A breast lift, or mastopexy, is performed as an outpatient procedure under general anesthesia. The procedure typically lasts one to three hours. After one or two hours in the recovery room, the patient is discharged to home. Patients are instructed to relax, but bed rest is not necessary. In fact, we prefer that you move around some. You may eat anything you want right after surgery. You may shower that day or the next day. There is very little wound care needed.
The incisions are covered by strips of 1″ paper tape. There is a large clear plastic dressing over the lower half of the breast. All of this will be removed approximately 10 days after surgery. There are usually only one or two sutures that need to be removed. The rest are buried under the skin and will eventually dissolve. Drains are typically not necessary. A surgical bra is worn for four weeks around the clock. Patients typically are off work for three to seven days. There are no restrictions after three weeks postoperatively. It usually takes 6 to 12 weeks for the breasts to achieve their final shape.
As one of the main concerns with mastopexy is scar quality, we have a special protocol that we use for the breast scars. When you are seen 10 to 14 days after surgery, we will remove the paper tape that we placed on the incisions in the operating room. Then, we will apply a clear plastic dressing called Tegaderm to the scars. You will be instructed to leave this on as long as possible. We would like for you to use the Tegaderm for a total of three months. Usually it will require changing every three or four weeks. The Tegaderm applied to the scar at the fold beneath the breast may require changing more frequently than the Tegaderm applied around the nipple. We have found that the use of Tegaderm for three months after surgery significantly improves scar quality.
Pain after mastopexy is usually very moderate. Often non-narcotic analgesics are all that is required. This allows for a faster recovery and reduces the side effects that are often seen with narcotics such as Demerol and codeine.
Early after surgery, the breast skin will be tight. The upper portion of the breast will be full, and perhaps rounded. The bottom portion of the breast will be flattened. This shape is temporary and as time goes on the upper portion will flatten and the bottom portion will fill out. As it does so a more desirable shape will be achieved. Unfortunately, the skin may continue to stretch and the breast may continue to sag beyond this desired endpoint. However, it will not return to the position and shape that it started from before surgery.
Tightening the breast skin forces the tissue into a smaller volume. It becomes more dense or firmer. This firmness is due to the external compression by the skin instead of a gain of internal cohesiveness by the breast tissue. Since the skin is weak to begin with, the early tightness is only temporary. If an implant is used the resulting tightness of the breast will depend on how much of the final breast comes from natural tissue and how much comes from the implant.