Mastopexy or Breast Lift is an operation designed to treat Ptosis ("drooping") of the breast by moving the nipple-areola complex to their normal position and tightening the skin envelope to improve shape and projection.

Ptosis or drop of the breast is a normal aging process and is a result of many factors, including the impact of post-pregnancy and breastfeeding, or the results of weight loss. The normal anatomical position of the nipple is in line with the fold under the breast (when looking at oneself side-on) or at the midpoint of the upper arm.

Many different surgical procedures are possible to improve breast ptosis and the scars vary according to the technique required. There is always a scar either partially or completely around the nipple. There may also be a scar that runs from the central point of the areola to the fold beneath the breast. Depending upon the surgical procedure needed, there may also be a scar in the fold beneath the breast. The scars are pink to start with and gradually fade over time. How well the scars heal and the quality of the scars depends on numerous factors such as: how well your skin heals, whether you are prone to hypertrophic or keloid scars (thickening). Any unnecessary tension or pulling on the scars can widen and thicken the scars, so post-operative care is of utmost importance in the quality of the scars long-term.

Breast-feeding, mammograms and self-examination are not affected, as the breast tissue itself is not removed; only the skin surrounding the breast tissue is reduced.

BEFORE SURGERY

Consultation, clinical history and examination, as well as photographs aid in the diagnosis of your concerns and help plan the appropriate surgical procedure.

A pre-operative visit is scheduled a week prior to the procedure to arrange blood tests and mammogram screening if none has not occurred previously.

• Stop smoking at least two weeks prior and for one month after your procedure.
  
  
• Eat a diet rich in veges, fish, fruits and salads.
  
  
• If taking aspirin, report to the surgeon and consult as to when to cease taking the aspirin prior to surgery.
  
  
• Do not take aspirin or anti-inflammatory medicines (Naproxen, Voltaren, Feldene, Brufen or Nurofen) 1 week before and 1 week after the procedure. These medicines can thin your blood and aggravate bruising or bleeding.
  
  
• You must also discuss any use of "Leisure drugs" with the surgeon at the time of consultation, as these could also have an impact on the success of the surgery.
  
  
• Pre-operative and Post-operative instructions are provided in the brochure given at the time of the pre-operative appointment.
  
  
• The clinical staff is pleased to answer any questions after the consultation and you are welcome to come back for a second consultation any time.

The Operation

The surgery is performed at a Day Surgery. No overnight admission is necessary. The operation is performed either under General Anesthesia or under Twilight Sedation and Local Anesthesia. Any drains required are removed the day following the procedure. The Operation takes between 3-4 hours. Once you are awake you can be discharged home. You will be wearing your special support garment. It is advised to wear your garment day and night for two weeks, then during the day for another three weeks. You must arrange for a relative or friend to collect you following your procedure. You will not be permitted to leave unaccompanied. We recommend that somebody be with you for the first 24 hours at home.

You must not drive yourself home or use public transport.

After the Operation:

Day 1
The practice nurse will call the day after the surgery. If drains are in place they may be ready to be removed.

Day 5-7
All dressings are left in place until this visit unless otherwise notified. Some sutures may need to be removed. Silicone patches will be applied to scars.

Week 6
Post-Operative check-up

Month 6
Post-Operative check-up. All enquiries and in-between consultations required are welcome.

Complications specific to Breast Lift / Mastopexy

Infection: Antibiotics are given at the time of surgery and for one week post-operatively. Further surgery may be required to improve scars if severe infection results.

Bleeding with collection of blood and bruising (haematoma) can occur. Further surgery to stop the bleeding may be required.

Nerve sensation: some numbness may occur, nipple sensation may be altered or lost, there may even be increased or decreased sensation to the nipple of breasts. It may take 9-12 months for full sensation to return.

Nipple Loss. This is the worst complication and is most common in very large breasts or in smokers or diabetics. If the nipple blood supply appears to be threatened at the time of surgery, conversion to free nipple graft may be necessary. This will be explained at the time of initial consultation.

Poor scarring and "dog ears". May need further surgery, usually after 3 months.

Main Risks of Any Surgery
Complications of General Anesthesia, Death, Heart Attack, Stroke, Bleeding, Infection, Allergies, Clots in legs (DVT).

Pre-operative Instructions

For morning procedures

NOTHING TO EAT OR DRINK AFTER MIDNIGHT.

For afternoon procedures

If your breast lift surgery is in the afternoon, you may have a normal breakfast at 6 am then no food or liquids until your surgery.

For all procedures

• Avoid recreational drugs for 1 week before surgery
• Avoid coffee and alcohol for 24 hours before surgery
• Stop smoking 2 weeks before surgery

THE MORNING OF YOUR SURGERY:

Skin Preparation: Shower or bathe with anti-bacterial wash. Wash your breasts and under your arms thoroughly. You may want to wash your hair, as it may be uncomfortable to lift your arms for a few days after your surgery. Do not apply any moisturizers, deodorant, talcum powder or other products afterwards. Do not use hairspray or perfume.

What to Wear: Wear simple, comfortable, loose-fitting, dark colored clothing that does not go on over your head. Wear tops with easy to fasten front closures such as buttons or zippers, bottoms that are easy to pull on and comfortable, easy-fitting shoes and socks. Do not wear new clothes. Sweat pants are ideal. No high heels or pantyhose. Do not bring jewelry or valuables with you. Bring a case for contact lenses if you wear them, and bring glasses if you need them, as it may be awkward to put your contact lenses in immediately after your surgery.

Going Home: It is essential that a Carer/relative drive you from the surgery to home. We recommend somebody be with you for the first 24 hours after surgery.

BREASTLIFT (MASTOPEXY): AFTER SURGERY

Day 1

• Immediately after your procedure you may experience
  
• Dizziness or light headed
  
• Shakes or tremors
  
• Nauseous
  
• Tired and very sleepy
  
• Breast tenderness/discomfort

REST: When you arrive home, be prepared to rest in bed for 2 hours. If you feel nauseated, lie on your back with your head down and remain still. Any sensation of nausea should pass by the morning after your surgery. After you wake up from the short rest period, begin to eat lightly and drink to replenish your body fluids. You may go to the bathroom with assistance as needed. If you feel fine, light activity will not harm you. Placing well-padded ice bags over your breasts may relieve discomfort significantly. You may feel uncomfortable for several days.

• Keep up fluids and healthy meals
  
• Rest
  
• For pain take 2 Panadol or 2 Digesic every 6 - 8 hours (no more than 8 in a 24 hours period)
  
• Do not drive whilst taking pain medication
  
• Take your antibiotic tablets as prescribed
  
• Do not shower

Day 2

• Some bruising, swelling tenderness and soreness

• Have a shower (have a carer close by in case you become dizzy)
  
• Wash your support garment if necessary and when dry put garment back on
  
• Continue pain tablets and antibiotics as prescribed
  
• Light activity is recommended to reduce the risk of leg vein clots.

• Antibiotics: Keflex (1 tablet three times a day). If allergic to Penicillin, another antibiotic will be prescribed.
• For pain: Take Panadol or Digesic 2 tablets every 6 - 8 hours (maximum of 8 tablets in a 24 hour period)
• Vitamin C: 1000 mg daily
• Zinc: 1 tablet daily
• For bruising: Arnica: (4 tablets under the tongue, 3 times a day)

• Aspirin for one week
• Alcohol, strong coffee
• Smoking for one month after the procedure.

1. Severe pain not responding to pain medication;
2. More swelling and/or pain on one side than the other; or
3. Drains that fill rapidly and have to be emptied more frequently than twice a day.

DON'T TAKE CHANCES! Always call your Doctor if you are concerned about anything you consider significant.

HYGIENE: Your Doctor usually uses dressings that are waterproof so you can shower. You can remove the sports bra for showering. If you have drains, do not sit in a bathtub with the drains underwater.

DRAINS: One drain may be placed in each breast at the time of surgery. If fluid accumulates during or after surgery, drains are used to promote fluid evacuation and speed healing. When the drain is inserted, the bulb at the end of each tube is compressed to create gentle suction. As the fluid collects in the bulb, it expands. Empty the drains by opening the plug at the top and pouring out the contents, twice a day or when the bulb is half full. After you empty the drain, squeeze the bulb to recompress it. Do not remove the bulb from the tubing. If the bulb fills rapidly after emptying, or you have to empty it more than twice a day, call your Doctor. You will be given a demonstration of drain care in the recovery room if you have drains.

• DO NOT CARRY ANY HEAVY WEIGHTS, BAGS OR PACKAGES for 4 weeks and refrain from any other physical activities that cause pain in the surgery area.
• Do not smoke for at least two weeks and preferably one month after your surgery for better healing.
• You may sleep on your back or on your side, but do not sleep on your stomach for 4 weeks.
• Do not sit in the sun or heat for 4 weeks. After that time, always avoid exposing your scars to the sun.

DRIVING: You may not be able to drive for about a week, although every patient recovers at a different pace. Our surgeon's recommendation to patients is not to drive until they are recovered sufficiently that if they were driving and had a car accident they could truthfully state that they did not suffer diminished capacity due to recent breast surgery. Make sure you are recovered enough to drive safely before you get behind the wheel. It is not safe to drive while taking oral pain medication.

HERBAL REMEDIES: Some patients report that arnica contributes to a reduction in bruising or swelling, resulting in reduced discomfort and edema, and improved healing. Ask us if you wish assistance in locating a source of arnica. Take arnica orally according to manufacturer's instructions on the packaging.

• Day 2
• Day 7
• 2 weeks
• 6 weeks
• 6 months

Finally
It can take up to 3 months to appreciate and reach your final shape.

We want you to have a speedy and uncomplicated recovery. If you are not sure about anything or have concerns please contact us sooner rather than later. Do not hesitate to phone us for advice at any time during your recovery.