Augmentation/Mastopexy is a procedure that is done to lift and enlarge the breasts. Incision patterns will depend on the amount of ptosis (droopiness), and excess skin. Depending on your anatomy and the amount of lift needed you may only need an incision around the areola, around the areola and down the front (like a lollipop), or around the areola, down the front, and under the breast (anchor pattern). Implants may be placed under the breast tissue or under the chest muscles. You may elect to use either saline or silicone gel implants. The method of breast lift, implant selection and size, along with surgical approach, will depend on your preferences, your anatomy, and your surgeon’s recommendation. Breast implants will add size and fullness to the upper portion of the breast, but breast augmentation alone is not used to lift the breasts. If you have droopiness to your breasts but you would also like them larger, you may need an augmentation/mastopexy (implant and a breast lift). If you have droopiness, but do not want your breasts any larger, a mastopexy alone might be the right procedure for you. If you don’t have any ptosis, but want your breasts larger, a breast augmentation may be what you need. Again, Dr. Lovelace will perform a personal consultation with you to determine what the right procedure is for you.
What are the other names for this procedure?
Breast Lift with Implants
How much pain will I have?
How much will it cost?
A price quote detailing the fees for the facility, anesthesia, any postoperative garments, and surgeon will be given at the consultation. Prices will vary depending on the time that is needed to do the procedure, and the complexity of the procedure. Dr. Lovelace will perform a personal consultation to determine what the right procedure is for you.
What is the hospital/surgery center time?
Surgery will be approximately 2-5 hours as determined on a case by case basis. Typically this is done as an outpatient procedure, but Dr. Lovelace may determine that an overnight stay in the hospital is needed.
What is the recovery?
Sutures that are placed are usually dissolvable and will not need to be removed. In some circumstances, a drain may be needed. These drains help prevent hematomas and seromas. If a drain is left in place, it is usually removed the 1-2 days after surgery. You will be placed in a compression garment after your surgery, and told to wear this at all times for 4 weeks, and then only at night for 4 more weeks. You will be expected to start walking immediately after surgery to help reduce the risk of blood clots. On average patients return to light duty work 3-7 days after surgery. You will be able to return to non-strenuous activity approximately 1-2 weeks after surgery. Approximately 8 weeks after surgery, strenuous activity will be allowed without restrictions. Scars will flatten and fade between 3 months and 2 years after surgery. No swimming pools, bath tubs, or hot tubs until the incisions are healed, and no scabs remain. You will be allowed to shower 48 hours after your procedure and wash over your incisions with soap and water. Your implants will be high postoperatively secondary to muscle spasm, but will drop down into position approximately 2 months after your procedure. Final bra size can be determined within 8-12 weeks.
What medications should I take or avoid with my surgery?
You should not take any blood thinners or anti-inflammatory medications for a week before your procedure, and you should hold all over the counter supplements a week before surgery. This will help reduce the risk of bleeding intraoperatively, and help reduce the risk of postoperative hematoma (collection of blood). If blood thinners are prescribed for you by your cardiologist or primary care physician, you should get clearance from them to hold these medications before they are discontinued. You should hold all hormones 6 weeks before surgery. Birth control pills should be held 6 weeks before surgery as well. Of course you should make sure to use alternative forms of birth control during and after this time. Hormones and birth control pills put you at a higher risk of blood clots. These clots can go to your lungs and cause serious illness or even death. We call this a pulmonary embolus. Steroids should be weaned off at least a month before your surgery, and this weaning process should be set up and cleared by your prescribing physician. Dr. Lovelace and the staff will go through your list of medication, and let you know what exactly you need to do with those medications preoperatively. Make sure that you bring all of your medications with you to your consultation. You will usually be given your prescriptions for your postoperative medication on your preoperative visit so that they can be filled and at your house when you get home from surgery.
Will I need clearances from any other physicians?
Depending on your age and medical issues, Dr. Lovelace and her staff will set you up with your primary care physician, cardiologist, etc. for clearance prior to your surgery. At that time any necessary labs, EKGs, or chest x-rays will be done. If you have not had a mammogram within the last year, Dr. Lovelace will request that you get one preoperatively.
What are the risks?
The risks of an augmentation/Mastopexy include bleeding, infection, scarring, hematoma, seroma, possible need for free nipple graft, possible need for drains, dog ears, dehiscence, contour irregularities, asymmetry, poor cosmesis, need for further intervention, numbness/hypersensation, intra-thoracic injury, nipple/skin necrosis, fat necrosis, capsular contracture, implant visability/palpability/malposition/rupture, breast ptosis over time, stretch marks, weight gain/loss/pregnancy can change result, cardiac/pulmonary/stroke/DVT/PE events, death, etc.