Breast droop (Ptosis) is part of the normal ageing process, but it can also be made worse by pregnancy, breast-feeding or weight loss.
At Brisbane Cosmetic Clinic, we use Breast Lift surgery to help restore the breasts closer to their original position on the chest. Dr Konrat does this by moving the nipple-areola complex to their normal position, and tightening the breast skin envelope and the breast to improve shape and projection.
Breast implants or fat transfer may be used in conjunction with breast lift surgery, depending on the amount of breast tissue you have. Dr Konrat will advise you on what she thinks will be the best for you at your consultation.
Scars from Breast Lift surgery vary according to the technique used, but there will always be scars. There is always a scar either partially or completely around the nipple and there may be a scar that runs from the central point of the areola to the fold beneath the breast, and possibly one in the fold beneath the breast. At Brisbane Cosmetic Clinic, Dr Konrat uses techniques that help reduce scarring to a minimum.
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, and 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 the utmost importance in determining the quality of the scars long term.
Mammograms and self-examination will not be affected by having a breast lift procedure. Breast-feeding may or may not be affected depending on the type of surgical technique performed.
Breast implants or fat transfer may be used in conjunction with breast lift surgery, depending on the amount of breast tissue you have. Dr Konrat will advise you on what she believes will be the best for you at your consultation.
It can take three months for you to be able to appreciate the final shape of your breasts. Breasts can continue to mature into their final shape and position, and scars can continue to fade for up to twelve months.
Dr Konrat performs Breast Lift surgery at a Day Surgery Hospital in Brisbane under general anaesthesia. No overnight admission is necessary, and you should be able to go home a few hours after your breast lift surgery.
The operation takes between 2-3 hours. It is a requirement that any and all breast tissue removed during surgery is sent to pathology for examination. This will incur a fee from the pathologist.
Drains: Rarely are drains required but if so, drains are removed either one or two days following the mastopexy procedure. Once you are awake, have had something to eat and drink and feel stable, you can be discharged home.
You will be wearing your special support garment. It is advisable 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.
Pre-Operation and Post-Operation Information
Below is the information you will be given to prepare for your breast lift surgery. You should read this carefully and make sure you understand all the instructions. You should ask Brisbane Cosmetic Clinic staff about anything that is not clear to you.
- You should have nothing to eat or drink (no sips of water) from midnight before your mastopexy surgery. Anything by mouth could cancel or postpone your surgery.
- Prescriptions: have your scripts filled prior to breast lift surgery.
- Constipation: to prevent constipation problems before or after surgery, we recommend Guardian Flakes cereal (from Coles/Woolworths).
- NO ASPIRIN, IBUPROFEN OR MEDICATION CONTAINING ANTI-INFLAMMATORIES.
- No vitamin E internally (pill) or externally (on the skin) should be used a minimum of seven days prior to surgery.
- Arnica tablets (homeopathic remedy that will help to minimize bruising and swelling) should be taken. Two tablets, three times per day sucked or chewed (not swallowed) for seven days prior to surgery and seven days after surgery. Please purchase 84 tablets (6×14 days) from your chemist.
- Any tablets that you are taking should be reported to the doctor and then taken as instructed.
- No alcohol should be taken within 48 hours prior to surgery. Alcohol impairs clotting.
- If you smoke, we strongly advise that you stop. Nicotine markedly impairs the healing process by encouraging infection and poor circulation.
- The morning or evening prior to your surgery you are requested to wash your hair and take a shower.
- Arrange for transportation to and from the hospital. Perhaps include a pillow and blanket in the car for your comfort post-operatively.
- Arrange for someone to stay with you at home for 24 hours after your breast lift surgery.
- If you experience any signs or symptoms of illness prior to your operation, you need to call us. Early treatment could prevent postponing your surgery.
Day of Surgery
- No food or liquids from midnight the evening before your surgery.
- It is important to wear comfortable clothes, preferably something that buttons down the front.
- Please remove your nail polish, contact lenses and do not wear jewellery and ensure you do not bring valuables with you to hospital.
- Dr Konrat will meet you to review your mastopexy surgery. She will be able to address any of your concerns. Your consent forms are signed at this time.
- After you have been admitted to the Day Surgery Hospital, your anaesthetist will consult with you prior to your surgery. Please advise him/her of any medical conditions or tablets you may be taking or any allergies you are aware of.
- After the surgery, your breasts may feel bruised, swollen or tender. All of the bruising and swelling can take up to 4 weeks or more to resolve. DO NOT BE UNDULY WORRIED ABOUT THIS.
- NIPPLE CHECKS: For the first 24 hours post operatively, check your nipples. There is a hole in your dressing for this purpose. Press lightly: if nipples are dark blue or purple, call our Office or After Hours Emergency numbers immediately.
- You have had a surgical procedure and you MUST expect discomfort. Your first night at home and/or your second or third post-operative days are likely to be your most uncomfortable times.
- Panadol and Celebrex may be prescribed for post-operative pain. It is important to take the tablets with food and plenty of water.
- You will also be prescribed a course of antibiotics (e.g. Keflex – one tablet three times a day). Please ensure you finish the course.
- Please sleep from side to side – not on your back – for the first two weeks following your mastopexy surgery.
- A small water resistant dressing will cover your wounds. Please do not remove these until you see the nurse/doctor at your first post operative checkup. You can get this wet and shower as normal the day after surgery, but you may not swim, spa, bath or submerge for one month following the procedure.
- Please pat your dressings dry with a towel. Do not blow dry.
- On day 10-14, any remaining stitches will be removed, if required. At this visit your dressings will be changed and you will be given special surgical tapes to be worn over your scars. You will change this surgical tape yourself once a week for 6 weeks, for healing purposes. Any questions in regards to when you can resume physical exercise, housework, etc., will be answered at your consultation.
- You may experience numbness in some areas of the breast. This may take several weeks or even up to 9 or 12 months to return to normal.
- If there is excessive bleeding, swelling, or pain unrelieved by medication, or if there is extensive bruising, or the nipples are dark blue or purple, please call Dr Konrat at the clinic on 07 3391 5710 or on the after hours mobile phone.
- If you have any questions pre- or post-surgery, we welcome the opportunity to assist, and are available to support your needs every step of the way.
Usually this procedure is day surgery, but requires at least 2 – 3 days of rest, with mobilisation on the hour each hour during the day. On discharge, go home and rest. Have someone drive you and stay with you overnight. When resting, flex calves by pointing toes towards the ceiling then towards the ground. This will maintain leg circulation and avoid clots in the veins of the legs. Do this 10 times per hour. Start gentle mobilisation as soon as possible.
All surgery, including cosmetic surgery, carries risks. Although the vast majority of Mastopexy patients do not suffer complications, you should not undergo Mastopexy (Breast Lift) surgery without understanding the risks involved. There are two types of risk; those that apply to any kind of operation, such as bleeding, anaesthetic risk and wound infection; and those that apply only to Mastopexy (Breast Lift) surgery.
If you have questions after reading this information you should discuss them with Dr Konrat at your consultation.
The following explains some but not all of the risks specifically associated with Mastopexy (Breast Lift) surgery.
- 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. Post-operative haematoma (unwanted blood collecting under the skin and breast tissue) and infection may occur. This can lead to delay or complete failure of the healing process. This may require an operation to drain either the infection or the collected blood. This may have an adverse outcome on the final quality of the result of the operation. Antibiotics may also be required.
- Nerve sensation: There may be a loss or reduced sensation in the nipple and areola following this procedure. Although this is usually temporary, sensation may take several months to return to normal or near normal. In some cases despite the nipple and areola remaining attached to their nerve supply throughout the procedure, the loss of sensation may be permanent. If the nipple and areola are removed and grafted into their new position, the loss of sensation is always permanent.
- 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. The operation is planned in such a way as to try and ensure an adequate blood supply is maintained to all the remaining parts of the breast (skin, fat, breast tissue and nipple).
- On some rare occasions the circulation is inadequate and some of the tissues may die. Although this is uncommon, it is more likely to occur in patients with large breasts and patients with very poor circulation. This may mean that the surgeon may have to compromise and alter the size and shape from that which is desired in order to maintain an adequate circulation.
- In rare cases, the nipple and areola tissue can lose its blood supply and die. Reconstruction in the form of a skin graft from another part of the body will be required to rebuild the nipple and areola at a later stage.
- Scars: There will be significant and obvious scars in the early months after surgery. The prominence of these scars will gradually reduce with time. The shape of the scar will involve a circle scar around the nipple, a vertical scar passing below the nipple downwards, and, depending on the surgical technique, rarely there may be a curved horizontal scar which may be long, and passes near the mid-line in front to outside the breast near the armpit.
- The horizontal part of the scar is long following large reductions, and would normally be visible at each end but usually only on close inspection. The vertical scar usually fades and has a tendency to be slightly stretched.
- Sometimes the scars may be more thickened than normal and this may be associated with them becoming red, thick and itchy. This is called a keloid scar. The scars can usually be improved by a second operation if desired. A surgical fee and associated day surgery costs will be incurred.
- The operation always leaves behind a scar in the pre-decided area. Very rarely, additional incisions or longer incisions may have to be used to achieve optimal results. Like all surgical scars it may be initially noticeable. It may take 9 to 12 months for the scars to improve. Occasionally, the scars may be persistently red, itchy, lumpy or keloid like for a long time and they may need some treatment for improvement.
- Generally speaking, taping the scar for the first 4-6 weeks after surgery and avoidance of over-activity and straining would allow the scars to mature early.
- Dog Ears describes a characteristic puckering of the skin that can occur after surgical wound closure. They are very common. If desired, these can be treated with revisional surgery. A surgical fee and associated day surgery costs will be incurred.
- Asymmetry: Some asymmetry of breast shape and size is likely to occur, and the position of the nipples may vary slightly. Every effort will be taken to keep this degree of difference to a minimum. Despite careful planning, occasionally, there may be asymmetry in the scars, levels of the infra-mammary fold, levels of the nipples or breast shapes. Many times this is related to pre-existing breasts asymmetry, but not well appreciated before surgery. Frequently some of these may be corrected by judicious use of compression supporting bras or straps. Occasionally, if very obvious, they may need further surgery at a later date.
- Seroma formation: Seroma is collection of the fluid under the skin. It Is not an uncommon complication after surgery. Use of drains is common after this surgery and these are normally removed in the first couple of days post operatively. Wearing a compression garment for breasts (special bra) reduces the risk of this complication but does not completely avoid it. When it occurs, it may need aspiration (with or without) ultrasonic guidance during follow up visits on a few occasions or rarely a surgical drainage if it is significant or if there is an infection.
- Wound Breakdown or dehiscence: Very occasionally there may be a breakdown in the wound edges, particularly near the junctions of the vertical and horizontal scars. This is a temporary nuisance and requires regular dressings, but rarely makes any difference to the overall final result. If the breakdown in wounds is larger then PICO or V.A.C. Therapy will be commenced to promote fast healing and to decrease the potential for infection.
- Revision Surgery: Further operations may occasionally be required to improve the results. This is particularly true if any of the above named complications develop. You should not undertake breast lift surgery unless you accept the possibility that you may wish to have, or need to have, further surgery at some time in the future. If further surgery were required due to complications you will be required to pay fees as quoted by Brisbane Cosmetic Clinic.
After the Operation
- Day 1: The practice nurse will call the day after the surgery. If drains are in place they may be removed that day or the following day.
- Day 10 – 15: Some of your stitches or skin clips may need to be removed at 10 – 14 days post surgery.
- Surgical tapes will cover your wounds. These tapes must be left intact until your first post operative visit. After showering, pat dry with a towel, do not blow dry.
- Week 6: Post-Operative check-up.
- Month 6: Post-Operative check-up. All enquiries and in-between consultations are welcome.
CALL Brisbane Cosmetic Clinic IF YOU HAVE:
- Severe pain not responding to pain medication
- Significant swelling, especially if much more one side than the other, fevers, shivers, feeling very unwell.
- Drains (if you have them) that fill rapidly and have to be emptied more frequently than twice a day
- Nipples that are dark blue or purple