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Over time, factors such as pregnancy, nursing, weight loss and the force of gravity take their toll on a woman's breasts. Sagging occurs when breast skin stretches and breast tissue and fat degenerate over time. The breasts often loose their shape and firmness and begin to sag. If you often wished your breasts were higher and firmer, a breast-lift (mastopexy) may be for you. Several different techniques can be used to correct this condition, depending on the degree of sagging. Also, a breast lift may be done in conjunction with breast implants. Implants may also help lift the breast by increasing the volume of the contents of the breast. Breast lift surgery is quite successful at making the breasts firmer and more shapely. Many women find that they no longer need to wear a bra to feel comfortable and look good in their clothes.

The Surgery
Your breast lift may be performed in a hospital, an outpatient surgery center, or a surgeon's office-based facility. Breast lifts are usually performed under general anesthesia, which means you'll sleep through the operation. The surgery usually takes one and a half to three and a half hours. The incisions used may be customized based on the size and shape of the breasts, and therefore may vary from patient to patient. Typically the surgeon repositions the nipple and areola to a higher position and removes excess skin from beneath the breast. Closing the remaining skin lifts the breast tissue to a higher position and re-shapes the breast to give it a more upright and youthful appearance

The Recovery
After surgery your breasts will be bruised, swollen and uncomfortable for a day or two, but the pain shouldn't be severe. The gauze dressing will be removed after a couple of days, and you will wear a surgical bra for many weeks. The stitches are removed about two weeks after the surgery. You may experience temporary numbness around the nipples as well as random shooting pains. These conditions generally go away within several weeks. After two weeks you may get back to your normal activities, including mild exercise. After four to six weeks more strenuous activities may be resumed. After a few months, your breasts will settle into a more natural shape. Breast scars are considered permanent, but should fade over time. As with all cosmetic procedures, the final result will be apparent in about one year.

The Best Candidates For Breast Lift
The best candidates for breast lift are 18 years or older with stretched skin that lacks firmness and volume. The best results are usually achieved in women with small, sagging breasts. Many surgeons recommend postponing a breast lift until after you’ve had children. And as always it’s important to be in good health with realistic expectation of what a breast lift can do for you.

The Risk
As a result of repositioning, the nipple may lose sensation or become overly sensitive. The procedure can also leave you with unevenly positioned nipples and permanent scars. Sometimes breast feeding may not be possible after this surgery. As with most surgery there’s always a risk of bleeding, infection and complications associated with anesthesia.

Background

Loss of skin elasticity, gravity and other factors such as weight loss, pregnancy and breast feeding ultimately affect the shape and firmness of a woman’s breasts. Breast lift surgery, also called mastopexy, removes excess breast skin to raise, reshape and firm breasts. The nipples and areolas (the pigmented skin surrounding the nipples) are repositioned, and the areolas sometimes may be reduced in size. If desired, implants may be inserted in conjunction with a breast lift to increase breast volume. A breast lift can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped.

Technique

Individual factors and personal preferences will determine the specific breast lift technique. A common method of lifting the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision is horizontal beneath the breast and follows the natural curve of the breast crease. After the plastic surgeon has removed excess breast skin, the nipple and areola are shifted to a higher position. The areola, which in a sagging breast may have been stretched, can be reduced in size. Skin that was formerly located above the areola is brought down and together beneath it to reshape the breast. The nipples and areolas remain attached to underlying mounds of tissue, and this usually allows for the preservation of sensation and the ability to breast-feed. In some instances, it may be possible to avoid the horizontal incision beneath the breast, as well as the vertical incision that runs from the bottom edge of the areola to the breast crease. Some patients are good candidates for this limited scar technique.

Benefits

• Breasts are firmer and more uplifted. The position of the areolas and nipples is enhanced. Data has shown the procedure can also have a positive psychological effect.
• Significant complications from breast lifts are infrequent.
• Unless the patient gains or loses a significant amount of weight or becomes pregnant, breast shape should remain fairly constant.

Other Considerations

• Every surgical procedure carries risks. Potential complications include reaction to anesthesia, bleeding, infection and poor healing.
• Patient may be instructed to wear a support bra for a few weeks, until the swelling and discoloration of the breasts diminish. Incision lines, which will heal and fade over time, will be permanently visible, although they are in locations easily concealed by clothing.
• Breasts may not be perfectly symmetrical or nipple height may vary slightly. Minor adjustments often can be made at a later time, but patients should remember that natural breasts usually show some variation.
• Permanent loss of sensation in the nipples or areas of breast skin may occur rarely.
• Occasional poor healing of incisions may lead to necessary revision surgery.
• Gravity and the effects of aging will eventually alter the size and shape of every woman’s breast, in which case the patient may choose to undergo a second breast lift procedure.