Breast Lift (Mastopexy) is chosen by women who have sagging (ptosis) of the breasts and wish to improve their cosmetic appearance. The nipple-areolar complex is usually positioned lower than the inframammary fold of the breast and the skin envelope is quite loose. Breast ptosis is further characterized based on the vertical relationships of the nipple to the fold and the distribution of the glandular tissue to the fold. The type of ptosis that is present and the recommendations for aesthetic improvement are individualized. Mastopexy approaches therefore vary and may require limited or more extensive incisions, depending on the degree and type of ptosis that exists.
Portions of the outer layer of skin (epithelium) are removed in order to tighten the skin envelope surrounding the breast gland. A small amount of breast tissue is usually removed from the lowest portion of the breast to minimize tension and stretching. The nipple-areolar complex is shifted to a higher position when necessary. Mastopexy does not include the removal of significant breast tissue and therefore is not covered by insurance companies and health plans.
Occasionally, patients with ptosis and small breast volumes benefit from placement of a breast implant in conjunction with mastopexy. If a patient has small breast volume and wishes to avoid use of an implant, mastopexy will provide an improvement in nipple position and breast shape but leave a small volume breast
Mastopexy provides a high level of satisfaction in women who are felt to be good candidates when appropriate pre-surgical planning is combined with meticulous operative technique. Patients should be self-motivated and have reasonable expectations regarding desired outcome. Mastopexy is for many plastic surgeons an artistic, three dimensional procedure which allows for sculpting and shaping of the breast tissue and skin envelope. A formal consultation with a board-certified plastic surgeon is helpful for patients considering mastopexy. The following topics are typically covered during the office consultation:
- Medical and Surgical History
- Personal History of Breast Surgery, Breast Disease and Mammography
- Family History of Breast Cancer
- Occupation and Job Requirements
- Participation in Sports and Hobbies
- Patient Motivation and Expectations
- Examination of the Breasts Including Standard Measurements for Dimensional Planning
- Implant Selection
- Recommendations regarding the incisional approach
- Discussion of alternatives (if applicable), and/or adjunctive procedures
- Discussion regarding anticipated recovery and limitation of post-operative activities
- Recommendations regarding anesthesia care
- Follow-up Care in the Office
- Financial Requirements/Considerations
- Scheduling Surgery and Pre-Operative visits
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