INTRODUCTION

IDEAL CANDIDATE FOR THE SURGERY
The ideal candidates to undergo breast surgery are healthy people who are emotionally stable and understand what results to expect from a surgery. Many women want a mastopexy after a pregnancy or a breastfeeding period that has resulted in empty or drooping breasts. Although there is no risk that the mastopexy can affect future pregnancies, you should be aware that your breasts might droop again after a new pregnancy.
PLANNING THE SURGERY
In the first visit, the plastic surgeon will assess the size and shape of your breasts, the firmness of your skin and your general health state. A breast screening will also be performed and in some cases a static mammography will as well be required. You will be informed about the different surgical procedures, and your plastic surgeon will discuss with you the shape and size of your breasts after the surgery as well as the options or the combination of procedures that are most suitable for you. You must speak sincerely and frankly about your expectations, so that the surgeon can also be frank and discuss with you the available alternatives for your problem, informing you about the risks and limitations of each and every one of them. You will also be informed about the kind of anaesthetics that will be used, about the need or not of being admitted in the clinic where the surgery will be performed and about the cost of the procedure.
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- Mastopexy through periareolar incision.
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- Result and resulting scars.
The procedures covered by the National Health Service do not include mastopexy for aesthetics reasons.
Remember to let your surgeon know if you are a smoker or take any medicine or vitamins, and to inform them about the number of previous pregnancies and if you are thinking of becoming pregnant or breastfeeding. Do not hesitate to ask any doubt you may have, especially those related to your expectations.
PREPARING FOR THE SURGERY
You will be given instructions on how to prepare for the surgery, including some rules about food and liquid intake, smoking and the taking or adjustment of current medication, including vitamins and iron supplements. Blood transfusion is not necessary for this surgery. Be sure to arrange for someone to take you home after surgery and, if necessary, to help you out for a few days.
PROCEDURE AND ANAESTHETICS
The mastopexy is performed in an operating room, in a clinic or hospital. Admission is normally required, being discharged the following day.
Breast surgery is performed under general anaesthetic, so the patient is asleep during the procedure. In some specific cases, it can be performed under local anaesthetic with sedation.
A mastopexy lasts between 1.5 and 3.5 hours. The incisions cover the breast skin area that will be removed and where the areola and nipple will be repositioned to a higher area. The stitches are placed around the areola, following a vertical line that goes down from the areola and along the crease beneath the breast. In some cases, when the breast is small and does not droop excessively, the incision can be placed only around the areola. In breasts that do not have too much volume it might be necessary to place an implant behind the breast tissue or the pectoral muscle. After the procedure, a bandage or a special bra are applied.
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- Mastopexy through a vertical incision.
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- Result and resulting scars.
AFTER THE SURGERY
It is quite common to feel a little tired after undergoing breast surgery, but you can return to normal life after 24-48 hours. Most discomfort can be easily relieved with the medication prescribed by your plastic surgeon, although your breasts may hurt for a couple of weeks. The dressing or bandage will be removed in a few days, being replaced by a support bra that you must wear as indicated by your plastic surgeon. It is usual to feel burning in your nipples for the first couple of weeks
After a mastopexy, it is quite common to lose some sensitivity in the nipples. Generally, this is a temporary situation, except in some reductions in which it can be permanent. The stitches are removed after 7 to 14 days; the oedema does not disappear completely until 3 to 6 weeks after the procedure
After a mastopexy you can go back to work after a few days, depending on the kind of activity you do. Follow your plastic surgeon’s directions on what kind of exercises you can do; you must avoid lifting objects above your head for 2 or 3 weeks. Your breasts may feel more sensitive for 2 to 3 weeks, so it is advisable to avoid intense physical contact for 3 to 4 weeks. At first, the scars will look pinkish, and their appearance will continually improve after 6 weeks. The mammographic screenings indicated for every woman’s age can still be performed.
ARE THERE RISKS? ARE THERE GUARANTEES?
A mastopexy is a safe technique, as long as it is performed by a qualified plastic surgeon. There may be, however, risks and complications associated to it, as there are in any other kind of surgery.
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- Mastopexy through inverted T incisions. The areola is repositioned and excess skin and gland.
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- Result and resulting scars. The scars are permanent but their appearance will improve with time.
A mastopexy leaves permanent, visible scars, although they can be easily concealed under the bra or the bikini. Scarring problems are more frequent among smokers. Some patients may feel their nipples are less sensitive or, in some occasions, are completely desensitised.
THE RESULTS
Bear in mind that the scars resulting from a mastopexy are important and permanent, although your plastic surgeon will do their best to make them the least conspicuous. With time, the scars will become less noticeable. The effects of a mastopexy are long-lasting but not permanent, depending on factors such as new pregnancies, weight fluctuations and age. If an implant has been used, the effect will last longer.
If your expectations are realistic, you will be very satisfied with the result of the mastopexy.
– Information obtained from www.secpre.org.