During the initial consultation, it is important to review the patient's medical history, goals, and expectations, as well as build mutual trust and rapport. Numerous before and after photos of breast lifts are reviewed at offices. The breast lift surgical procedure is carefully explained and the alternatives are discussed. Each patient has different breast contours and sizes and different expectations and requests. No single procedure will fulfill each patient's needs. A complete evaluation reviewing expectations and physical examination is required to determine the best choice of procedure(s). The breast lift surgical plan as well as the incision/scar placement, is reviewed. Breasts are naturally asymmetrical, and every effort will be made to make the breasts symmetrical and as close as possible to the desired size. However, no plastic surgeon can guarantee the exact size, shape, or symmetry of the breasts after surgery.
Prospective patients are encouraged to speak with previous patients about their breast lift surgery and results. Plastic and cosmetic surgeons are always available for questions. Following the initial consultation and after appropriate time for reflection, an appointment is scheduled for routine preparation and informed consent. Additional questions and concerns regarding the breast lift surgery may also be addressed. Routine blood analysis, a mammogram, and medical clearance are required prior to surgery.
Breast lift surgical procedures are performed under general anesthesia. Local anesthesia with intravenous sedation may also be used in some circumstances. Depending on which breast lift technique is used, the surgical procedure could take anywhere from two to five hours. Prior to breast lift surgery, the lines of incisions, the new nipple location, and remainder of the surgical plan is outlined on the breasts. After speaking with the anesthesiologist, the patient is brought to the operating room. Once the patient is asleep, local nerve blocks and a bleeding reduction medication are administered.
Standard Breast Lift Surgery
Many plastic and cosmetic surgeons use a "keyhole" pattern or "anchor" shaped incision. The incisions made during breast lift surgery extend in three different directions:
1. Entirely around the areola (the pigmented area around the nipple)
2. From the areola in a vertical direction down the crease under the breast
3. Horizontally along the fold or crease under the breast extending for a variable length
The greater the amount of lifting, the longer the horizontal portion of the scar will be. Excess skin is removed and sculpted from the inner and outer quadrants of the breast and from the area above the nipple. The remaining breast tissue and nipple are relocated in a keyhole pattern and the incisions are closed.
Many surgeons does not use clips or staples to close the skin. All incisions are closed with sutures predominantly below the surface of the skin to avoid cross-hatching suture marks and to optimize the chances for the finest scars.
A conservative size breast implant, or "auto" augmentation to preserve fullness in the upper portion of the breast, may also be performed along with the standard breast lift procedure. This additional procedure utilizes a portion of breast tissue still connected to the chest wall and its blood supply. This segment of tissue is then passed up and under a two-inch bridge of pectoralis muscle and secured.
Different Breast Lift Surgery Techniques
With a circumareolar-vertical or "lollipop" incision technique, the skin is elevated and the excess is removed from around and under the areola. The resulting scar extends completely around the areola and vertically down to the crease under the breast. A conservative size breast implant, or the "auto" augmentation technique, may also be performed with a breast lift to enhance the fullness in the upper portion of the breast.
With a circumareolar or "Benelli" breast lift surgery (sometimes referred to as a "donut" mastopexy), the skin is elevated and the excess is removed from around the areola only. The resulting scar extends completely around the areola. Similarly, a small breast implant may be placed to enhance the fullness in the upper portion of the breast.
Standard breast augmentation, with saline or silicone implants, may be performed with any of these breast lift procedures to increase the cup size of the breasts. Following breast lift surgery, a light dressing, a support bra and/or ace bandage are applied. |
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