Breast Uplift (Mastopexy)

Many women, following the birth of their children and or breast-feeding, find that their breasts have deteriorated in terms of size, shape, and feel. As the skin loses its elasticity, the breasts tend to lose their shape and firmness and begin to sag. Even without pregnancies however, the effects of time, gravity, and alternate weight gain and loss, can all take their toll. Occasionally, unfortunate young ladies who have not had children or even extreme changes in weight develop breasts which are inherently droopy or sagging.

Before Breast Uplift Surgery After Breast Uplift Surgery

In contrast to the mastopexy procedure, the main aim of the breast augmentation and breast reduction procedures is to change the size or volume of the breast. A breast uplift or mastopexy, however is a surgical procedure to reshape and raise sagging breasts without altering the overall volume of the breast. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple.

Breast Uplift (Mastopexy) FAQs

Am I a suitable candidate?

Only a consultation can determine this. During your consultation Mr. Karidis will ask you about your general medical history including details about any previous breast surgery, and childbirth.  The best candidates for a mastopexy are healthy, emotionally stable women who are realistic about what surgery can achieve. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the result may not last as long in heavy breasts. While women of all ages can benefit, it's usually never performed before the breasts are fully developed. As previously mentioned, patients who plan to become pregnant should usually postpone the operation until after their family is complete. If you are a smoker you will be asked to stop smoking well in advance of surgery.
Smoking seriously constricts blood vessels and therefore decreases blood flow to a given area resulting in poor healing.  Aspirin and certain anti-inflammatory drugs and other medications (discussed in DO'& DON'TS section) can cause increased bleeding, so you must avoid these.

As every patient and surgeon has a different view of what is a desirable size, position and shape for breasts, it is important that you discuss your expectations frankly at the time of the consultation. Following this you will be examined and your breasts will be measured with a tape measure in order to obtain an idea of the degree of droop present. A discussion will take place, in which Mr. Karidis will try to encompass all the variables present- such as your age, the size and shape of your breast, and the condition of your skin, and whether or not a breast implant is advisable. You will be shown where the nipple and areola will be repositioned to, the site of the scars as well as how your breasts may be shaped following surgery. Please remember to ask any questions you may have, especially those regarding your expectations and concerns about the results.

Is a mastopexy alone enough for me?

In circumstances where there is both an element of drooping and "emptiness" of the breast, particularily in the upper half, then an uplift on its own is probably not enough to give a satisfactory result. In these situations an increase in volume through the addition of a breast implant is also indicated. In this situation a breast augmentation and an uplift is performed simultaneously.'Do I need implants as well?'

Can I become pregnant and breast feed afterwards?

It is probably wise to defer a breast uplift procedure until after you have finished childbearing and breast- feeding. This is because the hormonal changes that accompany a pregnancy can stretch and change the shape of the breasts.  While a mastopexy doesn't usually interfere with future pregnancies or breast- feeding, it is important to understand that having an uplift will not prevent the breasts from drooping again if presented with the same circumstances that made them droop in the first place.

What type of anaesthetic is used and how long does the surgery take?

A mastopexy is usually performed under general anaesthesia and takes about 75 minutes.

How long will I be in hospital?

A breast uplift procedure normally requires an overnight stay in hospital although it can also be performed as a day case.

What happens after the surgery?

Following your recovery from the anaesthetic you will notice a drip in the back of your hand. This is there so that we may replace any fluids lost during the operation. For
a few days after your surgery, you will probably experience some moderate degree of pain, which should be controlled with painkillers.  After surgery it is important
that you maintain good circulation in your legs and thus you will be advised to actively move the joints in your feet, knees and hips quite regularly.

Normally the bandages placed whilst you are in theatre are left on for 10-14 days depending on your exact procedure. You will also be instructed to wear a moderately firm supporting bra without an underwire. The stitches used are usually dissolvable.

Post Operative Instructions

What kind of after effects should I expect?

Following surgery you will experience some swelling and occasionally bruising of the breasts. The bruising usually lasts about 2 weeks.  While most of the swelling will have dissipated by this time, some subtle swelling may still be present for up to 4-6 months.

Although preoperative markings always try to ensure that both nipples are placed in exactly the same position, natural tension forces within scars may however stretch these slightly which could result in unevenly positioned or shaped nipples postoperatively (always however take into consideration that normal breasts naturally have differences anyway!). If this is significant then corrective surgery-usually under local anaesthetic- will be able to remedy this.

Whilst the techniques used by the Mr. Karidis ensures the best possible continuity between the breast and nipples, thus increasing the possibility of breast-feeding after breast uplift surgery, this cannot however be guaranteed.

After surgery you may notice that the breasts feel quite firm and taut, particularly along the edges of the incision site. This will be as a result of the normal healing process laying down elements of scar tissue to facilitate healing. When this occurs, massage as instructed by your surgeon will speed up the recovery. It gradually resolves in time but may take a few months to complete. You may also notice in the first few weeks that your breasts appear unnaturally high and very propped up. Don't despair as gravity always loosens them up quickly and brings them back to a more natural, desirable level.

You should expect the sensation to the skin in the nipples and surrounding skin to be reduced after surgery. This is as a result of surgical trauma to the nerves in the region. Although this usually recovers in a few months, permanent numbness may conceivably ensue.

What are the scars like ?

Scars are not a complication but a normal event after any surgery. In a breast uplift, the scars, depending on the degree of sagging and the technique used, can be lengthy and take many months or years to settle. However as they are around and below the nipples, scars shouldn't be noticeable even in low cut clothing or a bathing suit. You should always expect the scars to be red, raised, lumpy and even itchy to begin with but with time they should fade and flatten. This is the natural evolution of the healing process. However it is important to keep in mind that this may take up to two years to complete. Daily massage of the scars during this time period is advised to expedite and facilitate this process. The office of Mr. Karidis also provides you with special silicone gel sheets which when applied to the scars improves their appearance. You must understand however that no responsible surgeon will ever be in a position to predict any scars ultimate appearance. Although as mentioned, scars do fade and improve in time it is unlikely however that these could ever be characterised as being mainly only "hairline" in nature. As a result of the unpredictability of scars, in cases where breast droop is minimal, it may be advisable sometimes to opt against surgery rather than opting for a minor lift with noticeable scars.

Is it painful?

Breast uplift surgery is never as painful as most people think it will be. Newer techniques have ensured more minimally invasive surgery. For a few days after your surgery, you will probably  only experience some minor to moderate degree of pain which should be well controlled with pain killers. This usually improves and dissipates after the first 4-5 days.

What could go wrong?

Whilst it is true that when a breast uplift is performed by a qualified plastic surgeon the risks are small, nonetheless, specific complications with this procedure can and do occur.

As in any procedure the risk of significant infection is always possible. This is minimised by careful surgical technique and the preventative administration of antibiotics both at the time of surgery and after. However despite these measures mild infection is relatively common and can occur around the incision sites, but usually subsides over a period of about 2 weeks.

Risks such as leg and lung blood clots are rare. Early mobilisation by moving around as soon after the surgery as possible reduces this considerably. Mr. Karidis regularly deploys anti-clotting measures such as special stockings(TEDS) and compression devices(Flowtron)  during surgery to minimise this.

As mentioned earlier, swelling should be expected after this operation. When mild or moderate swelling is present, the body rapidly reabsorbs this. Very occasionally, increased bleeding can lead to more significant swelling and the development of a haematoma (a collection of blood under the skin)-less than 1%. If this were to happen, surgical drainage to evacuate this would be required. Ultimately however this should not affect the final outcome. This is very rare in Mr. Karidis’s hands.

During the first 2 -3 weeks after surgery, some patients may experience a minor loss of wound adhesion or even chafing of the skin at any point of the incision sites. One of the most common sites is the point where the vertical scar meets the nipple and or the under-breast crease. This is a temporary complication, which will require regular dressing changes initially. Eventually a scab develops over this, which subsequently separates after 3-4 weeks. A padded dressing for a period of a few weeks decreases the likelihood of this occurring. However some distortion of the skin around the scar may ensue. Further revision surgery may be required if necessary.

How many Breast Uplift procedures does Mr. Karidis perform

In accordance with the National Healthcare commission guidelines, according to the last five years of annual audit figures submitted to the Hospital of St. John and St. Elizabeth in London, Mr. Karidis performed on average 30 breast uplift procedures per year. In the last 10 years he has performed over 250 breast uplift procedures.

How long before I'm back to normal?

Patients should always remember that healing is a gradual process. Despite being up and about in a day or two after this type of surgery, you should always try to make provisions to rest in the first few days after surgery.  Although many people go back to light work duties by 5-7 days others find it more appropriate to take a further 7-10 days to rest. Remember variations do occur in the time individuals take to heal and in fact it may be that you may need a few weeks to pass before you feel yourself again.  Walking is helpful in the first 3-4 weeks as this improves the circulation and helps reduce the swelling, as well as the chance of blood clots developing. Heavy lifting or Strenuous activity is prohibited in the first 6 weeks after surgery. Overall common sense rules in the recovery period. If what your doing is uncomfortable then don't do it!

Summary

The results of this operation are usually excellent and you can expect less drooping of your breast with nipples in a higher position and a fuller shape in the upper half of your breast. It is important to note however that although immediately after surgery, your new breast will be apparent, the final shape will take approximately six months to fully emerge.

Every effort will be made to make your scars as inconspicuous as possible. Still, it's important to remember that mastopexy scars can be extensive and are permanent. Fortunately however, the scars can usually be placed so that you can wear even low cut tops without these being visible.

Your satisfaction with a breast uplift is likely to be greater if you understand the procedure thoroughly and your expectations are realistic. Whilst a well performed mastopexy offers you many years of rejuvenated, younger looking breasts, it is important to remember that your breast won't keep firm and pert forever. With time and age, ultimately, gravity will always win the battle.

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