What is a Breast Lift?
At Cornerstone Plastic Surgery & Aesthetic Medicine, Breast Lifting is done to raise and reshape the breasts and improve their appearance. Sometimes we use implants at the same time. Dr. Frederick Coville most often performs breast lifts without the need for the traditional “inverted T” incision and keeps scarring to a minimum. Our breast lift treatment is often chosen by women who feel that their breasts have suffered the inevitable effects of gravity and ageing, or by women who have breastfed children; or lost a lot of weight, and feel that their breasts are no longer as firm as they used to be. It involves removing excess skin and sometimes breast tissue to reposition the nipples. The procedure often alters the size of your breasts somewhat, but is mainly designed to firm them up and correct their position.
The youthful shape and firmness of a woman’s breasts are adversely affected over the years by pregnancy, nursing, and simple gravity. As the skin loses its elasticity, the breasts often begin to sag. Breast lifts raise and reshape such breasts for a time – though surgery cannot permanently delay natural changes. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small, or have lost volume – after pregnancy for example – implants inserted in conjunction with mastopexy can increase both their firmness and their size. What can and should be done in your case will depend on your consultation with Dr. Frederick Coville. However, the following introductory paragraphs will, we hope, be helpful.
Is a breast lift right for me?
A Breast Lift can make you look younger and shapelier and so may enhance your self-confidence. But remember, it can’t alter your appearance completely, or give you back your youth. Please discuss your expectations thoroughly with Dr. Fred before deciding. The most suitable mastopexy patients are healthy, emotionally stable women who are realistic about what the surgery can accomplish. Small, sagging breasts usually benefit most. Breasts of all sizes can be lifted, but the results may not last as long with heavy breasts or those that have a great deal of stretch marks on them. Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less breast volume. If you’re planning to have more children however, it may be a good idea to postpone your breast lift. Mastopexy does not normally interfere with breast-feeding but a further pregnancy is likely to stretch your breasts and reduce their size once more.
Are there any risks?
A mastopexy is not a simple operation and is probably the breast procedure that demands the most experience and skill from the surgeon. When you choose a well-qualified surgeon such as Dr. Coville, any complications are likely to be minor. Nevertheless, as with any operation, there are some risks. Anyone considering surgery, however, should be aware of these potential complications before deciding to go ahead with it. Bleeding and infection are uncommon, but these can both cause scars to widen. The way to reduce your risks is to follow our advice closely both before and after surgery – poor healing and wider scars are more common with smokers for example. Dr. Fred routinely uses limited scar techniques for his breast lifts and only very rarely feels the need to create a “T-shaped scar.” That said, mastopexy does leave noticeable, permanent scars when you choose to be topless. They will however, be covered by your bra or bathing suit. The procedure can also leave you with nipples slightly unevenly positioned, or a permanent loss of feeling in your nipples or breasts. Dr. Coville will discuss these and other potential difficulties with you in detail during your consultation and will give you as much time as you need to feel comfortable in your understanding of the procedure.
In your initial consultation, Dr. Fred will evaluate your health and explain which surgical techniques may be the most appropriate for you, based on the condition of your breasts and skin tone. Every patient and every physician will have a different view of what is a desirable size and shape for breasts. It is very important, therefore, to discuss your expectations fully and frankly with Dr. Coville. He will examine and measure your breasts and discuss the variables that may affect the procedure. Things such as your age, the size and shape of your breasts, the condition of your skin, and whether an implant is advisable, will all be fully reviewed with you. You must also agree where the nipple and areola will be positioned since the procedure raises them. Dr. Fred will describe the procedures he feels will work for you in detail and explain any risks or limitations. Be sure you understand the scarring that will result.
Dr. Coville will also ask you about any medical conditions that could cause problems during or after surgery, such as high blood pressure, blood-clotting problems, or any tendency to form excessive scars. Be open, particularly about smoking and any drugs, medications, or vitamins you are taking – aspirin for example can affect clotting. Be sure to discuss your expectations frankly with him and our staff. He will be equally frank with you, describing your alternatives and the risks and limitations of each of your options. Dr. Coville will also explain the type of anesthesia to be used, where the surgery will be performed, and the costs involved. Do ask any questions you may have about discomfort, healing time and so on.
How do I prepare for a breast lift?
Our staff at Cornerstone Plastic Surgery & Aesthetic Medicine will give you detailed instructions to prepare you for your surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain medications. Dr. Coville may require you to have a breast x-ray (mammogram) before he agrees to operate if your age and family history suggest this would be wise. While making preparations, be sure to arrange for someone to drive you home afterwards. Someone should also be available to help you out for a day or two if needed. If you would like, we can arrange a health aide to stay with you to assist you during this period. If you are visiting us from out of town or abroad for your surgery, we will facilitate all the arrangements to make your recovery as comfortable as possible. Be sure to ask about our Seaside Recovery options.
Where will my surgery take place?
Breast Lifts can be done under local anesthetic and intravenous sedation, or general anesthetic. Dr. Coville will review your options with you during your consultation. The surgery is typically performed on an outpatient basis at one of the fully accredited surgery centers on the beautiful Southern Shore of New Jersey with which Dr. Coville is affiliated.
Mastopexy usually takes from one and a half to three hours for both breasts. Many techniques are available but Dr. Coville almost routinely eliminates the traditional anchor-shaped incision that many surgeons still use. Dr. Fred feels very strongly about the need to limit scarring on the breast. His limited scar techniques also provide a better-shaped breast with a stronger and longer-lasting lift.
The incision defines the area from which breast skin will be removed, and determines the new location of the nipple. In Dr. Coville’s experience, simply removing the excess skin is a procedure very often doomed to failure. Because the skin of the breast has lost its elasticity, it is not suitable to support the breast by itself. By removing some breast tissue and reshaping the breast “cone,” Dr. Fred is able to create an “internal brassiere” that supports the breasts more firmly and creates a much more attractive breast shape than traditional procedures. During the mastopexy, Dr. Coville will also move the nipple and areola up to a higher, more youthful position. The skin around the areola is then brought down and drawn together to redrape the breast. Stitches go around the areola and in a line extending downwards from the nipple and towards the lower crease of the breast.
Even less extensive incision patterns may be enough for some patients, especially those with relatively small breasts and minimal sagging. One such procedure is the ‘doughnut’ (or concentric) mastopexy where circular incisions are made around the areola and a doughnut-shaped area of skin is removed. If you’re having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.
Your breasts will be bruised, swollen, and uncomfortable for a day or two but the pain should not be severe. If you’ve had a breast implant inserted below the muscles of the chest you will most likely have a bit more pain. You’re likely to feel tired and sore for a few days following your surgery, but you’ll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication that Dr. Fred will prescribe for you before surgery so that you have them with you when you need them. For protection, you wear an elastic bandage or a surgical bra over gauze dressings. After a few days, you will be able to switch to a soft support bra. You will have to wear this around the clock for three to four weeks. All your stitches will slowly dissolve on their own but moisturizer may need to be applied several times a day if your breast skin is very dry. You can expect some loss of feeling in your nipples and breast skin that should subside after about six weeks. In some patients, however, the numbness may last a year or more, and rarely may be permanent.
You will be up and about in a day or two, but do not plan on returning to work for a week or more. Healing takes time. Avoid lifting anything over your head for three to four weeks and, if you have any unusual symptoms, call us at Cornerstone Plastic Surgery & Aesthetic Medicine immediately. Detailed instructions for resuming your normal activities may include no sex for a week or more, and no strenuous sports for about a month. After that, you can gradually resume these activities. If you become pregnant, the operation should not affect your ability to breast-feed because your milk ducts and nipples will be left intact.
Any scars will be firm and pink or red for at least six weeks. Then they may remain the same size for several months, before they tighten up. After several months, your scars will begin to fade, although they will never disappear completely. Dr. Coville will want to see you during this period to see if there is any need for him to treat your scars so that they heal as inconspicuously as possible.
Will I Be Happy?
Dr. Fred Coville will make every effort to make your scars inconspicuous and create a very pleasing breast shape for you. Nevertheless, you must remember that mastopexy scars are more extensive than those created in a routine breast augmentation and they are permanent. With time, they should eventually fade to thin white lines. Fortunately, Dr. Fred will keep them as small as possible and place them so that you can wear even low-cut tops and bikinis. Remember, too, that a breast lift won’t keep you firm forever. Gravity, pregnancy, ageing, and weight fluctuations will eventually have the inevitable effect again. If you choose to have an implant inserted at the same time, the additional weight may make you sag sooner. You are far more likely to be happy with your breast lift if you understand the procedure thoroughly and if you approach the surgery with realistic expectations.
For most patients, the results of a breast lift are extremely satisfying. Your decision to have a breast lift is a highly personal one that not everyone will understand. What is important is how you yourself feel about it. If you’ve met your personal goals, then your surgery is a success.