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Breast Lift (Mastopexy)

INTRODUCTION

Over time, a woman’s breasts can sag, lose their youthful shape, or both. Several factors can affect the shape and firmness of a woman’s breast such as genes, as in “I inherited my mother’s breasts”, weight fluctuation, pregnancy, breastfeeding, aging, and gravity.

Breasts that have sagged can be lifted to recreate that “perky” look, by removing the excess skin and repositioning the breast volume higher on the chest wall. Reshaping and tightening of the breast occurs in the process creating a more youthful looking breast. If the areola (the pigmented skin around the nipple) has enlarged with time and you would like it to be reduced, that can easily be done with a lift.

The degree of breast sagging can be a factor in what type of breast lift is needed. With removal of the excess skin, the breast may lose about 10-15% of its volume and be smaller than what is desired. Also, some women may have preexisting breast asymmetry or want more fullness of the upper breast, which generally cannot be achieved with a breast lift alone. In these situations, the best option may be to combine a breast implant with a lift. This is discussed further in the breast augmentation with lift surgery.

Very rarely are a woman’s breasts perfectly even, or symmetric. Sometimes, the lack of symmetry can cause a woman to be distressed, adding prosthetic implants in her bra to achieve symmetry. This is a common situation that women do not like to discuss. The solution is straight-forward. If a woman with uneven breasts seeks a breast augmentation, it is simple to fill one breast implant more than the other to make the breasts as symmetric as possible. Sometimes a breast augmentation is performed on one breast and a breast augmentation and lift, or a breast lift alone, or even a breast reduction is performed on the opposite breast simultaneously. The treatment plan is agreed upon during the consultation.

PREPARING FOR SURGERY

An initial consultation is set-up where we will discuss the breast lift procedure and to decide whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery. You are asked to stop medications that cause bleeding, such as aspirin, or aspirin-like products (Motrin or Ibuprofen), a week before this procedure. You are asked to stop smoking two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.

THE BREAST LIFT PROCEDURE

The breast lift scar undoubtedly causes a lot of women who seek this operation some anxiety, and that is understandable. The location of the scar will depend on the degree of breast sagging, and therefore how much skin needs to be excised.

• Minor Lift: A periareolar, Benelli, or “donut” lift is performed where a “donut” shaped segment of skin is removed from around the areola and the scar is only around the areola.
• Moderate Lift: A “lollipop” lift is performed where skin around the areola and from the lower aspect of the breast is removed with the resulting scar being around the areola and a vertical extension from the areola to the bottom of the breast at the midline, shaped like a lollipop.
• Major lift: A “wise pattern” lift is performed with an anchor incision. Skin is removed from around the areola and a significant portion of the lower half of the breast, leaving a scar that is shaped like a lollipop plus horizontal scars extending part or the total lower crease of the breast forming a scar that looks like an anchor.

BENEFITS OF THE BREAST LIFT PROCEDURE

The major concern of women having a breast lift is scarring. There is a trade-off between the amount of scarring on the breast and how long the lift will last. If a minimal lift is performed, the scars may be less, but the breasts will be more likely to sag sooner, since not enough skin is removed, and another lift may need to be performed in the future.

We get asked a lot of questions about scars. Usually, scars will heal very nicely. We also offer women a unique scar tape and cream system proven in a study on 800 patients to optimize scar healing. The vast majority of patients is very happy with their lift and is eventually very accepting of the scars as a good trade-off.

HOW WE MINIMIZE COMPLICATIONS OF BREAST LIFTS

At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.

General Complications
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class surgery center with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.

Bleeding
Bleeding after breast lift is very rare. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians, and by lab tests. In our practice, the rate of hematomas is less than 1%.

Infection
The most important step in avoiding infections, in my opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, our patients are prescribed a one-week course of antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a breast lift is extremely rare. Wound healing problems can occur at the superficial incision level where the tension is highest, and a small open wound may occur which will usually heal nicely with dressing changes and antibiotic ointment. The scar usually heals very well. Very rarely, we will do a scar revision to improve the appearance of that scar.

Ability to Breastfeed
Women are sometimes concerned that if they get a breast lift, they will not be able to breastfeed afterwards. The likelihood of losing the ability to breastfeed after a breast lift is very small. The inability to breastfeed after breast lifts that we have performed has not occurred with any of our patients to our knowledge.

Loss of Nipple Sensation
Loss of nipple sensation is a potential complication that is rare with less than 1% occurrence. Temporary loss of sensation from a “stunned” nerve or a bruised nerve may occur in the time period after surgery, but sensation in the vast majority of cases returns within a few weeks.

Smoking
Smoking is an absolute contraindication in breast lift. The carbon monoxide and nicotine in cigarette smoke causes severe reduction in blood supply to the skin and breast tissue during healing. This results in delayed wound healing, wound separation, death of the skin, loss of nipple tissue, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.

RECOVERY

Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that an adult stay with you at least the first 24 hours after surgery and drives you to your next day follow-up visit. With most procedures, you will be instructed to limit activity for the first week or two, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure. We also offer scar creams at an additional cost to optimize results.

To promote healing and minimize complications, you will be seen in a series of post-op appointments, including the day after surgery. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s cell phone number if you need to reach him after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.

MAXIMIZING POSITIVE OUTCOMES

At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.

There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.

We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Dr. Bitar is committed to continuing education, honing his skills and introducing new techniques always with the aim of improving safety and surgical results.

We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.

WHY CHOOSE BITAR COSMETIC SURGERY INSTITUTE?

Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar is a distinguished board certified plastic surgeon who stays on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, he is able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.

For more information, call our office at 703-206-0506.

Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.