
Over the years, factors such as
pregnancy, nursing, and the force of gravity take their
toll on a woman's breasts. As the skin loses its
elasticity, the breasts often lose their shape and
firmness and begin to sag. Breast lift, or mastopexy, is
a surgical procedure to raise and reshape sagging
breasts--at least, for a time. (No surgery can
permanently delay the effects of gravity.) Mastopexy can
also reduce the size of the areola, the darker skin
surrounding the nipple. If your breasts are small or
have lost volume--for example, after pregnancy--breast
implants inserted in conjunction with mastopexy can
increase both their firmness and their size. If you're
considering a breast lift, this brochure will give you a
basic understanding of the procedure--when it can help,
how it's performed, and what results you can expect. It
can't answer all of your questions, since a lot depends
on your individual circumstances. Please be sure to ask
Dr. Rieger if there is anything about the procedure you
don't understand.
Sometimes the patient may require
implants also to achieve greater breast size in addition
to correcting the sag of the breast. If a complete lift
is required Dr Rieger stages the implant and lift
procedures at separate times. The lift is performed
first and then about 2-3 months or anytime later an
augmentation may be performed.
A recent article in the American Journal of Plastic
Surgery reviews the the logic behind this staging of
procedures. Click here to read this well written
article.
The best candidates for breast lift
A breast lift can enhance your appearance and your
self-confidence, but it won't necessarily change your
looks to match your ideal, or cause other people to
treat you differently. Before you decide to have
surgery, think carefully about your expectations and
discuss them with Dr. Rieger.
The best candidates for mastopexy are healthy,
emotionally-stable women who are realistic about what
the surgery can accomplish. The best results are usually
achieved in women with small, sagging breasts. Breasts
of any size can be lifted, but the results may not last
as long in heavy breasts.
Many women seek mastopexy because pregnancy and nursing
have left them with stretched skin and less volume in
their breasts. However, if you're planning to have more
children, it may be a good idea to postpone your breast
lift. While there are no special risks that affect
future pregnancies (for example, mastopexy usually
doesn't interfere with breast-feeding), pregnancy is
likely to stretch your breasts again and offset the
results of the procedure.

Over time, a woman's breasts
begin to sag
and the areolas become larger.
All surgery carries some
uncertainty and risk
A breast lift is not a simple operation, but it's
normally safe when performed by a qualified plastic
surgeon. Nevertheless, as with any surgery, there is
always a possibility of complications or a reaction to
the anesthesia. Bleeding and infection following a
breast lift are uncommon, but they can cause scars to
widen. You can reduce your risks by closely following
your physician's advice both before and after surgery.
Mastopexy does leave noticeable, permanent scars,
although they'll be covered by your bra or bathing suit.
(Poor healing and wider scars are more common in
smokers.) The procedure can also leave you with unevenly
positioned nipples, or a permanent loss of feeling in
your nipples or breasts.
Planning your surgery
In your initial consultation, it's important to discuss
your expectations frankly with your surgeon, and to
listen to his or her opinion. Every patient--and every
physician, as well--has a different view of what is a
desirable size and shape for breasts.
The surgeon will examine your breasts and measure them
while you're sitting or standing. He or she will discuss
the variables that may affect the procedure--such as
your age, the size and shape of your breasts, and the
condition of your skin--and whether an implant is
advisable. You should also discuss where the nipple and
areola will be positioned; they'll be moved higher
during the procedure, and should be approximately even
with the crease beneath your breast.
Your surgeon should describe the procedure in detail,
explaining its risks and limitations and making sure you
understand the scarring that will result. He or she
should also explain the anesthesia to be used, the type
of facility where the surgery will be performed, and the
costs involved.
Don't hesitate to ask your doctor any questions you may
have, especially those regarding your expectations and
concerns about the results.
Preparing for your surgery
Depending on your age and family history, your surgeon
may require you to have a mammogram (breast x-ray)
before surgery. You'll also get specific instructions on
how to prepare for surgery, including guidelines on
eating and drinking, smoking, and taking or avoiding
certain vitamins and medications.
If you smoke, plan to quit at least
two weeks before your surgery and not to resume for at
least two weeks after your surgery.
While you're making preparations, be sure to arrange for
someone to drive you home after your surgery and to help
you out for a few days if needed.
Where your surgery will be performed
Dr. Rieger prefers to perform the operation in a
state-of-the art accredited outpatient surgery center.
Types of anesthesia
Breast lifts are usually performed under general
anesthesia, which means you'll sleep through the
operation.
The surgery
Mastopexy usually takes two to three and a half hours.
Techniques vary, but the most common procedure involves
an anchor-shaped incision following the natural contour
of the breast.
The incision outlines the area from which breast skin
will be removed and defines the new location for the
nipple. When the excess skin has been removed, the
nipple and areola are moved to the higher position. The
skin surrounding the areola is then brought down and
together to reshape the breast. Stitches are usually
located around the areola, in a vertical line extending
downwards from the nipple area, and along the lower
crease of the breast. Dr. Rieger places most of the
stitches under the skin surface to improve the
appearance of the incisions. In most cases only simple
butterfly paper tapes or steristrips are placed on the
skin and only two or three suture require removal.

Skin formerly located above the
nipple is
brought down and together to reshape the
breast.

Sutures close the incisions, giving
the breast its new contour.

After surgery, the breasts are
higher and
firmer, with sutures usually located around
the areola, below it, and in the crease under
the breast.
Some patients, especially those
with relatively small breasts and minimal sagging, may
be candidates for modified procedures requiring less
extensive incisions. One such procedure is the "doughnut
(or concentric) mastopexy," in which circular incisions
are made around the areola, and a doughnut-shaped area
of skin is removed.
If you're having an implant inserted along with your
breast lift, it will be placed in a pocket directly
under the breast tissue, or deeper, under the muscle of
the chest wall.
After your surgery
After surgery, you'll wear a sports bra. Your breasts
will be bruised, swollen, and uncomfortable for a day or
two, but the pain shouldn't be severe. Any discomfort
you do feel can be relieved with medications prescribed
by your surgeon.
You'll need to wear this bra around the clock for three
to four weeks. The steristrips will be removed after two
weeks.
If your breast skin is very dry following surgery, you
can apply a moisturizer several times a day. Be careful
not to tug at your skin in the process, and keep the
moisturizer away from the suture areas.
You can expect some loss of feeling in your nipples and
breast skin, caused by the swelling after surgery. This
numbness usually fades as the swelling subsides over the
next six weeks or so. In some patients, however, it may
last a year or more, and occasionally it may be
permanent.
Getting back to normal
Healing is a gradual process. Although you may be up and
about in a day or two, don't plan on returning to work
for a week or more, depending on how you feel. And avoid
lifting anything over your head for three to four weeks.
If you have any unusual symptoms, don't hesitate to call
your surgeon.
Your surgeon will give you detailed instructions for
resuming your normal activities. You may be instructed
to avoid sex for a week or more, and to avoid strenuous
sports for about a month. After that, you can resume
these activities slowly. If you become pregnant, the
operation should not affect your ability to breast-feed,
since your milk ducts and nipples will be left intact.
Your new look
Your surgeon will make every effort to make your scars
as inconspicuous as possible. Still, it's important to
remember that mastopexy scars are extensive and
permanent. They often remain lumpy and red for months,
then gradually become less obvious, sometimes eventually
fading to thin white lines. Fortunately, the scars can
usually be placed so that you can wear even low-cut
tops.
You should also keep in mind that a breast lift won't
keep you firm forever--the effects of gravity,
pregnancy, aging, and weight fluctuations will
eventually take their toll again. Women who have
implants along with their breast lift may find the
results last longer.
Your satisfaction with a breast lift is likely to be
greater if you understand the procedure thoroughly and
if your expectations are realistic.

If your expectations are
realistic, chances
are you'll be satisfied with your breast lift.
call 316-652-9333 for a
consult
about Breast Lift in Wichita, Kansas.
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Brochure © 2003 American Society of
Plastic Surgery