Breast lift (mastopexy)
Breast Lift or Mastopexy is cosmetic surgery for a woman who feels that her breast position or shape is not in harmony with her body and desires her breasts to be restored to a youthful appearance and position. Breast lift (Mastopexy) is a commonly performed operation by Dr. Taylor and Dr. Sullivan, named among Boston’s Best Plastic Surgeons by their peers in Boston Magazine and Castle Connolly. Breast lift can create natural appearing breasts, restores a more youthful and perky breast and nipple position and shape, and corrects sagging (ptosis) or deflated breasts from aging, pregnancy and breast feeding, or weight loss. In addition to sagging or drooping, these changes also cause the areola to become stretched out and large relative to the breast. A breast lift also reduces the size of the areola and restores proper relationship and harmony of the breast and areola. The incision and scar can be hidden around the nipple-areola complex or can extend down to or along the inframammary fold. The scars lighten and mature over the course of the year following surgery, often leaving a thin and faint line. The benefits with improvement in breast size, shape and position are usually worth the trade for the scar on the lower portion of the breast. Although “periareolar” approaches may have a shorter scar, the long-term results may be less favorable in terms of breast appearance and shape when compared to the longer scar techniques with the “lollipop” or “anchor” patterns. Dr. Taylor and Dr. Sullivan often work together as a team to perform breast lift. They will spend time with you to carefully select a surgical approach for breast lift. Women recover quickly from the procedure and return home on the same day with limited discomfort.
With breast lift, breast fullness can also be increased with simultaneous breast augmentation at the time of breast lift. Dr. Taylor and Dr. Sullivan commonly perform simultaneous natural breast augmentation with fat grafting or fat transfer. For a smaller breast enlargement or augmentation, fat can be gently removed with liposuction from another area of the body where it is unwanted and moved to the breasts at the time of breast lift. For a larger breast augmentation, breast implants can also be used for a simultaneous breast lift and breast augmentation.
Breast Reduction is reconstructive surgery for a woman with breasts that are disproportionately large relative to her body, who suffers from pain, discomfort, or emotional distress. Breast reduction improves a woman's quality of life by enhancing breast appearance and restoring harmony with the body while at the same time alleviating breast weight and discomfort. Similar to a breast lift, a breast reduction also lifts the breasts to a more youthful position while simultaneously reducing the size and weight of the breasts. Dr. Taylor and Dr. Sullivan can evaluate your condition to determine if you qualify for coverage by your insurance company.
BREAST SURGERY (Breast Reduction, Breast Lift or Mastopexy) AFTERCARE INSTRUCTIONS
• In the week before your operation:
o Consider eating pineapple, it may help reduce bruising
o Consider supplementing with Arnica montana, it may help reduce bruising
o Complete household chores and prepare meals for the first few days of postoperative recovery
o Follow preoperative instructions with eating, drinking, and medications
• Postoperatively, get out of bed and walk (with assistance) every few hours after your operation to decrease the chance of postoperative problems such as blood clots.
• Practice 15-20 deep breaths every hour to keep your lungs open.
• After surgery, it is important for you to have someone available to stay with you for the first 24-48 hours, as you may feel drowsy. You may require help the first few times you get out of bed.
• Please take your medications as directed by Dr. Taylor or Dr. Sullivan to manage discomfort or symptoms.
o Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours
o Ibuprofen (Motrin) 800 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours
o Gabapentin 300 mg every 8 hours for 7 days
o Vitamin C 500 mg daily for 50 days
o Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though most patients may not need it
o Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day
o Zofran 8 mg every 8 hours if needed for nausea
o Scopolamine patch will be placed behind the ear on the day of surgery and can stay for 3 days
• Eat a light diet for 2-3 days and avoid spicy food. Some suggestions to ease abdominal discomfort or indigestion after surgery:
o Drink water or warm liquids
o Prune juice to prevent constipation
• You may shower or sponge bath the day after the operation with assistance and wash your skin as you normally would with soap and water. Avoid soaking the incision, although It will not hurt to get a splash of water on the wounds. Gently pat dry after washing.
• You may wear a camisole, postoperative bra provided at the hospital, or no bra after surgery. Dr. Taylor or Dr. Sullivan will advise you when you may wear an underwire bra - usually 6 weeks after surgery.
• Most wounds will be closed with absorbable sutures that are buried and skin glue. The skin glue forms a barrier to water. Please do not remove the glue, it will fall off on its own after a few weeks. Do not apply any lotions, potions, ointments, creams or solutions (e.g. no hydrogen peroxide or alcohol) as they can be harmful to the fragile healing tissue.
• Do not smoke or expose yourself to smokers or nicotine as skin and wounds can be compromised.
• Infection is uncommon, though please call Dr. Taylor or Dr. Sullivan immediately at any sign of infection which would be signaled by fever, increased pain, new redness or swelling in the abdominal area.
• For the first few days following surgery, avoid raising your blood pressure or heart rate as it can cause bleeding. We recommend gentle range of motion exercises with your arms 3 to 5 times per day starting the day of the operation.
• Please do not drive until turning the steering wheel can be done safely and without pain (usually 5 to 7 days). Do not drive while taking pain medications such as oxycodone.
• Do not perform chest muscle exercises or strenuous bouncing exercises for 6 weeks.
• The scars can be massaged starting 3 weeks after surgery. This may promote early softening and maturation of these areas.
• Massage to the areas of liposuction can help increase circulation and soften firm areas under the skin. Please wait at least 3 to 4 weeks after surgery to start massage to avoid increased swelling.
• Moderate swelling of your breasts is to be expected. They will initially appear quite high and perky, and will settle into a natural appearance over several weeks. Please be patient.
• If you elected to have simultaneous liposuction, swelling and bruising is to be expected. Please be patient, the swelling and feeling of tightness will gradually subside over the following months. Bruising may last for a few weeks and will move down your body due to gravity.
• It is not uncommon for wounds to develop along the incision under the breast. These typically appear 2 to 3 weeks after the operation and can be an inch wide. The wounds are often red with patches of yellow and white – this is not an infection. Infections are usually associated with fever and spreading redness. These wounds can be treated with soap and water wash and a dry gauze; and they will heal on their own in a few weeks.
• The incisions often appear lumpy and bumpy. This is normal and the incisions will flatten over a few weeks.
• The nipples can be inverted rather than projecting outward. This is normal and the nipples will usually project again within a few days to weeks.
• The areola can appear asymmetric or irregularly shaped. This is normal and is due to the dissolving suture - similar to the way a draw string works on a garbage bag. Please be patient, the irregular shape and asymmetry will resolve over a few weeks.
• Sensations like numbness, shooting pain, and burning are common during the healing process, may last several weeks, and gradually disappear. If the nipples are sensitive, it is best to desensitize them with gentle touch.
• Scars take one full year to mature. You may notice that they become red, raised and firm for several weeks to months before becoming soft, flat and pale. Avoid Vitamin E as it can irritate the scar. Mederma has no proven benefit and is not worth the expense. All incisions will be sensitive to sunlight during the healing phase. Direct sun contact or tanning booths are to be avoided. Silicone cream or skin moisturizer with sunscreen and gentle massage may be helpful.
• A small amount bleeding from the incision is expected. Please call our office (617-492-0620) if you have:
o Continuous bleeding
o Significantly more swelling on one side when compared to the other
o Worsening pain
o Fever, spreading redness or irritation of the skin
o Shortness of breath
It is important to be seen by Dr. Taylor or Dr. Sullivan after your operation. They will see you in follow-up appointments at 1 week, 1 month, 3 months, and 1 year or as often as needed post-op. Call to schedule your appointments at Taylor & Sullivan Plastic Surgery office at (617) 492-0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492-0620.