Cosmetic breast surgery
Low hanging breasts can be surgically reshaped
Ptosis or breast sag is when the areola is located too low and the stretched out skin is too large for glandular tissue. The breast seems empty (droopy breasts).
Breast ptosis usually occurs after weight loss or pregnancy with breastfeeding. The natural ageing of the chest also promotes ptosis. The volume of breast ptosis can be considered normal, too large (Mammary hypertrophy from ptosis) or too small (Mammary hypotrophy from breast ptosis).
Surgical mastopexy (treatment of ptosis or breast lift) repositions the nipple and areola to the correct height, lifts the breast and removes excess skin. The breast is raised, firmer and more beautiful. Depending on the profile and the request of the patient, Dr. Laveaux offers an optional alternative technique to obtain a firmer breast and a more generous cleavage (slight "bimbo" effect).
To achieve this breast reshaping, the surgeon is required to cut the skin, which causes scarring. The severity of the scars is proportional to the degree of ptosis :
- for mild ptosis, a periareolar scar around the areola, where the lighter skin meets the darker skin may be sufficient;
- for moderate ptosis, an additional vertical scar is necessary, from the areola to the fold under the breast;
- for major ptosis, an inverted T scar (navy anchor scar) is mandatory. It combines a periareolar scar, a vertical scar and a more or less horizontal scar located in the fold under the breast.
A procedure called "round-block" can treat some moderate hypertrophy and only result in a periareolar scar. Breast shape and appearance of the scar, however, can be less attractive than with a conventional technique. This method very often requires touchups several months after the initial procedure. This technique is for patients who wish to limit at all costs the length of the scars, despite any drawbacks as mentioned.
- Mammary Hypertrophy treatment : if the breasts are too large, the surgeon may remove a certain amount of gland during the treatment of ptosis (breast reduction + breast lift) ;
- Breast Implants : in the case of associated stunting or asymmetry between the two breasts, the surgeon can place the implant either during the same operation or during a separate procedure in order to give the breasts sufficient volume ;
- Fat transfert (lipofilling) : fat injections can be performed either in the same operation or at a later time as is most often done to increase the breast size or simply improve the neckline.
Principle of the breast uplifting
- The procedure is performed under general anesthesia and lasts from 1 and a half to 3 hours ;
- Hospitalisation ranges from 10 to 24 hours.
- The after-effects are slightly painful requiring only simple analgesics ;
- Edema (swelling), ecchymosis (bruises) and a hindrance to elevate the arms are frequent in the early stages ;
- A compression bandage is applied on leaving the operating room (type of elastic bustier made to measure). It will be replaced before the patient leaves the clinic or at the first appointment. In some very rare cases, a drain is inserted. It is removed before the patient leaves the clinic.
Complete healing is achieved within 2 to 3 weeks. The concealed stitches are dissolvable. Some small stitches may be removed between the first and third week. The dressings are semi-permeable, so showers are allowed. Special adhesive dressings will be applied to the scars for 2-3 months in order to improve their appearance.
Returning to work is possible between 5-10 days after surgery depending on the job.
The patient may resume sporting activities after 1 or 2 months. You must wear a support bra 24 hours a day for 1 month.
The aesthetic, functional, and psychological improvements are always very satisfactory. The shape of the breast will be permanent and the scars will be fully developed, that is, discreet, one year after the operation.
Risk of complications
As with any surgery, a number of complications can occur. But the likelihood of these complications is reduced in the hands of a qualified plastic surgeon and in the presence of a competent anesthetist. The patient’s compliance to instructions given by the surgeon is also essential, including:
- Stopping smoking 1 month before and after the breast lift (reduction of all risks) ;
- Not taking aspirin for 10 days before and after the breast lift (reduced risk of hematoma).
Fortunately, postoperative effects are generally manageable following a breast lift that has been carried out properly, so serious complications are rare.
In spite of the fact that complications are so rare you must be aware of the following problems :
- Haematomas are quite rare but can occur. They can be evacuated.
- Infection : this is extremely rare when the procedure is carried out in sterile environment.
- Delay of healing process.
- Numbness of the nipples may be observed. It is usually transient and most patients recover normal nipple feeling after 6 to 18 months.
In case of a complications, your surgeon will treat them successfully if necessary.
In practice, the vast majority of cases take place without any problem and the patients are satisfied with the result.
Health Insurance coverage
As this procedure is considered purely for aesthetic purposes, no coverage is provided by health insurance.
Frequently asked questions
Does the procedure prevent pregnancy or breastfeeding ?
No. Pregnancy and breast-feeding are possible but can alter the result. A period of 6 months is recommended before or after surgery.
Can breast sag reoccur ?
Yes. With age the breasts tend to sag. Similarly, after pregnancy or weight loss, the results of the operation may be altered.
Can the procedure be repeated several times ?
Yes. A treatment for ptosis can be carried out several times in a lifetime.
Treatment of Ptosis and breast cancer.
The risk of breast cancer is unchanged after a ptosis treatment.
In some cases, the treatment of breast ptosis can lead to the discovery of breast cancer, either through systematic analysis of the gland that may be removed (anatomo-pathological exam) or through mammographic assessment conducted generally before the procedure.
Author: Dr. Christophe Laveaux
Specialist in aesthetic surgery - Antibes
Reproductions, even partial, of the texts are allowed on the express condition cite the author (Dr. Christophe Laveaux) with a direct link to the article mentioned.