Introduction

The fall and emptying of the breast or mammary ptosis, which is influenced by several causal factors that we will now comment on, is a problem in women that can be serious since it can greatly affect self-esteem and emotions, and must be treated.

Oftentimes, women who have had one or more pregnancies or who have had frequent weight fluctuations notice a loss of plumpness of the breasts, which appear to empty or sag, and it becomes a cause of discomfort and loss of self-esteem. Other times it is due to the aging of the tissues and the skin, due to weight and gravity, factors that together cause the breast to descend and empty. Let’s not forget to name the congenital problem that some young patients have with tuberous breasts or “conical and drooping” since puberty.

The breast continues to be the element of the female body that, above all, has a strong aesthetic and symbolic value in the psychology of women, and for this reason, breast surgery also occupies the first place in the statistics on the number of operations.

What is mastopexy?

The suffix “Lexi” in surgery indicates that something must be lifted or repositioned in its correct form. While “masto” indicates the anatomical part involved: the chest or breast in this case. This makes us immediately understand that the goal of mastopexy is to lift and reposition the breasts, which is why it is often referred to as a “breast lift.”

To perform this type of intervention, the surgical technique is performed that removes excess skin from the breast that can form after pregnancy, after breastfeeding, after weight changes, or simply due to aging and the passage of time. . The breast is also rounded and configured with the previous shape in its previous position.

In the same surgical act, many times it is decided to introduce a breast implant, what we commonly call prosthesis, or the patient’s fat, to achieve an adequate volume in the breast when it has been significantly emptied. The aesthetic result is further improved and the most permanent elevation in time of the upper breast pole is achieved.

Mastopexy is part of the group of breast surgeries related to other names such as:

Reduction mammoplasty
Breast reconstruction
Breast augmentation
Gynecomastia

What kind of women are candidates?

Mastopexy can be performed both in young women with premature problems who have reached the age of majority and who are in good health and older women. In case of being secondary to pregnancy and lactation, it is recommended to wait a prudent time of at least three or four months until the breast and the hormonal system have returned to normal.

Based on the data collected during the first consultation and the exploration of the patient’s anatomy and the characteristics of the breasts, the surgeon will determine whether the patient can undergo this type of surgery or not.

a renowned surgeon with more than 20 years of experience in breast surgery, if the patient wishes to perform a mastopexy, but is thinking of becoming a mother shortly, it is recommended to postpone the intervention until after pregnancy and breastfeeding. since these can modify the shape and size of the breasts. Likewise, if you want to lose weight, it is better to do it before the intervention since fluctuations in it can also change the shape of the breasts and increase excess skin. It also warns that when the patient has better skin quality, the result is better. and more durable over time than in patients with poorer skin quality, greater sagging, and even stretch marks. However, advances in surgery and improvements in current surgical techniques make these elements salvageable in most cases, generally achieving good and long-lasting results when a good surgeon or specialist plastic surgeon with great experience is chosen. in this field.

Mastopexy is recommended for all those women who perceive dissatisfaction with their breasts to the point of hurting their personal and relational life, especially in the presence of one or more of the following conditions:

Breast ptosis
Breast emptying
Asymmetry
Enlarged and drooping nipples or areolas
Causes and degrees of breast ptosis

Causes and degrees of breast ptosis

Breast loss called breast ptosis is due to several causes :

Number of pregnancies
Overweight
Changes in weight
High breast volume
Aging of tissues and skin
Menopause

There are three degrees of breast ptosis:

First degree, mild ptosis: The breast appears slightly empty, with the nipple and areola above the breast fold line.
Second degree, moderate ptosis: emptying begins to be more evident, and the nipple and areola are lowered to the same level as the breast groove.
Third-degree, severe ptosis: loss and considerable emptying of breast volume, the nipple and areola are located below the submammary groove

breast is not the same as an empty breast since sometimes, after breastfeeding, the mammary glands atrophy and give the breast the appearance of emptiness and, therefore, falsely sagging (pseudoptosis).

How to find the right surgeon?

The first step, and one of the most important, is to have a true specialist in Aesthetic and Reconstructive Plastic Surgery, with said qualification approved by the Ministry of Health

The second step is to find a specialist with enough years of experience in breast surgery, seek opinions from other patients who have undergone surgery with this surgeon, and see images of their results.

What will the first visit be like?

During the first consultation, the surgeon will analyze the general state of health of the patient, asking questions about their medical history, familiarity with certain pathologies, and lifestyle, to determine if surgery can be performed and with what procedures.

During the visit, the doctor will evaluate the size and the initial shape of the breast, as well as the shape of the areola and the nipple. Other elements to take into account are the quality and degree of tone of the breast muscles and tissues. All of this is necessary for the surgeon to understand the degree of breast ptosis and establish the goals that best suit the physical conformation of the patient to obtain a natural result.

Furthermore, at this stage, the surgeon will also be able to establish whether, in the case of breast hypotrophy or poor breast development, it may be advisable for the patient to insert the breast implants or fat micrograft to shape the breasts or to correct any asymmetry or volume. According to the surgeon, prostheses are recommended when the flattening of the upper area of the breast has such a degree of ptosis that it cannot fill itself.

How it is performed?

The patient entered the agreed clinic on the same day of the intervention and spent the night there with the appropriate surgeon, anesthesiologist, and nursing team care. The procedure lasts approximately 2-3 hours and is performed under general anesthesia.

According, incisions can be made by following 3 different techniques:

Periareolar incision or round block: follows the perimeter of the areola and is indicated for cases of falls or mild ptosis. It is often used in combination with prosthetic insertion to enhance the shape and volume of the breasts.
Periareolar and vertical incision: it is made following the perimeter of the areola and then it is advanced vertically downwards, towards the breast groove. It is recommended for patients with a moderate degree of ptosis.
Anchor or inverted t-incision: it is recommended for patients with severe sagging and excess skin on the breasts, which cannot be satisfactorily corrected with other smaller incisions. This is the most used technique for cases in which breast reduction must also be associated.

What to do before the operation

Preoperative preparation is no different from that planned for any other breast surgery, so the same recommendations should be followed:

Preparation during the previous days with a good diet and with adequate vitamin supplements if required. Fasting from the night before the operation if the intervention is carried out in the morning.

It is advisable to go to the clinic with a trusted person, not only because you may need help to perform some movements, but also, and above all, not to face the surgery alone and to have the psychological support of a family member or friend.

Avoid blood thinners such as aspirin and some anti-inflammatories, alcohol, and tobacco (the latter for at least 2 weeks before the date of the operation, although sometimes a month is required). On the one hand, so as not to stimulate the risk of bleeding, and on the other, so as not to compromise the healing of the incisions.

The postoperative

In mastopexy without a prosthesis or with fatty tissue, the pain perceived by the patient is minimal since the operation involves only the remodeling of the superficial tissues, that is, the skin, fat, and the gland. In prosthetic mastopexy, on the other hand, a feeling of discomfort or tension may be felt in the chest, which can still be controlled by taking pain reliever medications prescribed by your doctor.

In general, during the postoperative period, a pressotherapy garment or special bra should be worn for about a month. Regarding the postoperative days of rest, these vary depending on the type of intervention and whether submuscular implants have been inserted or not, as well as the type of work performed by the patient. But in general, we can say that you can resume work after 1 week long as it is sedentary, or after 3 or 4 weeks if it involves more effort. You should not drive or make great efforts for 15 days and begin to lead a more or less normal life from the first month. The usual exercise can begin after this first month but when greater efforts or chest work is required, it is better to wait three months.

If posterior lymphatic drainage is necessary to recover better after surgery, it can be started after the first week. Generally, the surgeon usually indicates between 5 and 8 sessions depending on the case and subsequent inflammation.

Finally, it is advisable not to sleep on your stomach for at least a month to avoid the risk of putting excessive pressure on the chest and scarring.

After the operation, the chest will be swollen and bruises may appear. The makes a very thorough intraoperative intravascular coagulation and special care in suturing the scars to minimize the risk of complications and less bruising and inflammation following surgery. It also considers postoperative care and feeding the patient very important to achieve a better and lasting result. During the visits before and after the surgery at EónCLINIC, a great deal of interest is taken in this care and in instructing the patient on how they should be carried out both for the care of the skin and the scars and general nutrition.

Results

The final result and the new breast shape are visible from the first week, but we will need an appropriate time for the breasts to settle, and take their final shape and the results are natural.

The ISAPS reminds us that the results may be different from one patient to another and although it is an operation that offers a variable lasting result depending on factors such as aging, pregnancy, the type of lifestyle and nutrition, as well as the increase or weight loss, which could alter the shape of the breasts for years. The insertion of prostheses to complement the mastopexy, in general, offers more stable results over time and greater projection in the upper breast pole.

Risks and complications

Like all surgical procedures, this type of surgery must be performed by expert surgeons who know how to avoid the appearance of risks and complications and who are prepared to intervene appropriately if they appear.

Among the side effects and risks associated with mastopexy or breast lift, the reports the following:

Infections
Bruising
Seromas
Keloid or hypertrophic scars
Hypersensitivity
Necrosis
Asymmetry of the nipples or breasts
Permanent abnormalities of sensation

frequently asked questions

What results can be obtained? The results are always very good and allow the desired volume and shape to be achieved, contrasting the signs of aging.
After how long do I see the results? An appreciable result after 2 months, a definitive result after 6 months.
Can breast stretch marks be removed with a mastopexy? Only stretch marks included in the removed skin area are removed, the others remain.
What are mastopexy scars like? Scars are permanent, but in most cases they fade and improve significantly over time. The predisposition of the patient is very important.
Can breast ptosis be prevented? It is very difficult to prevent it, avoiding excessive weight changes and wearing support bras are the only weapons available, since the tendency to ptosis is physiological.
What are the risks and complications? Complications are rare (bruising, infection) and generally respond to proper treatment.
Is hospitalization necessary after breast lift? No, if it is limited to the extraction of the skin, while in the case of glandular mastopexy an admission of 1 or 2 days is required.