James A. Rieger MD -Board Certified Plastic Surgeon -Wichita,Hutchinson,Salina,Newton,Garden City,Dodge City Kansas

Breast Mastopexy ( Lift )                                                                   Free Consultation Visit at our Plastic Surgery Office

breast lift 

If you are considering a breast lift .......

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.

Sometimes a patient wishes to have the breast implants removed and then have a breast lift. Many of these patients choose implants that were too large in size originally and then over the years the breasts developed ptosis(sag) due to gravity. Some of these patients now simply wish to go to a smaller lifted "perky" shape and contour. The breast implant removal / explant procedure sometimes will involve removal of the capsule (the collagen envelope surrounding the implant) especially in the case of a older ruptured silicone breast implant. The lift can usually be performed at the same time as the removal (explant) of the breast implant. Sometimes the lift will be performed at a future time if a significant capsule removal is required. The options for breast implant removal will be reviewed in the office during a private consultation.

Our practice philosophy on lifts, implants and staging: The best long term results are achieved by first having a lift and achieving a tight youthful firm shape and later on placing implants. The reason is simple – the lift tights by removing loose skin, an implant expands. The goals are opposing each other. Therefore it is mathematically impossible to obtain as tight a lift if they are performed at the same time which may lead a sagging breast, need to use very large implants to fill loose skin and a higher risk of losing the nipple areola. The exception is when only the nipple areola needs a lift and not the breast itself. In that case a crescent lift can easily be done at the same time as augmentation. This technique involves removal of a crescent shaped area of skin above the areola concealing the scar at the edge of the areola. The nipple areola is then lifted up into its new higher position. Note:The crescent lift is not a substitute for a complete lift for significant breast sag. In these cases the best long term results are achieved by first having a lift and achieving a tight youthful firm shape and later on placing implants. See the photo albums on lifts and crescent lifts.

  A recent article in the American Journal of Plastic Surgery reviews the the logic behind the staging of the breast lift and breast implant 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. "Mommy Makeover" includes a wide array of cosmetic surgery options, including breast lift, breast augmentation, tummy tuck, body sculpting with liposuction and skin rejuvenation procedures. These procedures, which can dramatically improve how you look and feel.

before breast lift image

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.

 To improve the appearance of incision scars, Dr Rieger uses a new skin closure technique that does not require old fashioned metal staples.  This new technique uses the INSORB® Absorbable Skin Stapler which represents a revolutionary new skin closure modality. The INSORB® Absorbable Staple is comprised of a co-polymer which is absorbed over a period of 4-6 weeks. In most cases only simple butterfly paper tapes (steristrips) are placed on the skin and in most cases no sutures require removal ! 

breast lift incisions

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

breast lift closure pattern of scars

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

after lift image                breast lift before and after photos

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.

after mastopexy with clothes

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