The skin of the breasts can become loose after weight loss, pregnancy or simply the passage of time due to gravity. This unattractive saggy appearance can be corrected by a skin tightening operation called Mastopexy. This type of surgery is generally not covered by insurance, so it is performed in our office surgical facility to lower the cost. The operation lasts 2-3 hours depending on the type of technique used.
The breasts are elevated and reshaped so as to appear tighter and more youthful. The nipples are elevated and the areolas are corrected to a more normal size (38 mm) as they are often stretched out. These lifting procedures can be accomplished through incisions around the areola, “periareolar” (AKA, Donut lift) if minimal droop is present and the patient only needs a slight adjustment in nipple position. More commonly, a “circumvertical” (AKA, lollipop lift) is required, where the scar is around the areola as well as vertically from “6 o’clock” down. If there is significant looseness at the lower pole of the breast then an “inverted T” lift is required, similar to the “lollipop” lift but with the addition of another incision under the fold allowing for the breast envelope to be tightened in the horizontal direction as well.
All of these Lift procedures can be done on their own if there is sufficient breast volume preoperatively or may be done in conjunction with breast augmentation if the volume of the breast needs to be augmented. The scars are noticeable at first but fade significantly over time. We do not perform this procedure on smokers, as this significantly increases the risk of skin necrosis (skin loss from lack of blood supply). Complete tobacco abstinence for 6-8 weeks is required.
Occasionally, a small reduction of the gland on one side will be done if there is significant differences in size of the breasts.
Postoperatively, the breast feel tight and swollen at first, but then look more natural in 6 weeks. There may be some temporary numbness a the lower breast, but nipple sensation is preserved as the nipple-areola complex is not disconnected from their nerves during the upward mobilization of the gland.