Mastopexy

Mastopexy

Mastopexy is a plastic surgery procedure that consists of a breast lift to correct breast ptosis. Breast ptosis is the so-called droopy breast, sometimes caused by pregnancy, breastfeeding, weight gain or weight loss.

In this procedure, the surgeon removes the excess skin of the ptosis breast and reduces the size of the areola. If the patient wishes, the breast size can be increased at the same time, so the surgeon can also insert a breast implant during the operation.

Anaesthesia for mastopexy surgery

Mastopexy is generally performed under general anaesthesia, except for periareolar mastopexy, which only requires the repositioning of the areola with a shorter operating time; in this case it is possible to perform anaesthesia by local infiltration combined with mild sedation.

Surgical technique

The surgeon can perform a breast lift with different surgical procedures. The technique chosen depends on the volume and shape of the breasts and what type of breast lift is desired.

Generally, with the circular mastopexy we can already obtain a good aesthetic result; in case the surgeon is not fully satisfied with the aesthetic result, it is possible to lift the gland and restore its volume by inserting a suitable breast prosthesis  for the patient.

In this case, which is very frequent, we talk about Additive Mastopexy. This is often the solution that leads to the best final aesthetic result in terms of breast volume and lift.

In the case of Ptosis III or IV, in which the breasts are inverted along the thoracic side and the nipples look downwards (more than 4 cm), an “inverted T” mastopexy is performed, which consists in making a vertical cut in the lower part of the breast.

It is important to explain why in breast ptoses it is often necessary to place an implant in the same operation time.

In severe grade III or IV ptosis, the skin is relaxed and inelastic and cannot support the weight of the breast on its own – it slips downwards! In this case, the system for suspending the mammary gland from the chest wall no longer exists.

There are different techniques for implanting implants (subglandular, submuscular or dual plane, i.e. partially submuscular and partially subglandular) and many different types of implants in terms of shape (round or anatomical implants, also known as teardrop implants) and consistency. Much depends on the starting constitution of each individual patient. The choice depends on how the plastic surgeon decides to operate to meet the patient’s expectations.

Complications and risks of mastopexy 

General complications include:

1. Haematomas, which consist of a collection of blood that can form inside the breasts. Prof. Scalera limits this complication by carefully haemostatting each individual vessel until a perfectly bloodless surgical field is obtained. A surgical drain in inverted T-mastopexy is inserted during the operation and removed the day after surgery.

2. Infection of the surgical site. This is limited at most by taking antibiotics after the operation for 5 days.

Specific complications include seromas, which are a collection of serum around the breast implant that can be drained by the surgeon under local anaesthesia.

The scar is usually of excellent quality, except in rare cases of patients who tend to form keloids. In such cases, Prof. Scalera uses different types of laser, including the Candela Dye Laser, which makes it possible to treat and eliminate ugly keloid scars in just a few sessions.

Post-operative course

The patient will take antibiotics and painkillers for pain control if necessary. Must wear a supportive post-operative bra for about a month and sleep on her back, with two pillows, to keep her chest elevated. The breasts will take between two and twelve months to reach their final shape.