Breast Lift

A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin's natural elasticity or simply the effects of gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and it can be combined with mastopexy (breast augmentation) for added breast volume and firmness. Breasts of any size can be lifted, but results last longest when they are originally small and sagging.

Women planning to have children are advised to postpone surgery, since pregnancy and nursing can counteract its effects by stretching the skin. However, mastopexy should not affect your ability to breast-feed.

Mastopexy may be performed in a hospital, an outpatient surgery center or a surgeon's office-based facility. It is usually done on an outpatient basis under general anesthesia, and lasts from 1-½ to 3-½ hours.

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Breast Reduction

Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.

Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.

During the procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in some cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction. For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.

A little pain is normal after surgery, whether it's mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks.

Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.

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Breast Reconstruction

Breast reconstruction restores a natural, symmetrical appearance to the bosom, maintains body proportion, allows clothes to fit better, and most important of all, boosts self-confidence for women who have lost one or both breasts to mastectomy or who lack breasts due to a congenital or developmental abnormality. Reconstructive surgeons strive to create a new breast and nipple that resemble the woman's natural breast as closely as possible in shape, size and position.

Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.

The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.

There are several ways to reconstruct the breast, both with and without implants; your breast surgeon and plastic surgeon should work together with you in deciding which is the best for you.

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