Breast Reduction

What is a breast lift? What results can I expect?

A mastopexy, or breast lift, is a surgery that raises drooping breasts to a more youthful, attractive place higher on the chest.

What are some of the most common benefits of breast lift surgery?

This procedure is an excellent option for women who want to reclaim the firm feel and youthful contours their breasts had when they were younger. In addition to the improved appearance and feel of the breasts, women may also discover that they can go without a bra and still look and feel good in clothes that now flatter them even more.

Am I a good candidate for a mastopexy?

An experienced, board-certified plastic surgeon can talk with you about your goals and tell you if a breast lift is the right option to achieve those goals. In general, a woman with sagging breasts who is well both physically and mentally and who has received all the information she needs to make informed decisions about opting for surgery is a good candidate for a breast lift.

What will happen at the initial breast lift consultation?

The consultation is a time for you and your surgeon to talk about the improvements you want to achieve in the way you look and feel about yourself. The choices you will make will be unique to your own body, self-image, and lifestyle so it is important to inform your doctor about any concerns you have and to get clear, complete answers to all your questions. It will be very helpful if you bring to your consultation pictures of breast lifts that appeal to you.

At the consultation, Dr Evans will inform you about the surgery, about the type of anesthesia you will receive, and about what to expect from your breast lift before and after. The doctor will also take a complete medical history and conduct a physical exam. After your procedure is set up, but before the day of your procedure, you will be given detailed instructions regarding what you can and cannot eat and drink prior to your surgery, if you can use tobacco prior to surgery, and advice on losing weight ahead of your procedure day.

Measurements of your breasts will be taken, as will photographs. Dr Evans may also order a mammogram. Another consideration your surgeon will speak with you about is the new location of your nipples, and you will be asked if you wish to have your areolas (the pigmented skin encircling each nipple) decreased in size.

It is important to ask your surgeon all the questions you have about your procedure and the steps that come before and after it. Also, ask to view before and after photos of the doctor's recent breast lift patients. Ask the doctor if he or she has breast lift patients who would be available to speak with you about their own experiences. A successful and satisfactory breast lift is the result of getting educated about all your options, as well as the pros and cons involved, and then making each decision in the process from a position of knowledge.

What happens before I have the surgery?

The first step is to have a consultation with the surgeon. If you decide to have surgery, a date will be scheduled. At a second visit to the office, your surgery will be reviewed with you, photos will be taken, you will sign consent forms, and you will be given any necessary prescriptions and additional instructions. Before your surgery, payment in full is due; if you are financing, the arrangements will be made. One to two weeks before your surgery day, you will need to have blood drawn for pre-op lab tests and go for an electrocardiogram.

What happens on the day of surgery?

On the morning of your surgery, you will go to the surgery center. In accordance with your pre-op instructions, you will have not had anything to eat or drink after midnight. After you check in, your vital signs will be recorded and you will be given a gown to put on. An I.V. line will be put into your arm and your breasts will be marked in preparation for the procedure. Before you are taken into the surgical suite, you may be administered a sedative through your I.V.

What type of anesthesia is used?

In most cases, the surgeon will use general anesthesia, so you will go to sleep and have no memory of your surgery.

How is breast lift surgery done?

There are various ways of restoring sagging breasts, and the amount of sagging may determine which method is best for you. During the procedure, the surgeon cuts away extra skin from around the areola and, in some cases, from the underside of the breast as well. He or she can then reposition the breast skin to eliminate laxity and add additional volume to the breast by placing an implant to enhance projection and evenness of the skin. This allows for a higher, more youthful placement of the nipple and areola.

While particular breast lift methods may have distinctive differences, by and large they are normally classified as either verticle mastopexy (there is no incision placed under the breast)the anchor-shaped mastopexy, which may be used on very large reduction procedures, or the concentric (or "doughnut") mastopexy, which is ideal for petite breasts that have a minimal amount of sagging. The surgeon removes a round section of skin and then reorients the breasts. The anchor-shaped mastopexy is much the same, although it involves cuts away a larger amount of breast tissue, which is shaped like an anchor. Your surgeon can show you breast lift photos that illustrate the different methods, as well as breast lift with implants pictures.

As a rule, the greater the amount of tissue that is removed, the greater the amount of contouring is possible. If your breasts are drooping considerably, the skin has likely been pulled so much that a larger incision will be necessary to eliminate enough tissue to allow the breast to be raised to the desired position.

Since some breast volume is lost, you may have a breast lift with implants to improve the size and contour of the breasts. These breast lift implants are the same ones used for breast augmentation; in fact, many women opt to have a breast lift and augmentation combined. Operating time for a breast lift may range from one to three hours, with the particular surgical method dictating the length of time required.

Are drains placed?

Your surgeon may place a drain in each breast. This will be determined by the lift technique used. These drains are most often taken out one to three days after your breast lift and their removal is quite tolerable.

What happens after surgery?

When your surgery is done, you will be brought into the recovery room and kept there for one to two hours. A friend or family member will drive you home and your activities will be restricted for the first three or four days; you should not attempt to drive for a minimum of three to five days following your procedure. You can continue with strenuous exercise with your arms at four to six weeks. It is possible that you will be able to begin bicycling, walking, or jogging a little sooner than that.

What can I expect after surgery?

Following your breast lift, the change in the shape of your breasts will be instantly apparent, and the majority of patients are quite pleased with this striking improvement. Areas of numbness in the breasts after surgery are to be expected and may remain permanently; however, the vast majority of patients believe it is an acceptable tradeoff. For a period of several weeks to two months, you are required to wear a bra to uphold your breasts; however, underwire bras should not be worn as they may irritate the sensitive breast tissues as they continue to heal.

Will there be stitches that have to come out?

Yes. They will be taken out about a week after your surgery.

What size will I be after surgery?

It depends on your preference. You may opt to increase your size with a breast implant, go for a smaller breast size, or stay the same size. ??How much bruising, swelling, and pain is there? You should expect to have a fair amount of swelling after your surgery, and this will go away in two to four weeks. You may notice that the swelling, along with the pain, increases briefly during your first menstrual period after your procedure. Your breasts will look larger than they will eventually be due to swelling and, at first, the scars will look darker. Your breasts will be bruised, but it is usually not severe and diminishes over one to two weeks. Most patients say the pain is quite bearable.

What is the recovery period like after breast lift?

When you come out of surgery, your chest will be wrapped in a gauze bandage, which is removed after 48 hours. Most of the pain occurs in the first few days but eases shortly thereafter. In the meantime, pain medications will keep you comfortable. For the next several weeks, you will wear a surgical bra to support your breasts properly.

Approximately two weeks after your breast lift, you will return to the surgeon's office to have the stitches taken out. You will see bruising on your breasts and it is also possible that you could have incidental shooting pains and also temporary numbness surrounding the nipples. In most cases, these side effects stop after a period of weeks.

During the three or four days following your surgery, your activities and movements will be restricted to limit stress on the sutures and incisions. The majority of patients can return to their jobs within about two weeks, but they must not lift anything above their heads or engage in any stressful movements for several more weeks to make sure they continue healing well. Your doctor will give you a timetable for getting back to your regular activities following your breast lift.

While nearly all of your numbness, shooting pains, swelling, and bruising will go away within three to six weeks of your surgery, it may be a year before your breasts fully reflect their rejuvenated feel and appearance. Your breast lift scars, too, will fade as time passes; however, they may continue to be red and apparent to the touch for several more months.

After your breast lift procedure, you should maintain your monthly breast cancer self-exams and schedule periodic mammograms per your doctor's instructions.

When can I get back to work? When can I drive a car?

People whose jobs require a minimal amount of physical activity will likely return to work after three days. People whose jobs require a moderate amount of physical activity will probably be ready to return to work in seven to ten days. Patients with physically demanding jobs with heavy lifting should wait two to three weeks before returning to work. How soon you can get back behind the wheel safely will be determined by how much pain medication you are on, what your pain tolerance is, and whether your car is an automatic or a stick shift. As a minimum, you should wait three to seven days before attempting to drive.

When can I resume sexual relations?

It is advisable to wait at least one to two weeks so the healing of your incisions is well advanced. You may lengthen the amount of time it takes for your achiness to fade away by engaging in sexual relations too soon.??When will I see the final results? Most of the swelling will disappear in three to four weeks after surgery and all of it should be done at three months post-op. At this time, you will have a pretty good idea of what your final outcome will look like. Know that your breasts may still be a little firmer than what they will eventually become. The soft, natural feeling may take several months to develop.

What is the long-term outcome like for most people?

Once the surgery is done, your breasts will be more voluptuous. A breast lift is performed to keep scarring to a minimum. While it is true that scars may result from the surgery, by and large, patients are left with nearly imperceptible marks where the surgeon made the cuts.

After your breast lift surgery, you may see a small variation in the size or shape of one breast compared to the other. Remember that no one's body is equally proportioned and some variation is natural.

Breast lifts are sometimes done as part of a breast enlargement procedure in order to deliver the best possible outcome. A board-certified cosmetic surgeon is the best person to guide you in choosing the procedure that best meets your goals.

How long do the results last?

The results of most breast lifts remain evident for several years. Like any other cosmetic procedure, the results of a breast lift will not last the rest of your life. Surgery will restore the look and feel your breasts had when you were younger, but the stresses of weight fluctuations, pregnancies, and gravity will take their toll on your breasts over the years. Your skin tone and the surgical technique used can also affect the longevity of the results.

Will the scars be noticeable?

At first, they will be noticeable but over about one year, they may heal to the point that they are barely visible. Depending on the approach used You may have scars encircling the areola, down to the crease of the breast, or beneath the breast.

Dr Evans Frequently performs Breast Reduction with scars limiting to the areola or a small vertical extension below the areola. Thereby, limiting the total scars.

What can be done about the scars from a breast lift?

Scars from this surgery will change over a period of many months, and it may take as long as 12 months for them to achieve their eventual look. There are ways of lessening the appearance of the scars, such as:

• Bleaching creams
• Taping the scars
• Topical steroids
• Intense pulse light
• Silicone based gels
• Silicone sheeting

What risks and side effects are associated with mastopexy?

Among the risks and side effects related to mastopexy are breast asymmetry, uneven nipples, prominent scarring, loss of nipple sensation, numbness, loss of the nipple, inability to breast feed, adverse reaction to the anesthesia, recurrence of sagging, and infection.

Are there women who should not have a breast lift?

A breast lift is not appropriate for women who are not willing to have scars on their breasts, accept a possible lessening of nipple sensation, or accept a possible decrease in their ability to breast feed. Scars may inhibit a radiologist's ability to read mammograms accurately, so women who are at increased risk of developing breast cancer are advised against having a breast lift, as are women who are smokers. In addition, women with extra large breasts who desire a breast lift alone, rather than in conjunction with a Breast Reduction, to address droopiness are unlikely to be happy with their results because of the likelihood that the droopiness will return.

Will this surgery affect future mammograms?

Yes. The surgery will cause scars to form inside your breasts and the results of mammograms taken before and after breast lift will likely appear quite different. About one year after your surgery, you should have another mammogram in order to establish a new baseline. From then on, your age will dictate how often your mammograms should be scheduled.

How much does a breast lift cost?

Just as the cost of a Breast Reduction varies, a breast lift price depends on factors such as where in the country you are located, the method the surgeons uses, if you opt to have a breast lift with augmentation, and the particular challenges of your case. Based on the type of procedure chosen and the size of the breasts, the surgeon's fee could be as low as $4,500 to as much as $14,500. Keep in mind that does not include the costs for the surgical facility, anesthesia, testing, the cost of breast implants, and other associated costs. Several PPO insurance companies do offer partial coverage of "Breast Reduction " however , your insurance company may not cover the cost of breast lifts. Following your consultation a staff member will review you plan benefits . Our office staff Cannot guarantee what percentage your insurance will ultimately cover.

Can I get financing for my breast lift?

Yes. We have various patient financing options to meet a range of budgets. One of our staff members will sit down with you to discuss the option that is right for you to finance your breast lift costs.

How do I know if I need a breast lift?

The best person to assist you in answering this question is your plastic surgeon. By and large, the greater the distance between the nipple and the breast crease, and the more elongated the skin is in that area, the greater the chances of needing a breast lift.

Can I breast feed after a breast lift?

The majority of breast lift procedures preserve your ability to breast feed safely afterwards. The key is minimizing interference with the milk ducts. If you want to be able to start, or continue, breast feeding after breast augmentation/lift, be sure to ask your plastic surgeon what surgical method is least likely to be disruptive to breast feeding.

Is the nipple removed with a breast lift?

No. Usually, it is just relocated to a higher position, and the breast is recontoured to appear more youthful by removing extra skin from the breast.

What is an autoaugmentation?

This is a procedure in which the sagging part of the breast is moved behind the nipple. Your own tissue is used, essentially, like a breast implant, resulting in breasts that look voluptuous, contoured, and more youthful. This beneficial effect frequently occurs whith Dr Evans' verticle Mastopexy Approach.

What is the difference between a breast lift and a reduction?

In general, a breast lift is a cosmetic surgery intended to recreate the youthful character of the breasts. On the other hand, a Breast Reduction is intended to lessen the size of the breasts as a way of eliminating shoulder, neck, and back pain. Dr Evans can show you Breast Reduction pictures that illustrate the differences between a lift and a reduction, and he or she can detail how Breast Reduction costs differ from breast lift costs.

Will I lose nipple sensation from my Breast Reduction?

Loss of nipple sensation is a risk associated with Breast Reduction surgery; however, it does not always occur.

Is the nipple disconnected during Breast Reduction?

No, the nipple is not commonly disconnected during Breast Reduction unless the breasts are excessively big (breast hypertrophy).

Can large Breast Reductions be done with a short scar?

Yes, this can be accomplished, as long as the patient has good skin tone and she meets the requirements for the short-scar technique. Ask your surgeon to see Breast Reduction before and after photos. These Breast Reduction photos will help you understand what can be achieved with the short-scar technique.

Are all breast lifts the same?

Not at all. The way in which the surgeon keeps the nipple connected to the breast and retains the volume of the breast is called the pedicle, and the shape of the breasts after the lift procedure may vary with the pedicle technique used. The verticle mastopexy technique, which eliminates the need for an anchor incision, is used often in our practice, and many women are thrilled not to have those extra incisions beneath their breasts.

I had a breast lift fifteen years ago and my breasts are now drooping again. Can I safely have another breast lift?

You can. It is perfectly safe to have another breast lift procedure, though it is important to know that repeating the surgery carries a somewhat elevated risk of experiencing impaired blood flow to the nipple. Your surgeon can tell you more about this.

Will my stretch marks be removed with my breast lift?

Yes, if they are located low on the breast or in the area directly surrounding the areola. Stretch marks located high on the breast will not be removed by the lift procedure.

I am in my twenties. I have never had children but I have drooping breasts with stretch marks. Am I a candidate for a breast lift?

Yes. While it is not common, some women in their twenties do have sagging breasts. It is not always clear what causes this but one theory is that breast tissue sometimes changes significantly in response to fluctuating weight, and stretch marks can develop. A breast lift may be appropriate for a woman in her twenties, but she should be aware that the incisions will leave scars, and though they will become less and less visible over time, the degree to which they fade depends on the woman's skin type.

My nipples are very large. Can they be corrected during surgery?

It is not that rare for women to have duplicate nipples, or extremely large nipples. They can be made smaller as part of a breast lift procedure or as a stand-alone surgery done with local anesthesia.

I underwent gastric bypass one year ago and lost one hundred pounds. Now, my nipples are down to my belly button, but my breasts are flat. Do I need a reduction or a lift?

It is quite common for gastric bypass patients to lose a considerable amount of breast size as they lose body weight and be left with a large volume of extra, loose skin. A Breast lift surgery can remove this excess skin on the chest, but often the amount of breast tissue that is left is small.Dr Evans may discuss the option of placing an implants with your breast lift procedure to “recreate upper fullness in your breasts.