Of all areas of the female body, breasts are most affected by gravity. Sagging (ptosis) may occur due to weight gain and loss and breastfeeding, and depending on the quality of the skin. The bonds holding the breast tissue in place may loosen over time. Most of the time the placement of the nipple is substantially lower than its ideal place. The problem may be related to the breast tissue, the skin, or both. In some cases, the breast volume is sufficient but there may be sagging due to excess skin. And sometimes breast volume is insufficient, which results in empty-looking, sagging breasts. This situation often affects self-esteem and limits the choice of clothing.

When the sagging of the breast is significant, no other method than surgery will lead to healthy, nor definitive results. In my opinion, all types of breast lifts require the plastic surgeon to have the highest experience and ability. On the other hand, these operations provide highly satisfactory results.

BEFORE THE OPERATIONS

As it is the case with other breast enhancement procedures, the reasons why you want the surgery and your expectations should be discussed with your doctor. Inform your doctor of any family history such as breast diseases or cancer in your family, smoking habits and medications or any systemic disease. Ask your doctor about the operation and possible issues.

OPERATION

The surgery is performed in hospital environment under general anesthesia. Breast lift surgery is planned depending on the level of sagging. In cases where the placement of the nipple is right but the nipple is hollow (grade 1 ptosis) a breast implant will be sufficient. These are the most fortunate patients, as the least scarring will occur with prosthesis surgeries. The operation takes approximately 1 hour. In the event the nipple placement is low and there is severe excess skin, sagging skin tissue is remodeled, the excess skin is removed. The nipple is moved to its optimal placement. The scar will be located on the inferior side of the areola. There are techniques that consist of trying to treat the excess skin by removing it through only one incision around the areola, however they cause worse and bigger scars. In addition to the scar around the areola, other surgery techniques include another incision of 4-5 cm extending down the middle of the lower portion of the breast. There is no breast lift surgery not leaving a scar. But these scars, although distinct at the beginning, become imperceptible over time.

The final volume of the breast should be predicted in advance and discussed with the patient; if it will be insufficient following the remodeling of breast tissue and removal of excess skin, an appropriate breast implant will be placed during the surgery, thus making it possible to have firmer breasts of desired size. No additional scar will be necessary for the placement of breast implants. This procedure takes 1.5 – 2 hours and placing a drain may sometimes be necessary. They are taken out the next day and the patient is discharged with a special bra.

POST-OPERATIVE PERIOD

Post-operative period is generally comfortable. The pain is manageable. Arm movements may be limited for a few days if breast implants are used during the operation. A corset bra is applied on the breasts, it will be worn for 3 weeks. The sutures are not taken out. Edema may occur in early stages, as well as numbness in the nipple and color change in the skin. These will disappear soon after.

The patient can go back to work within 3 – 4 days. Heavy exercise should be avoided for 1 month. Cosmetic breast lift surgery generally yields good and long lasting results, improving the patient and their significant other’s self-esteem and mental health, giving them a joy of life. The newly reshaped breast will last a long time, however excessive weight changes, pregnancy, breastfeeding and gravity may cause sagginess once more.