Breast lift (Mastopexy)

Considerations

• Your breasts sag, but are the correct size.
• Your breasts have lost volume or firmness, e.g. after pregnancy.
• Your breasts have shrunken and lost elasticity after weight loss.
• If your breasts droop and you have lost a substantial amount of volume, then in addition to reshaping the breasts, an enlargement can also be performed (augmentation mastopexy) to achieve an optimum result.

Consultation

• Communication of wishes and expectations ascertain what you would like to improve.
• Explanation of the possibilities and scope of the operation.

• Medical history is taken.
• Physical examination is performed.
• Digital photos are taken.
• Desired breast size and shape are discussed, as well as the position and size of the nipples.
• Pre-existing asymmetry in the breasts or chest, skin quality and existing scars are examined.
• Individual factors and personal wishes help in jointly deciding the right breast size and choice of appropriate surgical technique, the position of incisions and resulting scars.
• Based on this, an individual treatment plan is drawn up and goals of the operation are discussed and defined.
• Risks and possible complications are discussed and documented.

• Full medical history (pre-existing conditions and previous surgery).
• Current diseases (high blood pressure, diabetes, thyroid dysfunction).
• Allergies or aversion to medications.
• Any important medical reports.
• Please bring any important medical information (in particular anything relating to your breasts, e.g. mammography) along to the consultation and inform the surgeon if you have a history of breast cancer in your family.
• If you are planning to lose a significant amount of weight or to get pregnant, this should be considered when planning a breast lift as the size of your breasts can alter unpredictably through weight fluctuation, pregnancy or breastfeeding.
• It may be advisable to wait for the stabilisation of your weight or until after pregnancy/breast feeding before surgery is undertaken.
• Depending on your age, personal and familial risk factors, it may be advisable to have a breast ultrasound (sonography), mammography or MRI (magnetic resonance imaging) before having a breast lift.

Procedure

• The most common form of breast lift.
• Involves three incisions: a circular incision around the areola, a perpendicular one running from the underside of the areola to the fold under the breast (inframammary fold), and one that follows the fold to the inner and outer aspect of the breast.
• This technique is particularly suitable for larger breasts or for those with a great amount of excess skin.

• The incision is similar to the T-shaped scar.
• However, the vertical incision is extended in one direction of the inframammary fold only, mostly extended outwardly.
• Less skin can be removed, which is why the technique is mainly used in medium and smaller-sized breasts with a moderate excess of skin.

• This technique has no incision in the inframammary fold.
• There remains an excess of skin above the fold on the lower aspect of the breast, which has to regress spontaneously.
• This technique is only used in women with elastic skin and predominantly for medium-sized breasts with a moderate excess of skin.

• The incision is limited to the outer circumference of the areola.
• This technique does not have a vertical incision between the areola and submammary fold nor a transverse incision in the fold and is the shortest scar possible in breast reduction.
• Because only limited skin can be removed through this technique, it is mainly used in breast lifts where only a small amount of tightening is necessary.
• If breasts are not only reshaped, but also increased in size, then the insertion of breast implants or the injection of fat is required. Further information on these topic are found under the headings “breast augmentation with implants” and “breast augmentation with fat”.

Risks

• Haematoma (bruising), bleeding and swelling
• Seroma (accumulation of wound fluid)
• Healing problems or infection
• Wound breakdown/dehiscence (separation of wound edges)
• Injury of nerves or vessels
• Numbness in area of operation (temporary or permanent)
• Circulatory problem of breast skin or nipple (skin slough)
• Scars
• Slight asymmetry
• Unsatisfactory aesthetic result
• Secondary surgery
• Thrombosis or embolism

Preparation

• To aid the healing process, avoid smoking for two weeks before and after the operation.
• Avoid medication that increases the risk of bleeding, like aspirin, non-steroidal anti-inflammatory drugs, as well as vitamins and homeopathic remedies for two weeks prior to the operation.
• Depending on your age and additional risk factors, a mammography (breast x-ray), sonography (ultrasound) or MRI (magnetic resonance imaging) is sometimes recommended before a breast lift and possibly a few months after the procedure.
• This can be helpful to detect abnormal breast tissue before (that can be removed during the operation) and after the operation.
• A breast lift will not increase the risk of developing breast cancer.
• Even after a breast lift, mammography, sonography or MRI can be undertaken.
• Breast lifts are mostly performed as an outpatient procedure under general anaesthesia.
• Make sure that you can be collected and cared for by someone for 24 hours after the procedure.
• In some cases it may be recommended to stay overnight as an inpatient in hospital.

Day of surgery

• During surgery you will receive various medications for your wellbeing.
• Usually breast lifts are performed under general anaesthesia.
• For your safety, your heart rate, blood pressure, oxygen supply etc. are monitored during the operation.
• At the end of surgery, drains are usually inserted to prevent the accumulation of blood and serous fluid in the wound.
• After surgery, the wound is dressed and a special compression bra is applied
• You will be taken to the recovery room, where you will have continued monitoring until you awaken and are able to get up.
• You will be allowed to return home after a few hours.
• If you are an inpatient, you will remain in the recovery ward under surveillance until the following day.
• Already on the day of the surgery you should get up regularly for a few minutes in order to minimise the risk of thrombosis.
• The level of pain after a breast lift is not severe and can be compared with muscular pain.
• You are advised to take mild pain relief that reduces swelling and should be continued for several days after surgery.
• In case of an ambulatory procedure, you should have someone to care for you continuously for 24 hours postoperative.
• We also provide the option of an over-night inpatient stay at the AARE KLINIK in a single room with a personal nurse care, if needed.

After surgery

• It is important to realise that recovery from an operation varies for every individual.
• In the first days after the breast lift, you should rest. Do not raise your arms above shoulder height, and do not lift heavy objects.
• As a rule, you need to sleep on your back for a few days.
• Only take the prescribed painkillers and avoid any medication that contains aspirin or other blood-thinning substances.
• Wear the special compression bra and adjust it continuously over a total period of 4–6 weeks as per our recommendations.
• Physically demanding and sporting activities should be avoided for several weeks.
• In the first 2–5 days after the procedure, a feeling of tension and light pain will be felt in the region of the surgery.
• Breast skin and nipples may feel numb or hypersensitive in the beginning. This is usually temporary.
• However, it may take weeks or months, in some cases even longer until sensation returns to normal.
• Slight swelling and bruising in the area of the breast usually subsides within 2–3 weeks.
• Typically you will be back on your feet a couple of days after surgery and be able to resume your daily activities.
• Drains are removed in the first days after the operation, after which you can take showers again.
• Full baths and excessive heat (e.g. sauna), however should be avoided for several weeks until swelling has receded.
• Most stitches will dissolve by themselves and do not need to be removed.
• Non-dissolvable stitches are removed after one week.
• You will probably be able to start work again one week after surgery depending on the kind of breast reduction and the kind of activities required in your job.
• After removal of the sutures, we recommend the start of an intensive skin and scar care with rehydrating creams and light massage.
• In individual cases it may be useful to have special treatment with silicone gel or silicone pads over a period of 2–3 months.
• The fresh scars should be protected from UV radiation for at least six months, in order to prevent increased pigmentation.
• After surgery you will be examined at the AARE KLINIK at regular intervals, so that the healing process can be assessed until the final result is achieved.

Outcome

• Your breasts may be swollen for some time after surgery. It may take several weeks until they have assumed their normal shape.
• The healing process is gradual and it takes several months before the operation result can be conclusively determined.
• Scars might be a bit red for several months or appear pigmented, but this will fade with time until the scars and are barely visible.
• Scars are easy to conceal, even when wearing revealing clothing.
• A breast lift raises and firms the breasts and gives them an improved shape.
• The position of the nipples is improved through surgery and is adapted to the shape and size of the breast.
• The result of a breast lift is usually long lasting. However, gravity and the aging process continue to affect the breasts of every woman, gradually changing their shape and size over time.
• Weight fluctuations, pregnancy and lifestyle can also affect the outcome.
• If you are unhappy with the shape of your breasts after a few years, another breast lift can be performed.

Costs

• Surgical fee (including consultation and post-operative care)
• Anaesthesia fee
• Technical infrastructure costs (AARE KLINIK/hospital)
• Inpatient hospital costs
• Compression bra
• Medication
• Diagnostics (laboratory, ECG, scans, etc.)

Appointment for a breast-lift with Dr. Scheufler in Bern