Many women experience a change in the shape and firmness their breasts. This may result from loss of the skin elasticity, weight loss, pregnancy and breast-feeding. Breast lift surgery, also called mastopexy, removes the excess breast skin to elevate and reposition the nipples and to reshape and firm the breasts. The areolae (pigmented skin around the nipples) may also be reduced in size. Sometimes, breast implants may be inserted in conjunction with a breast lift to increase breast volume if desired.
Things to consider before surgery
Mr Hanikeri recommends waiting until patients have completed their families and when they have achieved a stable weight that they are happy with before having breast lift performed.
The safety of the procedure is affected by smoking and Mr Hanikeri does not offer this surgery to patients who are still smoking.
In patients who have a child between the age of one and seven, Medicare rebates may currently apply. This is assessed preoperatively with photographs sent to Medicare for pre-approval. If approved by Medicare, then private health insurance rebates may also apply which will significantly reduce the costs associated with the surgery.
If implants are to be used, this may be done at the same time as the breast lift is performed, however, in some cases, the risk of performing both breast lift and breast augmentation together are high. If Mr Hanikeri feels that the patient would be better off having the procedures performed separately, he will advise them to do so.
There are several different techniques to reduce the skin in breast lift depending on the degree of excess skin and the amount of nipple elevation that is required. Mr Hanikeri uses are the circum-areolar “Donut” technique for minor lifts where the scar is just around the nipple. He uses the circumvertical “lollipop” technique if more significant elevation and skin reduction is needed and the “Anchor scar” technique if the amount of skin resection and nipple elevation required is very significant. Patients are shown diagrams and photographs of patients who have had the technique that applies to them.
After surgery-what to expect
Patients will be mobile immediately and can resume driving, light activities and light exercise such as walking with two weeks. They can usually return to normal activities and exercise within four to six weeks. Most patients are recommended to take around one to two weeks off work after the operation depending on the physical demands of their job.
Whilst scars are not completely predictable, most are barely visible and easily concealed in time. They may appear pink and slightly thickened for a few weeks to months after the surgery but will usually fade to be pale and soft by around three to six months. Their final appearance may take up to eighteen months to achieve. Most patients experience very minimal scarring in the longer term.
Mr Hanikeri will usually recommend topical scar therapy such as silicone tape to be used from around the fourth postoperative week, until around three months after surgery.
After the excess breast and areolar skin have been reduced, the nipple and areola are shifted to a higher position. Skin that was formerly located above the areola is brought down and together beneath it to reshape the breast. The nipples and areolae remain attached to underlying mounds of tissue, and this usually allows for the preservation of sensation and the perhaps also the ability to breast-feed.
In some cases, the breast gland at the bottom of the mound is repositioned underneath the gland at the top. This provides some improvement in the shape of the breast and improves the fullness in the upper part (Auto-augmentation).
In most cases, drains are inserted at the time of surgery and patients are required to stay in hospital overnight. The drains are usually removed after the first night and patients are then able to go home. Post-operative pain is usually minimal and is controlled with tablets prescribed by the anaesthetist who is present for the procedure.
Risks of breast lift