Aesthetic surgery of the breast encompasses a spectrum of options from breast lift alone to breast lift with size reduction to breast lift with increase in size. Reducing the discrepancy between skin envelope and breast tissue can either be addressed from “outside-in” with skin redraping, from “inside-out” with parenchymal augmentation, or a combination of the two. Mastopexy aims to create a beautiful breast by primarily addressing the shape and differs from augmentation where the primary goal is to alter the size of the breast. The two procedures are, however, not completely discordant and can actually complement one another as they address different parts of the breast (skin vs tissue).
The preoperative consultation is an opportunity to understand the patient’s goals and anatomy, and help the patient navigate a treatment choice that will help them achieve a beautiful appearing breast. Patients are asked if they are bothered by the shape or size of the breasts or both. This can help differentiate between the need for a mastopexy, augmentation, or mastopexy-augmentation. However often the patient’s complaints may not match their physical exam. Objective assessment (with precision measurement) by the plastic surgeon needs to be made in the context of a patient’s goals to optimize the outcome that they are seeking. History includes a summary of previous surgeries, existing asymmetries, and a breast health evaluation. This includes past history of breast cancer, abnormal mammograms and desire for future breast feeding. Patient’s weight history is documented including any major changes or surgical weight loss.
- Mommy Make Over candidates
- Massive Weight Loss patients
- Older women who seek breast lift along with some added volume
- Deflated sagging breasts due to any other reason/condition
Grades of breast ptosis
Periareolar / Donut Mastopexy and final scar location:
Circumvertical / Vertical / Lollipop Mastopexy and final scar location:
Wise pattern / Anchor Mastopexy and final scar location:
Mastopexy – Augmentation:
Augmentation of the breast can be combined with mastopexy in a single stage usually using autologous breast tissue (auto-augmentation), silicone implants or your own fat.
The pre-op and post-op protocols and regimens (care to be taken, medications, do’s and dont’s, recovery time, etc) are similar to any breast reduction or lift surgery with few changes, which the surgeon will inform you.
Post Operative Care
- Limit exercise for 4 weeks
- Take antibiotics and analgesics as prescribed
- Encourage hydration – 8 glasses of water a day
- No smoking (active/passive) for 4 weeks
- Post operative exercises as instructed
- Wear sports bra 24×7 for support for 2 weeks (non-underwired)
- Silicone sheeting post operatively for 3 months for scar reduction