Shape matters: Breast Lifting (Mastopexy)
Breast Lifting (Mastopexy)
Mastopexy is the medical term for procedures that raise the nipple and restore the shape of sagging breasts. According to Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson, about half of the women he sees for breast surgery at The Cosmetic and Restorative Surgery Clinic come to enhance the size of their breasts with implants. The other half aren’t looking for larger breasts. What they want are more shapely breasts. And some of them want the size of their breasts reduced.
A slight amount of ‘droop’ of a patient’s nipples (1-2cm) can, in fact, be improved with a breast implant, which gives lift as well as increased volume (see photographs). Often, the surgeon will choose an anatomic or teardrop implant to achieve the lift, but the lift is only modest.
If the breasts are sagging 3 to 6cm and the nipples point downwards, then more complex techniques are required. These techniques involve the excision of skin around the nipple areolar complex so that the nipple can be slid upwards. The blood supply, the nerve supply and, consequently, sensation in the nipple and breast are all maintained by this procedure. At the same time as the nipple is slid upwards, the breast tissue is reshaped, and the only scar that exists is around the nipple. This procedure is called the Benelli or Goes Mastopexy and its attraction is the absence or avoidance of a vertical or anchor scar underneath the nipple (see photographs).
Larger breasts, greater than a D cup, often sag and are associated with excessive weight gain in some patients.
Other women with large breasts but only a medium-sized frame, often suffer back pain, neck strain, rashes underneath the breasts and pain in the breasts; for these patients, an uplift is required as part of a breast reduction procedure. The breast reduction procedure often results not only in a scar around the nipple, as with the Benelli/Goes procedure, but also a vertical or sometimes a horizontal incision underneath the breasts.
Breast reductions entail more scars than other breast enhancement procedures (see photographs), but the scars fade with time. Only very occasionally do patients require a scar revision. Lasers can sometimes help in the postoperative period to lessen the redness of scars.
‘The best results with mastopexy are usually achieved in women with small, sagging breasts’
All breast reshaping (uplifting) procedures can be carried out under a light general anaesthetic or twilight anaesthesia on an outpatient basis. Sometimes a patient will be hospitalised overnight for a large breast reduction. Patients need one to two weeks off work and generally require six weeks before resuming full activities, including exercise and gym. Dr Hodgkinson insists that all his patients give up cigarette smoking before surgery – it has been well documented that patients who smoke before and during the postoperative phase, especially in breast uplifting procedures, can slow their healing and worsen scarring, so that scar revision is required.
Bigger breasts aren’t the main goal of good breast enhancement surgery. The real aim is a more shapely breast. For many women a lovelier breast is a smaller and less painful breast. Mastopexy involves complex and artful surgical techniques, which are in equal parts sculpture and surgery. So it pays to make sure your breasts are in good hands. acsm