed and re-draped allowing the nipple position to be elevated and to achieve a more “perky” breast.

The procedure is performed as a day stay. No drains are required. Patients usually return to work after 1 week.

Different procedures are available to improve the size and shape of breasts. A common complaint is a breast being droopy or saggy (ptosis). This can be because of heredity factors or acquired (breast feeding or significant weight loss). At times the droopiness may affect one breast more than another (asymmetrical ptosis).

Surgical Approach

Young women during puberty either one or both breasts may enlarge quite significantly leading to droopy breasts. If the enlargement is mainly due to breast fat rather than breast tissue (parenchyma), then liposuction can be beneficial. Liposuction works by removing the excess breast fat. This weight loss than allows the breast skin to contract and lift the nipple.

The procedure is performed under anaesthetic as a day surgery procedure. The procedure takes approximately 45 minutes per breast. Three small 4mm incisions are made around the inframammary crease where the underwire of a bra lies. Bruising is present for about 1-2 weeks post-operatively. Swelling can take up to 3-4 weeks to subside. An elastic sports bra is worn during this time, apart from showering. The final result may not be evident for at least 6-8 weeks.

If the breast glandular and fatty tissue is insufficient and the droop is minimal, then a textured surface implant placed behind the breast tissue on top of the muscle can reinflate the breast and lift the nipple. This technique is ideal for women with a bra cup size from an A cup to a small B cup.
When there is a normal amount of breast tissue and breast fat (full B cup through to C cup) and the breasts are droopy, then a mastopexy is appropriate. A mastopexy involves removing overstretched sagging skin via a tailor made approach. Incisions are made on the breast and the redundant skin is discarded. The breast tissue is then resuspended back onto the chest muscle. The nipple position is lifted. Dissolvable sutures are then used to close all incision lines. The breast is transformed from a pendular shape to a more conical shape with better projection.

The incisions vary depending on the amount of skin to be removed. The incision can either be: – Around the nipple only (Benelli approach) – Around the nipple and a vertical extension to the inframammary crease (“Lollipop” approach) – The above procedure with an extension along the mammary crease.

The procedures are performed under anaesthetic as a day surgery procedure or overnight stay. Patients are required to stop smoking for four weeks pre-operatively and six weeks post-operatively. The procedure usually takes 1.5 to 2 hours to perform. No drains are required. Patients are allowed to shower the next day. Patients can return to work after one week. Upper body gym work can recommence after four weeks. Scars usually take between four to twelve months to fade.

A mastopexy can be performed in conjunction with a breast implant. At times, depending on the desired final breast shape and size, a mastopexy can be performed as a primary procedure once the breast sagginess has been corrected. Then a breast augmentation, with an implant, can be performed as a secondary procedure four months later.

At times patients who initially are requesting a breast augmentation find that they have sufficient breast tissue after all. Following a breast lift they find they no longer need, or desire an implant, to improve their breast shape and size.

Patients must remember that a mastopexy procedure does leave scars of some sort on the breast which may or may not be visible. The vast majority of times these scars are not unsightly and patients are not concerned by their scars once they have matured.

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