Breast Lift

A patient with grade 1, 2, or 3 ptosis who wishes to reposition her NAC and breast tissue to a more youthful position may be a candidate for the procedure.

Women who smoke, have a high risk of breast cancer (scars may make reading mammograms difficult) or are unwilling to accept scars on their breast, a potential decrease in nipple sensation or the ability to breastfeed should not have this procedure. Also, women with very large breasts who only want a lift will ultimately be disappointed because of a high rate of recurrence unless a breast reduction is performed.

The risks include unattractive scars, loss of nipple sensation, numbness on the breast skin, asymmetry, inability to breastfeed, loss of nipple, and most commonly, recurrence of ptosis. The factors which caused the problem initially, (aging skin, heavy mound, pregnancy, etc,) may be present after surgery so that the recurrence of ptosis is very possible if not likely.

The options for a breast lift are dependent on the position of the nipple and the goals of the patient and surgeon. With significant ptosis, many incisions will have to be made which will leave a scar around the nipple, from the nipple to the breast fold, and along the breast fold. In a patient with less ptosis, the size of the scars can be reduced because less skin is removed. An additional option is to place a breast implant below the pectoralis (chest wall) muscle which simultaneously enlarges and lifts the breast. This may be done at the same time as the lift or 6 to 12 months later depending on the particular circumstances.

Most surgeons, including Dr. Wigoda, will use general anesthesia.

The scars are usually visible but may heal so that they are not very noticeable. The scars may extend around the areola, down to the breast crease, and under the breast. The scars will typically lighten over one year.

This is an important point to discuss with Dr. Wigoda. You can be made larger with an implant, left the same size, or made smaller.

After surgery, it is expected that the breasts will have a moderate amount of swelling. This swelling will resolve over 2 to 4 weeks. The swelling and pain may worsen for a short period during the first menstrual period after surgery. The breasts will appear slightly larger than they will ultimately be because of this swelling. The scars will also appear darker initially. Both breasts will have some bruising although it is generally mild and resolves over 1 to 2 weeks. The vast majority of patients report the pain as very tolerable. For the most part, all of the pain and discomfort resolves completely with time, generally 2 to 4 weeks.

Yes. There will be some scar formation on the inside of your breast. A mammogram done after surgery will very likely look different than one before surgery. You should obtain a mammogram approximately 1 year after surgery for a new baseline. Afterward, the frequency of mammograms will depend on your age.

Because for the most part, the connections between your breast tissue, breast ducts, and nipple do not interfere with a lift, your ability to breastfeed should not be affected.

Unfortunately, as you age, your skin ages and loses its elasticity. Because of this, the weight of your breasts will cause the breast ptosis to recur to some extent. The exact amount the breast will “drop” and the amount of time it will take for this to occur is very patient dependent. It will vary with age, skin quality, and size of breasts.

Dr. Wigoda may place one drain in each breast, depending on the technique used. The fluid will drain into a collection device that can easily be emptied. The drains will usually be removed 1 to 3 days after surgery. Drains are placed and removed at the discretion of the surgeon. Removal of the drains is not painful.

You will first have a consultation with Dr. Wigoda to discuss your particular case. Once you have decided to proceed with the surgery and have scheduled a date, you will return for a second visit at which time Dr. Wigoda will review the surgery with you, photos will be taken, consent forms will be signed, and further instructions and prescriptions will be provided. Full payment is made before surgery (or financing is arranged). You will have lab tests drawn and an electrocardiogram performed by your primary care physician (or we will recommend where to do this) one to two weeks before the surgery.

You will arrive at the office surgery center. You will not have eaten or drunk anything since midnight the night before. You will be checked in and your vital signs will be taken. You will put on a gown. An intravenous line will be started. Dr. Wigoda will mark your breasts with a marker. You may be given a sedative in your I.V. to help you relax before you are taken back to the operating room.

Bandages will be placed and your chest will be wrapped in an ace bandage. You will recover for 1 to 2 hours in the recovery room. You will then be driven home by a friend or family member. Your activities will be limited for the first few days. It is advisable that you not drive for at least 3 to 5 days after surgery. As the pain and swelling decrease, you will be able to resume normal activities. Dr. Wigoda will allow you to resume strenuous exercise with your arms after 4 to 6 weeks. You may be able to resume exercise with your legs (walking, jogging, bicycling, etc) slightly sooner.

After surgery, it is expected that the breasts will have a moderate amount of swelling. Most of the swelling will resolve over 2 to 4 weeks. The breasts will appear slightly larger than they will ultimately be because of this swelling. Both breasts may have some bruising although it is generally mild and resolves over 1 to 2 weeks. The amount of pain post-operatively is very patient dependent. Some patients will experience mild discomfort, particularly with raising the arms and with increased activity. It is unusual to have significant pain. The vast majority of patients report the pain as tolerable. Some patients have reported difficulty getting comfortable when going to sleep for the first 1 to 2 weeks. Patients may also experience hypersensitivity of their nipples. For the most part, all of the pain and discomfort resolves completely with time, generally 2 to 4 weeks.

For sedentary work with minimal physical activity, you can expect to go back after 3 days. For moderate activity, it will take about 7-10 days to be comfortable. For manual type labor with heavy lifting, you will need to wait 2 to 3 weeks. It will take 3 to 7 days to be able to drive safely, depending on your pain tolerance, how much pain medication you are taking (if any), and whether you drive an automatic or manual transmission automobile.

Dr. Wigoda will remove the sutures after approximately 7 days.

You may want to wait for at least one to two weeks until your incisions are well on their way toward healing. Early sexual activity may prolong your soreness and discomfort.

It will take 3 to 4 weeks for most of the swelling to resolve and probably 3 months for all of it to resolve. After this, you should have a reasonably good idea of what the final look will be. Your breasts may still be a little firmer than they will ultimately be, however. It often takes months before the breasts feel very soft and natural.