Ptosis may be a result of a significant breast weight reduction, significant reduction of breast fat or reduction of glandular tissue. It is categorized in three grades:
Mild ptosis: the nipple-areola complex is slightly below or in the level of the inframammary fold.
Mild to moderate ptosis: the nipple-areola complex falls less than 3 cm below the inframammary fold.
Severe ptosis: the nipple-areola complex falls significantly below the inframammary fold. The fall is bigger than 3 cm.
Semi-circular: the shape is typical of breasts in young white and Asiatic women. The horizontal dimension of the upper breast line is approx. 12 cm, the vertical dimension is 11 cm.
Cylindrical breasts: sagging breasts with extended vertical dimension.
Pedicle breasts: typical shape of negro race; the breast base attached to the chest wall is narrower than the horizontal dimension of the pendulous part.
What is a breast lift (mastopexy)?
Breast lift or mastopexy is required by all women who want to lift and shape their sagging breasts. The operation aims to restore the juvenile appearance of the breasts. Mostly it includes the height adjustment of the nipple-areola complex and the modelation of the mammary gland. The less sagging the breasts are the less it is necessary to intervene in the mammary gland and the operation is thus based on the upward transport of the nipple-areola complex. The operation does not prevent the influence of gravitation and time and therefore the effect is not permanent. The surgery is mostly performed from aesthetic reasons. From the medicinal viewpoint the surgery is recommended in case of significant asymmetry or after a partial reduction of the mammary gland. Breast lift is necessary when the breast implants are removed. The correction of your breast may also result in the reduction of the areola size as it usually boosts together with the breast sagging. If the breast droop is accompanied by a more significant loss of volume, in some cases the shape may be improved and the breast strengthened by breast implants adding volume.
Why breast lift Prague?
Prague has many attractive features for those considering breast lift surgery abroad. Its location in Central Europe is easy to access; its mild climate is conducive to healing and its experienced clinics and breast lift surgeons ensure you’ll receive the best possible care. Breast lift Prague costs are often much more affordable than in the UK or with the NHS. For more information about getting to and around the Czech Republic, please visit our handy cosmetic surgery Prague info guide.
Breast lift surgery
Before the surgery
Before a surgery of this character the surgeon shall devote you enough time to discuss your expectations and suggest the method which will suit you the best as from the viewpoint of operation goals as well as the actual situation (breast shape, skin quality, other surgeries performed in the breast area). Normally the surgeon takes photographs from front and side view. At some clinics the computer modeling is used, which enables you to imagine better the final effect of the surgery. Your breasts shall be measured and according to your age and family history you shall be sent to the breast X-ray (mammograph). Usually this examination is repeated soon after the operation and the third X-ray is made when the healing process is over.
In most cases, breast lifts will be performed under general anesthesia. Typically, people are requested not to drink, eat and smoke for about six hours before the general anesthesia and may need to stay overnight in the hospital.
Breast lift surgery
Mastopexy usually takes one and a half to three and a half hours. Techniques vary according to the scar position. The surgeon decides for a breast lift type according to the extent of ptosis and the requested post-operative effect. The size and weight of the patient’s breasts influence the decision.
Periareolar skin resection (around areola): This technique is used by surgeons to treat mild ptosis. An egg-like incision is performed around the areola. The surgeon separates the skin from the underlying tissue and moves it upwards. The method treats the ptosis only in small not too heavy breasts. If the breast was too heavy, the scar would be deformed.
B technique: to treat mild and mild to moderate ptosis. The principle is identical as in periareolar resection but a little side incision is added to the main one. The result is the so-called S-shape scar.
Periareolar resection with vertical incision: Like the previous technique it treats mostly the mild to moderate ptosis. The incision is performed around the nipple and then downwards to the inframammary fold.
Inverted T incision (anchor): This incision is used to perform mastopexy in severe ptosis. The incision is made around the areola and downwards to the inframammary fold and in the fold.
Modification of the nipple-areola complex: It is also a modeling surgery which however includes only the nipple-areola complex. This technique is used to treat inverted nipples, hypertrophy (nipple growth) or the variability and asymmetry of areolas.
Inverted nipple: a genetically influenced anomaly may be also a result of a reductive mastectomy or a tumor. The nipple is pulled into the breast interior. The inverted nipples must be treated not only from the aesthetic reasons but also due to often infections which are the result of difficult hygiene in this place. The therapy is surgical and there are many techniques dealing with the issue. The effort to maintain the nipple function for lactation is balanced by the unreliability of a technique. The most often method include the fixation of nipple with a stitch and silicone drain. The nipple is inverted using the stitch and an incision is made in the lower part. The fixing drain is inserted into the incised tissue. The effect is rather aesthetic. The surgery is performed in out-patients under local anesthesia. The client must count with the nipple function disturbance and therefore in younger women the release of lateral ligaments is recommended. (Inverted nipples)
Nipple hypertrophy: it is a modification of nipple with a growth of tissue either congenital or acquired during the life. There are many techniques which are not demanding unless the young age of the patient requires maintaining the breastfeeding function of the nipple. The incisions may be made across the nipple to narrow it, or a horizontal V-shape incision. The incision may be also performed only from one side. The nipple scarring is minute and the procedure may be performed independently under local anesthesia.
Areola lift: An average areola has 40 x 40 mm in size. The surgery must also consider the underlying muscle which shrinks the areola and may influence the final result. The procedure is performed together with breast lift or as an independent procedure under local anesthesia. The scar is located around the areola from which the excess skin is removed.
Re-operation: The primary dissatisfaction of the patient is not often in breast lift surgeries; much more often the ptosis reappears as the result of time influence. The re-operation is not advised earlier than a year after the first operation. Larger complications and more scarring of breast tissue should be counted with. The incisions may be done in the original scars.
In all cases the incisions and scars are as little visible as possible; always hidden in underwear or swimsuits. Breast lift is also performed in patients who previously underwent the treatment with breast implants. It is often a rather difficult procedure and it often includes the change of implants due to their worse quality.
Are you a good candidate for breast lift (mastopexy)?
A breast lift can enhance your appearance and your self-confidence, but it won’t necessarily change your looks or cause other people to treat you differently.
The best candidates for mastopexy are healthy, emotionally-stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.
Many women seek mastopexy because pregnancy and lactation have left them with stretched skin and less volume in their breasts. However, if you’re planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies or breast-feeding, pregnancy is likely to stretch your breasts again and offset the results of the procedure. Mastopexy brings other risks for patients with the danger of repeated breast cancer as the recurrence of the disease is worse diagnosed in the scarred tissue of the gland. If you are a patient who has a scarred breast interior or another complication after the insertion of implants, the mastopexy is also contraindicated.
During your initial consultation, your surgeon will explain the surgery in detail, discussing which surgical techniques are most appropriate for you.
Be sure to discuss your expectations frankly with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each.
Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. You may be asked not to use any medications containing acetylsalicylic acid (such as Acylpyrin, Aspirin, Alnagon, Mironal, etc.) They can increase bleeding during and after surgery.
It is assumed that no acute illnesses (viral illness, cold, etc.) will have occurred at least three weeks before the planned operation. Report any illnesses to your doctor.
If you smoke, you are advised to interrupt smoking to heal without problems. Smoking may complicate the healing process because the blood supply is disturbed as the result of vasoconstriction.
While making preparations, be sure to arrange for someone to drive you home after your breast lift and to help out for a few days, if needed.
After your breast lift surgery
You’re likely to feel tired and sore for a few days following your surgery. Your breasts will be bruised, swollen, and uncomfortable for a day or two. Your doctor can control most discomforts with painkillers or other medication. You will be released from the clinic the following morning. Before you leave, the bandages will be changed.
For several days it is recommended to avoid physical strain. Within a few days, the bandages or surgical bra will be replaced by a soft support bra. You should wear it as directed by your surgeon. The stitches are removed approximately a week after the surgery.
Healing is a gradual process. Although you may be up and about in a day or two, don’t plan on returning to work for a week or more, depending on how you feel. Avoid lifting anything over your head for three to four weeks. Healing may be supported by a biostimulation laser or with various creams and gels; we recommend DermatixSiGel (applied twice a day, the treatment starts when stitches are removed), silicone strips (to strengthen and moisturize the scar). The healing process may be also supported by Wobenzym. Some clinics offer the patients these products within the post-operative treatment.
If you have any unusual symptoms, don’t hesitate to call your surgeon. You may resume routine activities after 7 to 10 days. Physical exercises are not recommended earlier than six weeks after the procedure. For a six-month period, regular check-ups at a mammary clinic are recommended.
Swelling and bruising of your breasts may take three to five weeks to disappear. You should be able to return to work within a few days, depending on the level of activity required for your job.
Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid too much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually three to four weeks after surgery. If your breast skin is very dry following surgery, you can apply a moisturizer several times a day.
Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.
You should see your surgeon any time your breast shape changes, when the consistency changes (your breast becomes hard) or any inflammation appears.
If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.
As in any other surgery bleeding complications and infections should be envisaged. The patients are most often disturbed by the change of skin sensitivity. It is a natural condition after the operation and it should adjust within 3 months. In this time period the scars should become softer. A significant asymmetry may exceptionally occur after the surgery. The necrosis in the nipple area is encountered rarely. The necrosis is usually caused by tension or pressure in the scar. In people with inclination to keloid scars (rigid punched out scars) every cosmetic surgery is contraindicated. The stretching of areola is unpleasant and aesthetically undesirable. Blood clots may form in vessels during the post-operative stage. This complication may be prevented by an early mobilization (it is suitable to start walking slowly after the operation).
How long will the effect of a breast lift last?
Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that mastopexy scars are extensive and permanent.
The duration of a breast lift is variable depending on size (effects of gravity), pregnancy, aging, and weight fluctuations.
How to choose the right plastic surgeon
As breast lift is a substantial surgery which in case of success may boost your self-confidence and vice versa; the choice of a surgeon is a rather discussed topic. There are no 100% sure instructions not to put a foot wrong. Even with the best surgeon you cannot be sure of a surgery without complications. However there are few suggestions to make the choice.
- Find out where in your surroundings breast reductions are performed.
- If you have the chance, ask the clients of the particular clinic about their satisfaction. This method however cannot assure that if they were satisfied you shall be as well, but it is certain evidence.
- Do not economize and undergo initial consultations with more surgeons and make the choice according to your own intuition and good feeling. Own experience is priceless.
- Do not be afraid to ask the surgeon during the initial consultation what kind of education he/she has, if he/she is attested (examined by an expert committee) for plastic surgery, what kinds of surgeries he/she performs most often and how many breast reduction surgeries he/she performs annually.