(also known as Mastopexy)
Many women find that over time, their breasts have developed sag. The effect of gravity, pregnancy or weight loss may result in the skin stretching to the point where breasts develop downward migration, frequently with a nipple position that has descended as well. Through modern breastlift techniques, Dr. Behar can return your breasts to the more youthful appearance that you previously enjoyed. Interestingly, sometimes breasts will develop spontaneously with a somewhat down-turned appearance. These breasts may also be appropriate for breast lift techniques to provide a more attractive, shapely breast contour and appearance. In either instance, mastopexy can provide you with the more attractive breast appearance that you desire.
Dr. Behar finds that the simplest way to think about breast sag (or “ptosis”) is that it is simply an imbalance between the size of the breast and the amount of skin supporting the breast. If your breast size has become smaller after pregnancy or breast-feeding, or if the skin has stretched out from either pregnancy or after significant weight gain and loss then breast lift surgery can help to re-balance the amount of skin to better match the size of the breast itself. Sometimes, patients will benefit from both a reduction in the excess skin as well as from enlargement of the breast itself. In this case, we call the procedure a breast lift with enlargement (or an “augmentation mastopexy”). Either way, by carefully removing excess skin and repositioning the nipple and areola into the proper location a more attractive appearance of the breast can be achieved. All this can be done while hiding the necessary scars in the least objectionable locations.
During your consultation with us, we will discover what it is you would like to achieve. For patients who would like larger breasts with a lift, augmentation mastopexy can be considered. If you like the present size of her breasts, but simply are dissatisfied with their position, then a breast lift alone may be all that is needed to achieve your aesthetic goal. Prior to your consultation with Dr. Behar, it will be helpful if you can look at yourself in a mirror and try to define exactly what it is that you like and don’t like about your breasts. Dr. Behar will ask you specific questions during the consultation to help him understand what it is that your are unhappy about so that he can help you achieve your aesthetic goals most successfully and accurately. If you over 35 years of age, we will typically ask if you have begun and remained up-to-date with the generally recommended mammogram schedule prior to our proceeding with breast surgery. During your consultation, you will learn what surgery would best suit you and what that surgery involves, as well as the anticipated recuperation and risks.
With few exceptions, breast lift, with or without augmentation, is performed as an outpatient (meaning no overnight stay is needed). The surgery will be performed under general anesthesia for your comfort and to enable Dr. Behar to most successfully accomplish your goals. After your surgery, you will recuperate in the recovery room of the outpatient surgery facility and then safely return home at the appropriate time with a support bra in place and with instructions for your postoperative care. Close follow-up will be provided after the surgery to make sure you are recuperating smoothly and that all of your questions and concerns are answered and any after-care delivered. Necessary prescriptions for pain medication (usually only needed for a few days after surgery) and antibiotics will be provided.
Most breast lift surgery alone involves only the skin and the soft tissue of the breast itself. The muscles are typically not affected, nor is there any implant necessary in a typical mastopexy. For this reason, your recuperation is usually easily tolerated and requires only that you avoid strenuous activities for two to three weeks after surgery. You should also avoid excessive stretching of the chest area for three to four weeks after the surgery. If, however, breast augmentation is also performed at the time of the breast lift, then we may recommend an additional light-duty schedule regarding your work and/or activities at home during your recuperation period.
Frequently the implants will be placed under the muscles of your chest. In that case, you will need to avoid any strenuous activities with the upper body for at least three to four weeks postoperatively (six to eight weeks in the case of very strenuous activity of the chest muscle). In most cases, you will be able to return to work less than a week after your surgery, as long as your duties do not require strenuous lifting.
You will see an immediate improvement in your breast contour by the time you return for your first follow-up visit, less than a week after surgery. You will see that your breasts are more attractively shaped and your nipples are positioned back where they belong for your new, more youthful appearance. While there may be some bruising and swelling, it is usually not too dramatic. Most of your sutures will be the absorbable, buried type of sutures. Therefore, very few will need to be removed postoperatively. Typically, by your second postoperative week, no special care will be needed. We ask that our patients bring to our attention any worrisome changes that might occur during the postoperative recuperation, such as any excess redness, sudden swelling, any fever over 101 degrees, or any increase in pain over time rather than the typical reduction in pain as your recuperation progresses. Some pain after surgery is, of course, to be expected but it is typically very tolerable following breast lift surgery.
Long Term Considerations
We are frequently asked about the scars associated with breast lift. While scars are a necessary part of any surgery, breast lift surgery does entail more scars than simple augmentation alone. After all, undergoing a breast lift involves skin removal and when that skin is removed, invariably, scars result. The degree to which the scars are visible, however, is limited by their careful placement around the edge of the areola, in the shadow of the lower portion of the breast and within the fold of the breast itself. In general, when our patients are asked after surgery whether or not the scars bother them, the typical answer is that they really don’t notice them much. Scars are best thought of as a small price to pay for the dramatic improvement in the shape and position of your breasts achieved through breast lift surgery. It is up to the patient to decide whether or not the scars are worth the benefits that this surgery can bring.
Another questions we are frequently asked is whether or not a breast lift will need to be redone in the future as sag may redevelop. While breasts will always remain subject to the effects of gravity, in our experience, the sag that redevelops after mastopexy is typically less objectionable and slower to develop than the initial appearance of the breasts that prompted surgery in the first place. In addition, repairing the sag that may recur after a surgery is typically a less involved process than the initial breast lift itself. Typically, revision of the breast lift is not necessary for many years after the initial mastopexy, and is frequently not deemed necessary at all by most patients. In our experience, the most common distinction between those patients who choose to undergo touch-up surgery are those with a very high aesthetic standard. In those patients, touch up is a great way to maintain the results previously enjoyed. Most patients remain very happy with the results following their breast lift surgery for many years afterwards.
(also known as Reduction Mammaplasty)
If your breasts are larger than you would like them to be then a breast reduction can be considered. During breast reduction, the size of the breast is reduced and a simultaneous breast lift is performed. It is easiest to think of a breast reduction as simply a breast lift with reduction of both excess skin and excess breast tissue. During breast reduction, Dr. Behar will place scars in discreet locations and reduce and lift the breast tissue itself to allow you to enjoy breasts that weigh less, fit clothing better, and provide you with a slimmer appearance. Comfort during exercise is generally improved dramatically.
In general, patients who undergo breast lift or breast reduction are amongst the happiest encountered in our practice as they are able to rather quickly enjoy a day-to -day improvement in their appearance and comfort.
Schedule a consultation
If you have been unhappy with the shape and appearance of your breasts, and you’re in the Nashville area, perhaps it is time to consult with Dr. Behar to discover what breast lift, or breast lift with augmentation or breast reduction can provide. During your personal consultation with Dr. Behar he will help you to understand what can be achieved through mastopexy so that you will be able to decide if it is for you. Please visit us at either of our convenient locations in Middle Tennessee: Cool Springs/Franklin, or in Smyrna to learn more.