Breast Lift

A breast lift is also called a mastopexy. Often after massive weight loss, the female breast loses volume and the skin sags. Often, the result is an elongated breast. During the breast lift, the breast is lifted and the nipple is returned to its natural position. This leads to a more natural appearing, fuller breast.

 

Types of incisions: crescent, Benilli or doughnut, vertical or lollipop, Wise or inverted T or anchor

The amount of excess skin determines the type of incision required for the breast lift. If a small lift needs to be performed, then only a small incision is needed. If a large lift needs to be done and there is a significant amount of excess skin, then a larger incision needs to be made.

If a small lift needs to be performed, this may be accomplished through an incision around the nipple areolar complex. Typically, this incision is placed on the upper portion of the nipple areolar complex from the 9:00 to the 3:00 position around the areola. A crescent area of breast skin is then removed from the top portion of the nipple areolar complex, and the breast is lifted.

If more of a breast lift is needed, a Benilli or doughnut mastopexy is performed. In this type of breast lift, an incision is made completely around the inner nipple areolar complex. Another incision is made around the outer nipple areolar complex. The skin between the two circular incisions is then removed. The skin that is removed is in the shape of a doughnut, thus the “doughnut” mastopexy. Sutures are often placed inside the breast to lift the breast from the inside, similar to bra.

If even more of a breast lift is needed, then a vertical or lollypop incision is created. This procedure uses part the same technique as the doughnut mastopexy where an incision is placed 360 degrees around the nipple areolar complex. However, unlike the doughnut mastopexy, another incision is placed from the 6:00 position on the nipple areolar complex down to the breast fold or infra-mammary fold. In this surgery both the nipple areolar complex and the entire breast is moved upward.

If even more of a breast lift is required, then an anchor, Wise, or inverted T incision is used. This technique uses the above vertical or lollypop incision, however, an incision is also placed under the breast in the breast fold or infra-mammary fold. This is a common procedure for massive weight loss patients.

Whatever procedure is employed, the nipple is usually never removed and nipple sensation is usually intact.

Breast lift and augmentation

If one has enough breast tissue and is content with one’s breast size, then a breast lift may be the appropriate surgery. If one does not have enough breast tissue, then a breast augmentation and lift may need to be performed at the same time. The breast lift with augmentation incision follows the above descriptions of types of incisions made for a breast lift. Often, the breast implant will fill the breast and determine how much redundant breast skin there really is; this in turn, determines the type of incision that is needed.

Pre Operative visit

Dr. Katzen will review with you exactly what you are looking for with breast surgery. If you desire breasts to be returned to their “original” position, a mastopexy may be the best surgery. If you desire larger breasts and have your breasts returned to their original position, then a breast augmentation and lift may be the best choice. Often, breast asymmetry can be corrected during this procedure. Depending on your insurance and physical examination, this procedure is covered by insurance. Dr. Katzen will personally review your breast concerns and guide you towards the breast results that you are seeking.

The Procedure

The type of breast lift will determine how long the surgery takes. Typically, mastopexies take 2 to 4 hours. Dr. Katzen performs this procedure with a board certified anesthesiologist in a board certified surgery center or hospital. Before the surgery, markings are placed were the incisions are planned. Once the patient is completely asleep, the breasts are sterilized and draped and an incision is made. Dissection is carried through the breast tissue. The appropriate breast lift is then performed. The patient is elevated on the table to confirm nipple position, to confirm symmetry, and to ensure size appropriateness. The incisions are then meticulously closed with sutures. Typically, you will spend 1 to 2 hours in the recovery room. After the recovery room, you will be allowed to go home. Dr. Katzen will see you several days later. After surgery, your breasts will feel tight and engorged. Over time this will subside and your breasts will feel much more natural. Depending on their type of work, most patients are able to return to work approximately 5 to 7 days after the procedure.