At times, patients present with a condition where the breast has fallen in position. Ideally, the breast should be centered halfway between the elbow and the shoulder. But, sometimes because of gravity and changes that occur over the years, the breasts have a tendency to descend or become saggy. This commonly happens in patients who have nursed or who have lost weight. Patients who have nursed, often times, not only loose volume but the breast drop in position and simultaneously they can have excess skin and stretched skin of the abdomen and of the breast. There is a procedure that is extremely common today that is called a Mommy Makeover where patients who have this condition have a minor tummy tuck and breast surgery to reverse the signs of pregnancy.
Patients who have sagging breasts have to consider having a breast lift or what’s referred to as a mastopexy. Generally this requires an incision that goes completely around the areola and then down the front of the breast to the crease. This has been referred to as a popsicle incision. At times, the circular portion of this incision is not required and it’s only the vertical incision from the bottom of the areola and the bottom to the crease under the breast that is required. This varies from patient to patient. It is important for patients to understand that these incisions will be visible for a variable period of time, usually to begin with are pink and visible but in time the pink usually subsides and after a reasonable period of time, the incisions fade and become relatively inconspicuous.
The objective of doing a mastopexy is to elevate the entire breast so it comes to rest in a normal and anatomic position halfway between the elbow and the shoulder. There are certain patients who can have a mastopexy and obtain a desired result but there are other patients who, as a result of the mastopexy, have a void in the upper portion of the breast which creates a shelf like deformity. Patients such as this are given the option of using a very small implant to fill that void so as to have a normal anatomic appearance of the breast.
Mastopexy, with or without an implant, is performed at Newport Beach Center for Surgery, usually under a very light general anesthetic. The incisions are made which are superficial and the breast is then elevated to a more ideal position. Portions of skin are removed and the incision is then meticulously closed in such a way as to minimize the potential of obvious visible scarring. On completion of this procedure which parenthetically is relatively bloodless. A supporting compression dressing is applied to maintain the breasts in its elevated position. The patient is transferred to the recovery room and after a short stay in recovery is then discharged to the care of a responsible adult.
The patient generally experiences very little discomfort. No actual pain, and is able to resume light physical activities even the day after surgery. The patient is allowed to resume normal diet and sleep patterns. The morning after surgery the patient is seen in the office. The dressing is removed and the general check up of the breast condition is performed. The patient is then advised to use a support compression, sports type of bra and to resume all normal activities including personal hygiene so that the patient can then, the day after surgery, take a shower and perform all her personal hygiene. We recommend that the patient get dressed and rather than going to bed, to actually go out and to resume their normal activities. Patients who have breast lift surgery usually require no more than extra strength Tylenol for pain control. The procedure does not result in excruciating pain or significant discomfort. After approximately one week the sutures are removed and we then monitor the result of the incision healing. In the event, although rare, the patient begins to develop undesirable scar tissue, then a variety of methods are used to prevent scar formation. In the vast majority of cases the patient is extremely pleased with the result and is literally able to go braless and to engage in all normal physical activities.
Breast Surgery Information