Mastopexy – Breast Lift

What is a Mastopexy?


Mammary ptosis is defined by a sag of the gland and a distension of the skin envelope. In other words, sagging of the breast.

  • When a breast is too low and more frequent "emptied" in its upper part.
  • It can be isolated: it is called pure ptosis.
  • It can also be associated with some degree of breast enlargement.
  • breast ptosis can be conversely seen in the context of a breast that is too small (mammary hypotrophy).

Breasts may fall after pregnancy or after significant weight changes.

  • In both cases, the breasts have been strained for a variable period, and breast volume then declined to leave excess skin resulting in sagging breasts.
  • This residual breast volume can be sufficient and justify an isolated breast ptosis cure (ie lift the breasts only).
  • Sometimes the breast volume can be so reduced so it requires that a breast augmentation prosthesis is performed in the same time as ptosis cure.
  • In some favorable cases, breast augmentation with implants alone can help reduce the appearance of ptosis, limiting the scars to 4 cm on each side (see breast augmentation).
  • Unlike hypertrophy, breast ptosis does not create an aesthetic discomfort and is therefore not supported by health insurance.

 

Why have a Mastopexy?


Mammary ptosis or Mastopexy prevents the fall of the mammary gland, and distention of the surrounding skin.

  • The installation of implants is not mandatory, it depends on the initial volume of the mammary gland.
  • The operation helps reshape the breast by acting on the skin envelope and the glandular tissue to obtain harmonious, beautifully curved and ascended breasts.
  • The gland is concentrated and placed in a good position.
  • Then the skin envelope is tailored, which requires removing excess skin to ensure a nice form for the new breasts.
  • This allow to replace the areola and nipple that were located too low.
  • When a Mastopexy is associated with a hypotrophy of the breast, it may be desirable to introduce, in the same operation, a prosthesis to restore within a satisfactory volume. Conversely, when breast hypertrophy is associated, breast reduction is associated in the same operation.

 

The consultation


A preoperative mammography should be performed if there was none in the previous three years.

This will detect any abnormality preoperatively and serve as reference for future mammograms.

 

What happens during a Mastopexy?


Duration of surgery: 2 hours 2h30

hospitalization time: 2 days

Type of anesthesia: general

  • Some drugs favoring the bleeding should not be taken during the 10 days preceding the intervention: aspirin, anti-inflammatory drugs, anti-coagulants ...
  • Some drugs can be taken before surgery to reduce swelling and post-operative bruising.
  • Hospitalization takes place the morning of surgery while fasting.
  • The procedure is performed with the patient in a sitting position, to obtain the most symmetrical result.
  • A drainage by suction drains externalized in the armpits can reduce the risk of hematoma: these suction drains will be removed the day of the release.

 

What happens after the surgery?


  • There is usually some bruising (bruises) and edema (swelling) of the breasts that disappear within weeks.
  • However, the procedure is not painful or is very little unless implants are placed during surgery (especially if they are placed behind the pectoralis major muscle).
  • There are no stitches to remove.
  • A contention bra with elastic fabric that opens from the front, the size and cap will be defined with the surgeon before the operation, it must be worn day and night for a month.
  • During this period, any sport is prohibited, as well as carrying heavy loads.
  • It is recommended to take a week off after the intervention.
  • The scars should not be exposed to sunlight for 6 months after surgery.

 

The risks of a Mastopexy


  • As with any surgical procedure, there is a risk of hematoma or postoperative infection, although this is very rare. They require appropriate treatment (drainage, antibiotics ...)
  • Skin necrosis can very rarely occur at the areolas or vertical and horizontal scars. It prolongs the duration of healing and leaves a wide scar that can be redone secondarily.
  • This complication is greatly favored by smoking. Thus, smoking cessation is recommended at least one month before surgery.
  • The sensitivity of the areola and nipple is generally diminished after surgery, but usually normalizes in a few months.
  • The scars can be large or hypertrophic in an unpredictable way. They can sometimes require surgical correction when they are wide or injections of corticosteroids when they are hypertrophic.
  • Finally, breast asymmetry sometimes exists after surgery. It is all the more frequent when such an asymmetry existed before. It may require surgical correction several months after surgery.

With regard to anesthesia, during the consultation, the doctor-anesthetist will inform the patient of the anesthetic risks.

  • It should be noted that anesthesia induces in the body reactions that are sometimes unpredictable and more or less easy to control: the use of a perfectly competent anesthesiologist, exercising in a truly surgical context, makes the risks involved become statistically almost negligible.
  • Indeed, it must be known that techniques, anesthetic products and monitoring methods have made enormous progress over the last twenty years, offering optimal safety, especially when the intervention is carried out outside an emergency context and on healthy person.

 

The scars of a Mastopexy


The final scars depend on different parameters (desired volume, degree of ptosis, quality of the skin ...).

  • These scars are always located around the areola and generally have an inverted "T" shape under the areola (vertical to the base of the breasts and horizontal in the inframammary fold).
  • The horizontal scar is shortened or even suppressed if the ptosis is not marked (vertical scar or "I").
  • In cases where only a breast augmentation is provided to correct the ptosis, the scars are minimal and are located either at the bottom of the areola, in the inframammary fold or in the armpit.

cicatrice ptose

After a Mastopexy


  • The final shape of the breasts can only be judged after 3 months and the final appearance of the scars after 6 to 12 months.
  • The final results are durable if there is no pregnancy after surgery, and the weight remains (relatively) stable.
  • In case of associated breast augmentation, the higher the volume, the greater the risk that the breasts will sag again.
  • The same is true of the quality of the skin: the finer the skin, the more stretchy it is, the greater the volume.

Information Sheet SoFCPRE (Société Française de Chirurgie Plastique Reconstructrice et Esthétique)

Last update of this page : 06-06-2019