1. Is it safe to do mastopexy on a nicotine user?

Nicotine is a vasoconstrictor - an agent that causes the small blood vessels beneath and which supply the skin to contract, limiting blood flow to the tissues. The effects of any form of nicotine (cigarettes, the patch, or nicotine gum) can last 6 weeks or longer, even after quitting! For this reason, you should eliminate nicotine from your body for at least 6 weeks before any elective surgical procedure. Vasoconstriction of the skin and tissues of the breasts during a breast lift, reduction or even augmentation can cause death of breast skin, the nipples, or cause severe infection or wound healing problems. It is not worth the risk of having a mastopexy if you are actively smoking!


2. Can breasts sag after a breast lift surgery?

After a breast lift ("mastopexy"), the breasts will initially be very perky and firm with normal postoperative swelling. It takes at least 6 weeks to 3 months for the majority of this swelling to be resorbed by the body. It then takes a year or more for the scars to be completely "mature" - flatter,softer and faded. The results of a breast lift are permanent, and most women do not experience significant sagging of their breasts after mastopexy surgery. Normal aging will continue at the same rate from the time of surgery. If you undergo future significant weight gain or weight loss, become pregnant after surgery, have loss of volume from breast feeding, and depending on your natural skin tone and elasticity of your tissues (genetically determined traits), you may develop some droop to your breasts over time.

Some women choose to undergo a breast augmentation or repeat breast lift in the future, if their breasts significantly change over time. This is why I counsel my patients to wait until they have finished having children to have a breast lift!


3. Do I need a mammogram before breast lift surgery?

If you are age 40 or more, a screening mammogram is usually recommended for a baseline. A mastopexy may slightly change your mammogram image because the breast tissues are rearranged and you may have some swelling that lasts for a year or more in your breasts.

Breast lift surgery will not interfere with your ability to have mammograms,to do breast self-exams, to detect breast cancer or a breast lump if it develops, and it will not change your breast cancer risk overall. If you have a positive family history of breast cancer or ovarian cancer (a mother, sister, aunt, grandmother on either side of your family - mother's or father' s side), it is probably a good idea to have a mammogram before surgery even if you are under age 40. Be sure to ask your Primary Care Physician or OB-GYN for their guidance and opinion as well.


4. How Does a Breast Lift Work?

Regardless of whether you breast feed or not, having babies "suck the life right out of them" (your breasts)! If you are "happy in a bra" and do not usually wear padding in your bras to achieve your aesthetic goals, a breast lift may be your answer for sagging breasts. Breast lift surgery (known as mastopexy) can restore droopy breasts to a normal size and shape. This operation, although similar to breast reduction, is considered cosmetic and is rarely covered by insurance.

A mastopexy:1. Reshapes and lifts the breasts2. Removes excess skin from stretched-out breasts3. Lifts the nipples and areolas to a more youthful position4. Makes the diameter of stretched areolas smaller

Breast lift surgery creates scars that are permanent, but which fade with time, and are hidden in a bra and even in a triangle-string bikini top. If you desire both replacement of lost volume and a lift to your nipples, a combination augmentation-mastopexy may be indicated. A breast lift usually takes around 3 hours to perform, and is done as out patient surgical procedure. You will need at least a few days up to a couple of weeks off work for recovery, when you will be on pain pills as needed. Postoperative physical restrictions include avoiding lifting more than 5 pounds for 2-3 weeks, avoiding aggressive exercise for at least a month after surgery, with gradual return to all regular activities by 6 weeks.


5. When Is the Best Time for a Breast Lift?

A "mommy makeover" surgical procedure such as a breast lift should only be considered at least 6 months after the birth of your last child or 6 months after you have finished breast feeding, so that your body has the chance to recover as much as possible and to enable you to achieve as much as you can on your own, with a healthy diet and regular exercise.

I encourage each of my patients to become as physically fit as possible before considering any major surgery. If you are athletic and your body is used to being stressed physically, and you have had a good heart and lung workout, then surgery will be much less of an insult to your body. If you are a couch potato and do no physical activity at all, then surgery will be a huge stress to your system and your recovery will be much more difficult.


6. How can I judge how much skin should be removed during the procedure?

Your Plastic Surgeon will be the one to determine how much skin will be removed during a mastopexy. However, the more important aspect of this operation is the re-arrangement of the breast tissue itself ("parenchyma") underneath the breast skin. A breast lift is truly a three-dimensional procedure!

The skin is an ineffective brassiere and cannot be relied on alone to hold the breasts up - the parenchyma re-arrangement is the most important part of the procedure to maintain a beautiful, lifted and youthful shape to the breasts over time.


7. What type of anesthesia is used during mastopexy?

During mastopexy, you are fully asleep in the operating room under general anesthesia. Some surgeons also use local anesthesia so that your incisions are numb immediately after surgery for a few hours.