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Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts--at least, for a time. (No surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume--for example, after pregnancy--breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. If you're considering a breast lift, this brochure will give you a basic understanding of the procedure--when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don't understand.
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The best candidates for breast lift
A breast lift can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with the surgeon. 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 nursing 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 (for example, mastopexy usually doesn't interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.
All surgery carries some uncertainty and risk
A breast lift is not a simple operation, but it's normally safe when performed by a qualified plastic surgeon. At the Riley Surgery Center, we boast an excellent staff of experienced doctors and nurses, as well as a state-of-the-art Surgical Suite. Nevertheless, as with any surgery, there is always a possibility of complications. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. You can reduce your risks by closely following the physician's advice both before and after surgery. Mastopexy does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit. While they'll never disappear completely, these scars eventually will fade with time.
Planning your surgery
In your initial consultation, it's important to discuss your expectations frankly with the surgeon, and to listen to his opinion. Every patient--and every physician, as well--has a different view of what is a desirable size and shape for breasts. The surgeon will examine your breasts and measure them while you're sitting or standing. He will discuss the variables that may affect the procedure--such as your age, the size and shape of your breasts, and the condition of your skin--and whether an implant is advisable. You will also be advised where the nipple and areola will be positioned; they'll be moved higher during the procedure, and should be approximately even with the crease beneath your breast.
The surgeon will describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. In your initial consultation at the Riley Surgery Center, the surgeon will also explain the type of anesthesia to be used and a preoperative evaluation by the anesthesiologist is standard, typically the day prior to the operation. During the consultation, before and after pictures are displayed to help you better understand the concepts presented. Also the costs involved will be discussed. Don't hesitate to ask the doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing for your surgery
Depending on your age and family history, the surgeon may require you to have a mammogram (breast x-ray) before surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. A night-before shampoo and bathing with an anti-septic soap (prescribed) is standard and you will be asked to shave your arm-pit areas. Carefully following these instructions will help your surgery go more smoothly. In any case, a checklist is provided to you to ensure you do not forget any details and close companionship with our clinic manager is appreciated. While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
Where your surgery will be performed
Your breast lift is performed in our state-of-the-art Surgical Suite at the Riley Surgery Center. A breast lift procedure in our clinic is performed on a day care basis. You do not stay overnight. Ambulatory nurse care is available on request and a same night visit by our anesthesia nurse is standard (included in the price).
Types of anesthesia
Breast lifts are usually performed under general anesthesia, which means you'll sleep through the operation. In selected patients--particularly when a smaller incision is being made--the surgeon may use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort. In any case, a nurse anesthetist and anesthesiologist are present to make sure you are completely secured during the procedure.
The surgery
Mastopexy usually takes one and a half to two and a half hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast. The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast. Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. One such procedure is the "doughnut (or concentric) mastopexy," in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed. If you're having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall. At the Riley Surgery Center, polysaccharide-filled implants are used which combines natural feel and safety (see "breast augmentation").
After your surgery
After surgery, a special surgical bra is fitted (provided) that should be worn for four to six weeks after surgery to help support the operation and also to create as much comfort as possible. Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn't be severe. Any discomfort you do feel can be relieved with medications prescribed by the surgeon. The stitches will dissolve by themselves after a week or two. After about a week, the surgeon will instruct you how to massage your breast to keep them soft If your breast skin is very dry following surgery, you can apply a moisturizer several times a day. Be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so.
Getting back to normal
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. And avoid lifting anything over your head for three to four weeks. You will be scheduled for follow-up visits to monitor your progress. If you have any unusual symptoms between visits -- for example, heavy bleeding or a sudden increase in pain -- or any questions about what you can and can't do, our staff can be contacted 24 hours a day. The surgeon will give you detailed instructions for resuming your normal activities. You may be instructed to avoid sex for a week or more, and to avoid strenuous sports for about a month. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breast-feed, since your milk ducts and nipples will be left intact.
Your new look
The surgeon will make every effort to make your scars as inconspicuous as possible. Still, it's important to remember that mastopexy scars are relatively extensive and permanent. They often remain red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops. You should also keep in mind that a breast lift won't keep you firm forever--the effects of gravity, pregnancy, aging, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer. Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.
The costs
Breast lift procedures at the Riley Surgery Center have an all-inclusive price of US$ 3800,00 This includes peri-operative consultations and companionship, operating room, pre-operative anesthesia consult, anesthesia fee, same night anesthesia nurse visit, 2 surgical bra's and before and after photos (which can also be e-mailed to you). Operation report, eventual implants specifications and a cost breakdown are provided on request free of charge. The listed price does not include implants. If implants are needed, an additional charge of US$ 900,00 applies. Initial consultation (US$ 50,00), ambulatory nurse care (US$ 30,00 per visit) and all prescribed medication are excluded.
Financing is available. In addition, quoted prices are subject to discounts if you are local or medically associated.
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