TESTS AND PROCEDURES

Mastopexy (Breast Lift)

March 16, 2019

Mastopexy (Breast Lift)

Two images of female chest showing right breast, comparing breast position before and after mastopexy, incision sites, and area of tissue removed.

Changes in breast shape and firmness often happen due to pregnancy, weight loss, or aging. Breast tissue and skin lose their elasticity (ability to expand or stretch and return to normal). This allows the breasts to droop and lose their shape. Mastopexy is a type of cosmetic surgery done to reshape the breasts if they have sagged. It is often called a breast lift. Having a breast lift changes the look of your breasts and may improve their appearance.

Preparing for surgery

Prepare for the surgery as you have been told. In addition:

  • Tell your healthcare provider about all medicines you take. This includes herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery.

  • Tell your healthcare provider if you think you may be pregnant.

  • Your healthcare provider may choose to delay your surgery if you are smoking. Smoking affects the blood supply of your skin, and can lead to wound healing problems. 

  • Don't eat or drink during the 8 hours before your surgery, or as directed by your surgeon. This includes coffee, water, gum, and mints. (If you have been instructed to take medicines, take them with a small sip of water.)

The day of surgery

The surgery takes about 2 to 4 hours. You may go home the same day. Or you may stay overnight.

Before the surgery begins

  • An IV line is put into a vein in your arm or hand. This line delivers fluids and medicines.

  • You will be given medicine to keep you pain free during surgery. This may be general anesthesia, which puts you into a state like deep sleep. (A tube may be inserted into your throat to help you breathe.) Or you may have sedation, which makes you relaxed and sleepy. If you have sedation, local anesthesia will be injected to numb the area being worked on. The anesthesiologist will discuss your options with you.

During the surgery

  • The healthcare provider makes incisions in the skin around your breast. You and your healthcare provider will have discussed incision sites before surgery.

  • The healthcare provider moves the breast tissue higher on the chest. Breast skin is tightened to hold the tissue in position. Any excess skin is removed.

  • The areola (dark skin around the nipple) and nipple are moved higher on the breast. If the size of the areola is being decreased, skin is removed. The areola is stitched into place.

  • The process is repeated on the other breast.

  • The incisions are closed with sutures, surgical glue, or both. A tube (drain) may be placed into an incision before it is closed. This drains excess fluid that may build up as the wound begins to heal.

After the surgery

You will be taken to a room to recover from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. You’ll be given medicine to control pain. When you’re ready, you will be able to go home with an adult family member or friend. Or, you may be taken to a room to stay overnight.

Recovering at home

Once home, follow any instructions you are given. Your healthcare provider will tell you when you can return to your normal routine. During your recovery:

  • Take any prescribed medicines exactly as directed.

  • Wear the special bra or bandage you were given before discharge as directed by your healthcare provider.

  • Care for your incisions and the dressing (bandage) over them as instructed by your healthcare provider.

  • Follow your healthcare provider’s guidelines for showering. Don't swim, take a bath, use a hot tub, or do other activities that cause the incisions to be covered with water until your healthcare provider says it’s OK.

  • When you shower, gently wash your incision sites. Then pat the incisions dry. Don’t apply lotions, oils, or creams to the incisions until after they are fully healed.

  • Don’t raise your arms above breast level for 10 days. And don’t lift, push, or pull anything heavier than 10 pounds for at least 7 days.

  • Don’t drive until you are no longer taking prescription pain medicine and your healthcare provider says it’s OK. When riding in a car, carefully position the seatbelt so that it doesn’t compress your breasts.

  • Be aware that breast swelling may last for 3 to 5 weeks. If advised by your healthcare provider, use a cold pack wrapped in a thin towel to relieve discomfort and control swelling. It’s important not to leave the cold pack on for too long, or your skin could be damaged. Put the pack over your bandages for no more than 20 minutes at a time. Then, leave it off for at least 20 minutes. Repeat this as often as needed during waking hours until swelling starts to improve. Don’t fall asleep with the cold pack on. If you’re not sure how to safely use the cold pack, ask your healthcare provider.

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

  • Extreme chest pain or trouble breathing (call 911 or other emergency service)

  • A fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Bleeding or drainage through the special bra or bandage

  • Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Pain that is not relieved by medicine

  • More soreness, swelling, or bruising on one breast than the other

  • Breast that is very warm to the touch

Follow-up

You will have follow-up visits so your healthcare provider can see how well you’re healing. If needed, stitches or drains will be removed during one of these visits. If you have any questions about your recovery, let your healthcare provider know. Also, be aware that your breasts may sag again over time. If you have any concerns about your surgery results, talk to your healthcare provider.

Risks and complications

Risks and possible complications include:

  • Bleeding

  • Infection

  • Blood clots

  • Excessive or visible scarring

  • Changes in breast or nipple sensation (temporary or permanent)

  • Potential for breasts to sag again

  • Breasts that are not the same shape or size

  • Not being happy with cosmetic result

  • Risks of anesthesia

Updated:  

March 16, 2019

Sources:  

Oncoplastic techniques in breast conserving surgery. UpToDate

Reviewed By:  

Fraser, Marianne, MSN, RN,Lickstein, David, MD