Breast Reduction and Breast Uplift (Mastopexy)

Procedure

The surgery is performed in the surgical facility under a general anesthetic administered by an anesthesiologist. A long acting, local anesthetic is also added to help eliminate discomfort following surgery. While the procedure is carried out, you will be on a specially designed table, in a sitting position. This allows the doctor to accurately assess size, shape, and symmetry.

A more shapely breast—lifted and reduced in size—is created by elevating the nipple (which normally remains connected to its nerve and blood supply) to a more acceptable position. If the nipple is enlarged, its size is reduced. The breast and torso are measured to determine the amount of reduction required, and a pattern is drawn on the breast. If necessary, the internal breast tissue is reduced and molded into a normal size and shape. Sometimes, during uplift operations, a small implant may be placed to add extra support and shape to the breast. The doctor will discuss this with you before surgery. The final incision lines are made around the nipple, down the bottom center and horizontally under the breast, and any excessive skin removed. Deeper, internal stitches are absorbable, while the outer stitches are removed in seven to ten days.

A comfortable bandage is fitted after surgery and worn for 48 hours. We recommend continued support of the breasts with a well-fitted, comfortable bra after reduction to prevent sagging. A small drain may be used to collect fluid for a day or two after the procedure to help decrease swelling and discomfort, and will be gently and painlessly removed in our office or the first postoperative morning.

For the first two days, you will spend most of your time resting in bed. You may experience much less discomfort than you expected, but will probably want a mild pain medication such as Tylenol. Stronger medication will be available if you need it.

By the third day you will be up and walking around. When you get up out of bed, try rolling on your side toward the edge of the bed and bring your knees up to your waist. Move your legs over the side of the bed and gently help yourself up by pushing up with your elbows. The idea is to let your legs do most of the work so your arms can rest. When you shower, gently wash your stitch line with mild soap, then apply a thin layer of the doctor's special formula ointment or a mild antibiotic ointment such as Bacitracin. If Steristrips or tape are in place, you can remove them if they become loose by gently pulling along the line of the incision rather than against it.

By the third or fourth day you may be bored and possibly a bit depressed. This is perfectly normal at this point when the mind is active but the body still requires rest. You are also probably anxious to see the final result of your surgery, but you must be patient. As your swelling resolves, your new body will emerge. For now, keep your mind off your appearance by reading, watching television, or doing light projects.

Most patients are driving by the fifth to seventh day, and return to work or school in one to two weeks, depending on the level of activity required and the rate of recovery.

By two weeks half of the swelling is resolved, three-quarters by one month, and the remainder in one to three months. Eighty percent of the uplift patients retain the same degree of nipple sensation after swelling has resolved. Ten percent experience an increase and ten percent a decrease in sensation. Any change following surgery may be temporary; resolution can occur over several weeks to several months. Regretabley all breast reduction patients should expect loss of nipple sensation. Although breast feeding is desirable for infants, it can have an effect on the operated breast, sometimes resulting in size reduction, and discomfort. This should be considered before a decision is made about breast lift and subsequent pregnancy and nursing. Breast reduction should not be done until ones family is complete.

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