Generality
Mastopexy is a cosmetic surgery, performed to correct breast ptosis in women. Mammary ptosis is the so-called sagging breast .
There are various surgical techniques for performing a mastopexy. Depending on the technique used, the operating surgeon will incise the breast differently.
After mastopexy surgery, there is a period of hospitalization lasting a few days.
During this time, the medical staff monitors the patient's condition at regular intervals, making sure that everything goes well.
Mastopexy is a major surgery operation, so it is not without risks and complications.
What is mastopexy?
The mastopexy, commonly called breast lift, is the cosmetic surgery aimed mainly at the correction of mammary ptosis, that is the failure, with subsequent downward movement, of the female breast.
REVIEW OF MAMMARY PTOSI?
Mammary ptosis is a natural consequence of aging, to which various factors can contribute, including:
- Cigarette smoke;
- A high number of pregnancies;
- The constant practice of physical activities that cause the movement of the breast in several dimensions of space;
- A high body mass index;
- The marked and sudden loss or gain in weight.
The breasts of women who develop mammary ptosis change at least from 3 points of view: position, volume and size.
Mammary ptosis does not cause symptoms and is not life-threatening. However, it is still a condition of considerable medical interest, as its appearance involves, in several women, a certain aesthetic discomfort .
Aesthetic surgeons measure the severity of breast ptosis in 4 degrees : grade I, grade II, grade III, and grade IV. Grade I corresponds to episodes of mild breast ptosis; grade II for episodes of moderate breast ptosis; grade III in episodes of advanced breast ptosis; finally, grade IV for episodes of severe breast ptosis.
Indications
Since mastopexy is a somewhat complex and risk-free procedure, cosmetic surgeons recommend it only to women who have moderate (grade II) or higher breast ptosis. In the presence of mild breast ptosis (grade I), it is not worthwhile to subject an individual to a potentially so dangerous intervention.
Preparation
Mastopexy is a major surgery, therefore it requires special preparation.
In general, this preparation includes a specialist consultation, a series of clinical examinations to assess the patient's health status and, finally, once the suitability for the intervention has been ascertained, a series of important recommendations.
PRE-OPERATIVE SPECIALIST CONSULTATION
The pre-operative specialist consultation is a very important moment in the preparatory phase, because, on that occasion, the cosmetic surgeon:
- Analyze the characteristics of the breast of the hypothetical patient, even prescribing a mammogram;
- It evaluates the extent of mammary ptosis, establishing if there are really the conditions for operating mastopexy;
- Exposes the method of intervention to the hypothetical patient (from which is the operative technique to the possible complications, etc.).
The specialist consultation in question is a useful moment also for the patient, since the latter can remove any doubt about any aspects of the procedure that are still unclear.
From the specialist consultation, the cosmetic surgeon understands if there are the bases to make a mastopexy.
PRE-OPERATOR CLINICAL EXAMINATIONS
If the conditions exist for a mastopexy, about a week after the operation, the patient must present herself at the hospital center, where the operation will be held, to undergo a series of clinical tests .
These clinical examination tests - also known as pre-operative examinations - serve the operating surgeon to make sure that there are no contraindications to a surgical operation. Among the classic pre-operative examinations, we include the blood test, the urine test, the electrocardiogram and the blood pressure measurement.
PRE-OPERATIVE RECOMMENDATIONS
First of all, the future patient must:
- Stop smoking if you are a smoker. Cigarette smoking promotes the onset of infections, where there are surgical wounds. Furthermore, it alters the blood supply to the skin and this slows down the healing process.
Generally, doctors advise to stop smoking at least two weeks before the operation and, if the patient wants to start again, to resume only after two weeks have passed from the operation;
- Stop taking any antiplatelet drugs (aspirin) and anticoagulants (warfarin). This pre-operative indication is explained by the fact that the aforementioned drugs "dilute the blood" and therefore represent a factor favoring bleeding.
From the wounds of the mastopexy a loss of blood is expected, which, if the aforementioned drugs are taken, can be conspicuous and dangerous for the patient's health;
- Warn the medical personnel of any allergies to those drugs (painkillers, sedatives, anesthetics, etc.), which could be used during mastopexy surgery.
Mastopexy is an intervention that requires general anesthesia . In order that general anesthesia does not involve complications, it is essential that the patient, on the day of the operation, presents himself at full fast from at least the previous evening. By complete fasting, abstention from foods and drinks other than water is meant; the latter is allowed up to a few hours after the procedure.
What are the main implications of general anesthesia?
Task of an anesthesiologist, the practice of general anesthesia involves:
- Sleeping of the patient for the duration of the procedure;
- Continuous monitoring of the patient's vital parameters (heart rate, blood pressure, body temperature, oxygen level in the blood, etc.), through appropriate instrumentation.
Generally, the anesthetic for falling asleep takes effect within 10-15 minutes; its effects last as long as the anesthesiologist does not interrupt the administration. After a few minutes from the end of the anesthetic administration, the patient wakes up.
Procedure
The mastopexy procedure begins as soon as general anesthesia has taken effect and the patient proves to be completely unconscious.
In order to modify the sagging breast, the cosmetic surgeon must perform a series of incisions on the breasts, an incision which, in general, also involves the nipple.
Once the incisions are made, the surgeon works on the shape of the individual breasts and on the size of the nipples, in order to obtain what was planned at the beginning of the operation.
Once the modifications are completed, he closes the incisions, applies stitches and bandages the breast for protective purposes.
INTERVENTION TECHNIQUES
There are various surgical techniques for performing a mastopexy.
Each technique involves a characteristic incision of the breast.
Among the possible surgical techniques that allow performing a mastopexy, the most widely used are:
- The technique that involves periareolar, vertical and horizontal incision;
- The technique that involves periareolar and vertical incision;
- The technique that involves the periareolar incision.
The different surgical techniques for mastopexy also allow performing breast augmentation (breast enlargement) or reductive mastoplasty ( breast reduction).
CANONICAL DURATION OF A MASTOPHASIS
Generally, a mastopexy intervention lasts from 2 to 3 hours . The type of surgical technique adopted has an important influence on its duration.
Post-operative phase and recovery
After mastopexy surgery, hospitalization is generally expected for a few days . During this time, medical personnel assist the patient in every need and periodically monitor his vital parameters, ensuring from time to time that everything is proceeding for the best.
FIRST SENSATIONS
Upon awakening from anesthesia and for at least the next 24 hours, it is highly probable that the patient feels confused, dazed and not very receptive to stimuli: these are normal consequences of general anesthesia.
Once the effects of anesthetics have ended completely, the operated person may complain of breast pain . As long as the feeling is mild or at least bearable, there is no need to worry.
To cope with pain, doctors often recommend taking a pain reliever such as paracetamol or ibuprofen.
I GO BACK HOME
For the return home, the support of a trusted family member or friend is highly recommended.
In the first few days, the reflexes of a person subjected to general anesthesia are not optimal, so carrying out activities, such as driving a vehicle, could be very dangerous.
RECOVERY AND HEALING
As a rule, cosmetic surgeons remove the sutures applied during a mastopexy after 10-14 days (NB: if the sutures are absorbable, the times do not change much). During this time, the healing of surgical wounds should have reached a good point.
For optimal recovery and healing, it is essential that the patient:
- Take care of your personal hygiene. Otherwise surgical wounds could become infected;
- Rest for at least a couple of weeks after work. In this case, the type of work practiced is very important, as heavy work requires a longer rest period;
- Refrain from sports activities for at least one month;
- Wear a bra specially designed for women who have undergone mastopexy for a few weeks.
Risks and complications
Like any major surgery, the mastopexy has various risks and can lead to complications, sometimes even very serious.
ADVERSE EFFECTS
For adverse effects, doctors mean minor issues.
In the case of mastopexy, the main adverse effects consist of:
- Sharp and protracted pain for longer than normal;
- Appearance of swelling, ecchymosis and / or a feeling of soreness at the level of the operated area;
- Presence of a very evident scar;
- Reduced skin sensitivity in one or both breasts.
COMPLICATIONS
For complications, doctors mean problems of a certain clinical relevance.
The complications of a mastopexy include:
- Episodes of infection. The treatment consists of an antibiotic treatment;
- Episodes of subcutaneous bleeding. The treatment consists of a surgical operation aimed at draining the accumulated blood and stopping the loss of blood;
- Permanent sense of numbness in the breast;
- Obvious redness of the surgical scar. It could be a permanent complication;
- Unwanted changes in the shape and size of the breast;
- Slow healing of surgical incisions;
- Necrosis of one or both nipples, following a change in the blood supply;
- Inability to breastfeed for the rest of life. Generally, for the category of women who require a mastopexy, this is a minor complication;
- Recurrence of breast ptosis.
Contraindications
There are no absolute contraindications to mastopexy.
However, it is good to point out that:
- Doctors advise mastopexy to women of childbearing age and still want to have one or more children, as this makes breastfeeding impossible.
- Mastopexy is temporarily contraindicated to women who, having undergone breast augmentation with prosthesis, developed a complication known as capsular contracture . The contraindication ends when women with the aforementioned problem undergo surgery to remove the breast prosthesis.
- Doctors consider mastopexy dangerous for all those women who have a family predisposition to breast cancer. Mastopexy surgery, in fact, can drastically alter the architecture of the mammary glands, thus further promoting neoplastic changes.
- Doctors have shown a greater risk of necrosis of the nipple in all those women who habitually use aspirin, smoke, suffer from diabetes and / or are obese.
Results
Currently, mastopexy operations provide excellent results; however, their effects do not last forever. The number and position of the scars resulting from the incisions vary according to the technique used to perform the operation. However, in general, these scars are very thin. For this reason, they are not very visible and, normally, the final result satisfies the patients.
