Breast surgery

Breast Lift (Mastopexy)

A breast lift (mastopexy) is performed to reshape breasts where the skin has stretched and the nipple has dropped below the breast crease (ptosis). These changes commonly occur after weight loss, pregnancy, or breastfeeding.

A mastopexy involves removing excess skin, reshaping the breast tissue, and repositioning the nipple and areola to a higher point on the breast. The areola may also be reduced in size for proportion. Most patients maintain a similar bra cup size, but the breasts may feel firmer and sit higher on the chest after surgery.

Several different surgical techniques may be used, depending on the degree of ptosis and skin excess:

• Periareolar mastopexy: A circular incision around the areola, suitable for mild cases but limited in lifting ability.
• Vertical (lollipop) mastopexy: An incision around the areola and vertically down to the breast crease, often used for moderate ptosis.
• Wise pattern (anchor) mastopexy: An incision around the areola, vertically down, and along the crease. This approach is typically chosen for more severe ptosis or where large amounts of skin need removal.

All mastopexy techniques result in permanent scars, which usually fade over time but remain visible to some extent.

It is important to note that a breast lift alone does not always restore upper pole fullness. Some women choose to combine mastopexy with implants (augmentation mastopexy) to restore lost volume, particularly in the upper part of the breast.

Augmentation Mastopexy

An 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. 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 Reduction

Breast reduction surgery removes both excess skin and breast tissue. This procedure reduces the size of the breasts and repositions them to be more proportionate with the rest of the body. Some patients also experience relief from neck, back, or shoulder discomfort associated with larger breasts.

Breast Augmentation

Breast augmentation may be appropriate for patients who have lost breast volume after weight loss but do not have a large amount of loose or stretched skin. In these cases, the main concern is restoring fullness or achieving a modest lift in breast position rather than removing excess skin.

This procedure involves placing a silicone implant either beneath the breast tissue (subglandular) or partially beneath the pectoral muscle (subpectoral). Both approaches have advantages, and the choice depends on the thickness of the patient’s existing breast tissue, the desired shape, and individual anatomy.

Breast augmentation can restore upper pole fullness, create a rounder contour, and may slightly elevate the breast if the skin and tissue support are adequate. However, it does not correct moderate to severe droop (ptosis). If there is significant excess skin or the nipples sit well below the breast crease, a breast lift or augmentation mastopexy may be more appropriate.

Implants are available in a range of sizes and shapes, and these options are discussed during consultation. While implants can achieve increased volume, they are medical devices and may require future revision for issues such as rupture, capsular contracture, or changes in position.

Recovery from Breast Surgery

• Many patients undergoing breast lift or breast augmentation return home the same day.
• Breast reduction and augmentation mastopexy patients often stay in hospital overnight.
• Most patients can return to driving and work after about one week, depending on their recovery and the type of work they do.
• Dissolving sutures are generally used. Drains may be required for breast reduction and sometimes for augmentation mastopexy.
• Scar care often begins with paper tape dressings and continues with longer-term management strategies.

Long-term results are influenced by the quality of the skin, the weight of implants (if used), and natural ageing. All breasts gradually droop over time due to gravity and loss of skin elasticity.

Important information:

Breast surgery carries risks including bleeding, infection, wound healing problems, changes in nipple sensation, asymmetry, implant-related complications (if used), and anaesthetic risks. Scarring is permanent, though it usually fades over time. Individual results and recovery vary.