A lot of women find that they lose breast volume after pregnancy and breast feeding, or weight loss, leaving them with loose skin – breast ptosis (drooping breasts). While a breast lift (mastopexy) can remove the loose skin, lifting the breast into a higher position, if you want to restore or increase the volume, then breast augmentation can be performed at the same time as the lift.
A breast lift (mastopexy) together with breast augmentation is performed under a general anaesthetic, with the operation taking 2-3 hours*. It is usually performed as a day-stay or overnight-stay procedure in Sydney*.
Following a mastopexy (breast lift) or breast augmentation it is important to have restricted light activities, with no lifting or heavy duties for 7-10 days. Most patients may drive again and return to work within 10 days after the surgery*. Heavy activities and sport should not be undertaken for at least one month following the surgery*.
*Note results vary from patient to patient
Frequently Asked Questions
If you have loose skin or mildly droopy breasts, which commonly often occur after pregnancy, breast feeding and weight loss, breast implants alone may be used to correct these problems, but with larger amounts of loose skin you may need a breast augmentation to restore the volume with a breast lift (mastopexy) to remove the loose skin. Breast augmentation and lift (mastopexy) may also be used to improve volume differences between your breasts if this is bothering you.
Breast augmentation and lift (mastopexy) can be performed at any age once your breasts have stopped developing (often about 16-18 years of age). If you are about to have children soon then you should wait until after pregnancy and breast feeding, as these often change your breasts and change the result of breast augmentation and lift (mastopexy) – if you are young and this is many years away then this is not an issue. Many patients also have breast augmentation and lift (mastopexy)after having children.
A breast augmentation and lift (mastopexy) does not affect your ability to breast feed as the breast tissue itself is not altered – it is important to realise that only about two-thirds of people can successfully breast feed even if they have not had breast surgery.
A breast augmentation and lift (mastopexy) is not permanent, but usually lasts 5-10 years*. How long it lasts depends on the size of your breasts (larger breasts drop faster if they are not well supported), weight fluctuations, hormonal changes and ageing. Even if your weight is stable then hormonal changes such as pregnancy, breast feeding & menopause can cause your breasts to change, possibly requiring another operation. Also, as time goes on the chance of having something happen to the breast implants also increases*.
Whatever type of breast lift (mastopexy) you have there will be a scar around the areola. With larger amounts of loose skin, you need a scar vertically down from the areola to the crease under the breast, and patients with very droopy breasts also need a scar that runs along the crease under the breast.
Most breast implants placed underneath the pectoralis major muscle, as this gives a more natural shape, a lower chance of long-term problems such as capsular contracture and rippling, and it is easier for mammography.
Breast implants are available as round or shaped implants – which one is right for you depends on many factors such as the result you are trying to achieve, how thin you are, how much breast tissue you have naturally, what shape your breast is and what size implant you want. If you are thin and want a natural result, so that no one knows you have breast implants, a shaped implant may be the best choice. If you have a reasonable amount of breast tissue before the surgery or want more upper pole fullness, then a round implant may be a better choice. Dr Charles Cope will discuss these options with you.
Modern cohesive silicone implants have had a textured surface for 30 years, with far fewer problems than the old type of smooth implants that were used in the 70s and 80s. The commonest cohesive silicone implants used in Australia are produced by Mentor (owned by Johnson & Johnson), and have a long track record. There are newer modern versions of the smooth silicone implants (e.g. those made by Motiva), which some patients are choosing because of the rare risk of BIA-ALCL (breast implant associated anaplastic large cell lymphoma), which is associated with textured breast implants. Dr Charles Cope will discuss these options with you.
Modern breast implants have been around for 30 years with few problems; however, they do not last forever. As time goes on the chance of having some problem with your breast implants increases – possible problems include capsular contracture, implant displacement or movement and rupture. On average implants last 10-15 years, with 2-3% of people needing another operation every year*. If you are lucky implants can last 30-40 years without problems*.
There have been increasing reports of a rare form of cancer associated with textured breast implants – BIA-ALCL (breast implant associated anaplastic large cell lymphoma). This is rare (estimates run at about 1:36,000) – you are much more likely to be killed in a car accident (1:6000 per year in NSW)
As time goes on the chance of having some problem with your breast implants increases – possible problems include capsular contracture, implant displacement or movement and rupture. On average implants last 10-15 years, with 2-3% of people needing another operation every year*. If you are lucky implants can last 30-40 years without problems*.
Recently increasing number of patients are having small volume breast augmentation performed using fat transfer alone. A cup increase in breast size can often be achieved with one procedure (much less than the average increase in size achieved with breast augmentation with implants), so often multiple fat transfer procedures (sometimes even 3 or 4) are required to achieve the result usually achieved with a breast augmentation with implants and lift*.
The operation is performed as a day-surgery or overnight stay procedure in an accredited hospital, depending on what you are like with anaesthetic recovery.
It is normal for scars to be red, lumpy and obvious for 6-8 weeks after surgery. After this they gradually fade, with most people’s scars being white by one year, although uncommonly this process can take 2 or more years*. The simplest way to help this process is to keep tape such as Micropore tape or silicone tape on the scars for the first 3 months or so. An alternative to this is to massage the scars. Uncommonly, scars stay red and thick for months, requiring other treatments such as steroid injections or vascular lasers to help them fade.
During the first week after surgery you need to rest and take things quietly at home. When you go home there will be waterproof dressings covering your breasts, which normally stay on for one week, allowing you to shower normally. Most people find these dressings supportive, but if you find it more comfortable to wear a supportive sports bra that’s fine. Some people feel well enough to drive to the postoperative visit, which is usually 5-7 days later*. Most people return to office work within 10 days after breast augmentation and lift*.
For most people it is 4 weeks until they are ready to return to sport and full activities*.
*Note results vary from patient to patient