Many women look forward to the benefits of losing 50 pounds, 100 pounds, or even more after having bariatric surgery, but most are unaware that this weight loss may cause their breasts to lose their fullness, firmness, and shape. When breasts lose volume, they droop and sag. This common condition is called ptosis (pronounced toe-sis). If you feel self-conscious about your breasts, you may want to consider plastic surgery procedures that can restore the shape of your breasts and give your breasts a more youthful and pleasing appearance.
A breast lift, also called a mastopexy, is a surgical procedure that minimizes sagging and restores the contours of your breasts. The procedure primarily removes excess skin and tightens the remaining skin on your breasts to provide better support for the breast tissue. The breasts are lifted to a more natural position on the chest wall, restoring volume to the upper portion of the breasts, and raising drooping nipples to the center of the breasts. The amount of lift you need depends on the degree of ptosis you have. This procedure can produce remarkable results, regardless of the degree of sagging.
Your surgeon will determine the best type of breast lift for you depending on the degree of sagging, your breast size, and the location and size of the nipple and areola.
Breast Lift with Augmentation
In some cases, a breast lift alone may not give you the volume and fullness you desire. When this is the case, you may want to consider a breast lift with augmentation, which involves the insertion of implants.
When combined with a breast lift, augmentation can dramatically reshape breasts that have lost their firmness. In most cases, this combined procedure produces a more attractive silhouette and better overall body proportions.
Depending on your unique physical characteristics and your goals, augmentation may be performed at the same time as a breast lift or may be scheduled for a later date. When the procedures are performed on different dates, the breast lift is typically performed first, with augmentation taking place as a follow-up procedure.
One of the benefits of having augmentation in addition to a lift, is that your incisions may be less extensive than if you were having a lift alone. Since the implant will add volume to the breast, it means that less skin may need to be removed. If you choose to have augmentation in addition to a breast lift, you will have several choices to make regarding the breast implants, which come in a variety of sizes, shapes, and textures.
Breast implants have either a smooth or textured outer shell made of silicone elastomer (a rubberlike substance) that can be filled with either sterile saline or silicone gel. Your surgeon can help you understand the differences, benefits and drawbacks associated with each.
Implants come in both a round shape and an anatomical (teardrop) shape that is designed to create a more natural-shaped breast and produce excellent results. Your surgeon will help you decide which shape of implant is best for you.
Size of Implants
Implants come in a wide range of sizes and are usually measured in cubic centimeters (cc), units of measure typically used for volumes of fluid. Implant sizes range from about 125 cc to more than 800 cc. As a reference, 30 cc is the equivalent of approximately one fluid ounce.
Selecting an implant size requires some planning with your surgeon. You may think all you have to do is tell your surgeon you want to be a C-cup or a B-cup; however, bra cup sizes aren’t standardized among bra manufacturers and may actually differ from style to style from the same maker.
Photos of women whose physiques you admire are probably the best way to communicate your goals. You can take pictures from magazines to your consultation. Many plastic surgeons also post their before-and-after photo galleries on their Web sites. If you see results that are close to what you hope to achieve, you can point them out to your surgeon.
Your surgeon will provide you with recommendations for size based on your physique and the amount of existing breast tissue you have.
Your Breast Lift with Augmentation Procedure
If you’re having your augmentation done after your breast lift, your surgeon will begin the procedure by re-opening a portion of the incisions made for the breast lift. He or she will create a “pocket” within the breast and insert the implant into the pocket, either below the pectoral muscle or above it.
The implant may be inserted prefilled, or it may be filled to the desired size at this time during the procedure. When an implant is filled during surgery, small adjustments in volume may be made to create an optimal shape. Once the desired contours have been achieved, your surgeon will close the incisions using absorbable or nonabsorbable sutures. At the end of your procedure, you may be fitted with an elastic binder or support bra.
Augmentation performed with a breast lift takes approximately two to four hours. When done as a follow-up procedure to a breast lift, augmentation typically takes only one to two hours.
Breast Surgery Facts
- Length of Surgery: 1 to 4 hours
- Type of Anesthesia: General or local with
- Hospital Stay: If breast lift is done alone,
it is often done as outpatient surgery. If it is
combined with other procedures, an overnight
stay may be required.
- Pain Level: Mild to moderate
- Drains: If used for breast lift, usually removed
in 7 to 10 days
- Compression Garment: Support bra for at
least 2 weeks
- Visible Sutures: Usually only around the
areola. Most sutures dissolve; very few, if any,
need to be removed
- Activity Restrictions: No strenuous activity
or heavy lifting for 2 to 6 weeks
- Return to Work: 1 to 2 weeks
- Final Outcome: 6 to 12 months
After Your Breast Procedure
After breast surgery, you will either go home the same day or spend one night in the hospital. You can expect to experience mild to moderate pain, which can be controlled with the pain medications prescribed by your surgeon. Your breasts will look swollen and may feel tight and firm. This swelling may increase in the first few days after surgery before beginning to subside.
Recovering from Your Breast Procedure
Your surgeon will give you specific post-operative instructions to help minimize your discomfort and speed your recovery. These instructions may include details on sleeping positions, wearing a support bra, emptying drains, personal hygiene, restricting activities, and returning to work.
After breast surgery, you will be advised to try to sleep on your back for at least one week. However, if you absolutely cannot get any sleep in this position, you may be allowed to sleep on your side. To help reduce swelling, prop up your upper body by placing a couple of pillows behind you while you are in bed.
After a breast lift with augmentation, you’ll be instructed to wear a support bra or sport bra at all times for about two to three weeks. After that, you can usually wear any bra that feels comfortable during the day, although underwire bras are not advised.
Showering is usually allowed once your gauze dressings have been removed, usually within a few days after your procedure.
After a breast lift with augmentation, you will need to avoid aerobic activities for two weeks and heavy lifting (greater than 10 lbs.) for about six weeks. In most cases, you can return to work in about one to two weeks.
Risks of Breast Procedures
As with any surgery, risks are involved with breast procedures. Potential complications can include visible scarring, temporary burning, tingling, or shooting pains, asymmetry, change in nipple sensation, and breast hardness.
When breast augmentation is performed in addition to a breast lift, there are additional risks, the most common being capsular contracture. When implants are placed in the body, a layer of scar tissue normally forms around the implant. In some cases, this scar tissue contracts and squeezes the implant. This capsular contracture can lead to excessive firmness and may change the shape of the breast or cause pain. Symptoms can range from mild to severe with the most severe cases requiring follow-up surgery.
Other risks associated with breast augmentation are rupture, deflation, leakage, hematoma, implant visibility, and surface irregularities, such as wrinkling.
How Long Will Breast Procedures Last?
Breast lifts permanently remove excess skin, and the results are typically long-lasting. Implants, however, are not considered lifetime devices and may require removal or replacement at some point during your lifetime.