Mastopexy

Mastopexy – Breast Lift

Mastopexy or relaxed breast lift is aimed to correct the ptosis (fall) of the breast that happens when the nipple is located in a position lower than the centre of the breast . This surgery remove and tightens the skin so to raise sagging breast. It is also possible to reposition the areola and reduce its diameter whilst in some case to add breast implants during the same surgery.
Symbol of fertility and femininity, a prosperous breast is very important from an aesthetic point of view. However, it happens that aging, the force of gravity, sagging of the skin and breastfeeding are at the origin of the loss of elasticity combined with atrophy of the mammary gland.
The breast tends to lose its form, flattens upward, and the areola-nipple complex lowers down under the sub-mammary sulcus.
Mastopexy is a surgical procedure which aims at lifting and restoring the profile and position of the breast.

Aesthetic defects and solutions

A falling breast can generate problems and embarrassment and be an obstacle to love life. If besides aesthetic and psychological reasons are added functional reasons due to the heavy weight of the gland that causes back pain there is no doubt that the problem can be disabling.

Emptied breast

When the breast is emptied for weight loss or excessive breastfeeding and the nipple is too low, we are in a situation where there is too much skin relative to the volume it should contain and it is a ptosis with glandular atrophy.
Sagging and relaxed breast
When the breast is big and the nipple looks down, we have a serious ptosis problem with hypertrophy.

Surgical solutions

Those who have problems with empty, sagging or relaxed breasts can bring back the breast to its initial position with the lifting intervention. Mastopexy is a procedure that removes excess skin by restoring the shape and preventing the loss of natural volume (which, if required, may still be increased or decreased). It is also possible to reduce the stretch marks present on the breast, thanks to the removal of the excess skin around areola.

– Breast lift augmentation with round block tecnique

It is an intervention that increases the volume with silicone gel implants and lifts the complex areola nipple by removing and tighetining the skin around and under the areola. This procedure in intended when the breast are really emptied usually after prolonged breast feeding.

– Breast lift without prostheses

It is a breast surgery called for severe ptosis or when the upper part of the breast is emptied and the mammary gland is still kept event though in a lower sagging position.

-Breast reduction lift

The surgery indicated in patients with a falling and disproportionate breast which needs reduction. The scar is “Inverted T” or “Anchor” and allows to lift and reshape the mammary cone in the ideal position usually withe the nipple areola complex at a line parallel to the middle of the arm.

Mastopexy with glandular auto prosthesis

It is an operation called for when the nipple has dropped a lot and the patient wants to maintain an important volume of her breast.The gland under the sulcus can be used to fill the upper part of the breast by means of a technique called “ glandular autoprosthesis” .

Basicly like Robin Hood did (taking away from the rich to give to the poor), the surgeon moves the excess mammary gland displaced on the abdomen to put it back on upper chest wall by fixing it to the pectoral muscle . In this way you recover most of the volume and move the nipple higher tightening and filling the new breast. It’s the real breast lift because it’s completely lifted up.

Non-surgical solutions

Breast lift without surgery
We are talking about a new Korean technique for supporting and lifting the mammary gland by placing absorbing PDP threads at least 10-15 cm long around and under the breast sulcus to set up a kind of mesh support that tightens the skin to get a mild improve of the ptosi.
It is indicated for who is not yet ready to undergo surgery and who also wants a slight result that can be repeated and improved from time to time during an outpatient session (thread breast lift).

Scars in Mastopexy

The final scars are usually thin and are not much visible. These are located on the border of the areola and perpendicularly downward to the inframmmary fold(vertical scar). In severe cases of ptosis, they are also positioned along the sulcus under the breast (inverted T shaped scar).
After healing with laser co2 or dermapen treatments may be further improved ad reduced.
When Inverted T-scars or anchor scar ( didascaly of pictures)
Scars around the areola and vertical: can be performed both in the case of mastopexy without prostheses and additive mastopexy. It occours always when the laxity and sagging of the skin does not allow to get a good result with round block Mastopexy.
When Periareolar Round block scars( purse string suture)
Scars all around the areola: round block Mastopexy is the technique that allows you to remove even a large quantity of skin when you have a emptied breast, and hide the scar just around the areola on a in the imaginary line that borders the different color of the areola to the surrounding skin.
It is necessary that a deep suture with not resorbable thread be placed to keep the size of the areola small and the scar not under tension, this is why we speak of the round block technique.
It is usually made in combination with a mammaplasty additive with round prostheses projected because the suture tends to flattens the projection of the breast cone. ( round block additive mastopexy)
When Scars of an additive mastopexy
Superior hemi periareolar: areola mastopexy can only be done when you have light ptosis and performed an additive mammaplasty and also want to lift a little (up to 2 cm) the complex nipple areola (additive mastopexy).

Specialist examination

Before choosing the surgical path, it is necessary to perform a specific consultation during which the surgeon evaluates the extent of the problem, describes the appropriate procedure and explains the patient’s post-operative status, risks and scar sites and extensions.
Dr Tommaso Savoia, to remove any doubts on the patient who wants to undergo the mastopexy procedure, will be able to underline with pictures “before and after” the results of the operation and possibly draw on the patient the incision lines and the future positioning of the areola-nipple complex. Where possible, other surgical procedures such as additive and reductive mammaplasty will be clarified.
This cosmetic surgery is recommended for those women who do not intend to plan further pregnancies. In case of new pregnancy, indeed, the results obtained could be frustrated.

Preparation for operation

At the end of the specialist examination, the surgeon will prescribe a series of clinical examinations to determine the physical conditions of the patient. In addition to the electrocardiogram, ultrasound and mammography, blood tests will be required: counting formula leukocyte, blood glucose, creatinine, azotemia, plasmatic electrolytes (chlorine, calcium, potassium, sodium), total proteins, liver function (ast, alt), coagulation (pat, PTT).
These measures are prescribed to be scrupulously respected:
-birth- control pill should be suspended at least one month before the date set for the surgery
-use of medications containing acetylsalilylic acid shall be suspended
-refrain completely from smoking at least four weeks before surgery
– inform surgeon about any medications
Surgery
Mastopexy surgery lasts about two hours, requires hospitalization at the clinic for one night and is performed under general anaesthesia or deep intravenous sedation.
Following the pre-operative design, the excess skin is removed and tightened so to and is put back in upper place the breast, obtaining a the conization of a beautiful younger breast shape .
The most common surgical techniques are to make an incision following the natural contour of the areola, and then continue vertically to the sub-mammary sulcus.
If there is severe ptosis (fall) of the breast, it may be necessary to make an incision along the sub mammary groove. The surgeon will remove excess skin from the lower part of the breast and bring back the nipple, areola and underlying tissue in a higher up (lift of the areola-nipple complex).
With Mastopexy, stretch marks cannot be completely removed from the skin, but can be reduced (especially in the upper quadrants). In the last step of the operation, the compression bandages are to be kept for the next few days are applied. For the post operative period are prescribed pain killers medication to be taken in case of pain and inflammation

Healing times:

After the surgery, the drains are maintained for 1 day and a compression dressing is applied, with a special bra (“sporty”, without underwire, with front opening and well disputed) to wear day and night for 30 days.
The compression dressing is removed after a few days; superficial stitching is removed after one week, while intradermal sutures resorb spontaneously after 2 weeks. It is necessary to limit arm movements and efforts for about a month; do not smoke to avoid coughs that cause bleeding and do not expose yourself to sunlight or sources of intense heat.
Physical activity can be resumed after 6 weeks, but should be limited to a very light stretch, always wearing the bra (avoiding great movements with the arms and weightlifting). Even the results are evident immediately, but the breasts will initially have an unnatural appearance: rigid and excessively raised.
Once the swelling disappears, the breasts will take on a natural and soft shape. The final shape of the breast will be appreciated after about 6 months of surgery. There may be a temporary loss of sensitivity in the nipples and skin, which will gradually fade over 3-6 months. In some cases, this loss of sensitivity may last up to one year; it will rarely be permanent. The final result is durable, but it will not stop the passage of time: the breast will undergo both the force of gravity and natural aging processes.