Breast surgery

The three most commonly performed breast operations after massive weight loss are breast lift (mastopexy), breast lift with implants (augmentation mastopexy) and breast reduction.

Breast lift surgery removes excess breast skin in an effort to reshape the breasts to a more appealing form. Most people maintain their bra cup size with this procedure. When a breast lift is combined with the insertion of a breast implant during the same operation, the procedure is called an augmentation mastopexy. Implants are used to restore or boost breast volume. Massive weight loss causes selective fat loss in the upper pole of women’s breasts. Breast implants are an effective way of compensating for this and also result in an increase in bra cup size. A natural breast has a ski slope gradient from below the line of your armpit to an apex at the nipple. Breast implants artificially boost the upper pole volume of the breast. A breast implant results in a convex upper pole that starts above the line of your armpit.

Some women only have a small degree of breast droop, and can achieve a breast lift using implants alone and do not require surgical re-positioning of their nipple. This operation has the additional benefit of using a small scar at the inframammary fold of the breast that cannot be seen. Breast reduction surgery removes excess skin and breast tissue to lift the breasts and make their size proportionately smaller to match your smaller body. Breast reduction also results in great improvements in neck, back and shoulder pain caused by the heavy, dragging weight of large breasts.

Dr Sanki will listen to your goals and advise which procedure will best suit you.

The Procedure

Aesthetic breast surgery after weight loss is a 1.5 to 4 hour procedure performed under a general anaesthetic in an operating theatre. Prior to surgery, Dr Sanki will carefully plan your operation by drawing on your chest and breasts.

Breast lift and breast reduction surgery can be done as a vertical pattern or wise pattern approach. The vertical pattern approach (lollipop shaped scar) is an excellent technique for improving breast projection and pulling in loose outer chest skin in those who have a smaller degree of skin droop and skin excess. The wise pattern yields longer scars but is the best technique for removing large amounts of skin. Breast lift and breast reduction surgery also reduces the size of the areola to be proportionate to the rest of the breast.

Augmentation Mastopexy begins like a breast lift to fashion a breast- skin envelope that will function like a well-fitted bra to hold the silicone implant in an appropriate position. A breast implant is then inserted into a pocket under the breast tissue. The size and shape of the implant will be discussed at length in your consultations. Breast implants have a silicone shell and semisolid (cohesive) silicone fill. Silicone has a similar density to breast tissue and feels quite natural. Dr Sanki uses both round and tear drop (anatomical) implants. The main disadvantage to using breast implants is that they are an artificial device that will therefore slowly deteriorate over time by hardening or rupturing. In addition, breast implants are as heavy as natural breast tissue and will therefore droop as readily as breasts of the same cup size.

Breast augmentation uses a small scar located in the inframammary fold of the breast to create a pocket for the implant to be inserted. The pocked can be subglandular (under the breast gland) or subpectoral (under the breast gland and under the pectoralis muscle). There are advantages to both approaches, and Dr Sanki will individualise your surgery to achieve the best possible result.

Recovery from breast surgery

Most patients describe that their recovery from their breast surgery is relatively easy as breast tissue is not as sensitive as other parts of the body and the wounds are well supported by a post-operative bra. Patients having breast augmentation or breast lift surgery generally go home on the same day. Breast reduction and augmentation mastopexy patients spend at least one night in hospital. Most patients are able to return to work and drive after one week.

Most of the stitches used are dissolving and do not need to be removed. Drains are used to siphon away inflammatory fluid in patients having breast reductions and sometimes augmentation mastopexy. Paper micropore tape is used initially for scar management and wound care.

The long term results of augmentation mastopexy, breast lift and breast reduction are dependent upon the strength of a woman’s natural skin. All women’s breasts droop over time with the effects of gravity. The droop will therefore occur more quickly in women who have poorer quality skin or heavier implants.