Breast Lift (Mastopexy) in Boston


Named Among the Best Plastic Surgeons in Boston

Helena O. Taylor MD, PHD, FACS & Stephen R. Sullivan MD, MPH, FACS

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 breastfeeding, 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.

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.

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 (areolar reduction) 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 or crease under the breast. The scars lighten and mature over the course of the weeks to months following surgery, often leaving a thin and faint line. A breast lift also reduces the size of the areola (areolar reduction) and restores proper relationship and harmony of the breast and areola.

WHAT ARE THE TYPES OF BREAST LIFT?

Periareolar or Circumareolar Breast Lift, also known as a “Donut” Mastopexy, places places the most limited scar at the edge of the areola

Circumvertical Breast Lift, also known as a “Lollipop” Mastopexy, places the limited scar at the edge of the areola as well as a short vertical scar on the underside of the breast

Wise pattern Breast Lift, also known as “Anchor” or “inverted T” pattern Mastopexy, places the limited scar at the edge of the areola and the short vertical scar on the underside of the breast as well as a scar along the inframammary fold

Augmentation and Breast Lift, also known as Mastopexy Augmentation, can use any of the patterns of breast lift described above and through this approach a breast implant can be placed or a natural breast augmentation can be performed with fat transfer

WHAT IS BREAST PTOSIS?

Ptosis is a word doctors use to describe drooping. Breast ptosis can be classified or graded based on severity of drooping.

Grading or breast ptosis or drooping is important because it helps determine the type of breast lift that may provide the best results. Mild or Grade 1 ptosis may be best treated with either the periareolar or circumvertical breast lift or the circumvertical breast lift. Moderate or Grade 2 ptosis may be best treated with the circumvertical breast lift. Severe or Grade 3 ptosis may be best treated with the circumvertical breast lift or the Wise pattern breast lift.

  • Grade 1 breast ptosis - the nipple and areola have fallen to the level of the inframammary fold or crease
  • Grade 2 breast ptosis - the nipple and areola have fallen below the level of the inframammary fold or crease
  • Grade 3 breast ptosis - the nipple and areola have fallen below the level of the inframammary fold or crease and point down toward the ground

PROCEDURE FOR BREAST LIFT

Breast lift is an outpatient operation performed under sedation or general anesthetic. There are many types or techniques for breast lift.

Most breast lifts will necessitate a short “lollipop” shaped scar while longer “Anchor” or “inverted-T” approaches are used for women who correction of significant sagging and skin tightening. During the procedure, breast tissue is preserved and excess skin is removed from the lower breast and around the areola to help create a rounded, lifted, and better contour.

The areola are usually reduced in size and moved up while maintaining connection to the breast tissue beneath. It is often beneficial to use liposuction to contour excess fat deposits in the armpit area. Long-acting local anesthetic is instilled for post-operative comfort, and the incisions are closed with dissolving sutures. We rarely use drains.

Dr. Taylor and Dr. Sullivan often work together as a team to perform breast lift. The operation takes approximately two hours. Women are placed in a soft surgical bra, recover quickly from the procedure, and return home on the same day with limited discomfort.

Benefits Of Breast Lift

  • Better fit in clothing and bra
  • Youthful breast shape
  • Restores breast position
  • Upper breast fullness
  • Corrects breast sagging
  • Improves appearance of breasts
  • Flattened breasts become rounded
  • Restores size of areola
  • Restores position of nipple and areola
  • Breasts can also be increased in size

WHAT IS THE RECOVERY WITH BREAST LIFT?

Breast Lift Boston

Dr. Taylor and Dr. Sullivan care about your recovery and want to ensure you have a gentle and easy recovery. They will talk to you about when you can expect to return to work and exercise depending on the specifics of what you do. On average, our Boston breast lift patients have minimal disruption in normal daily activities, take three to five days off from work, and take two weeks off from exercise.

You may shower the day of or the day after surgery. You can expect some tightness in your breasts and soreness for a few days. We often infuse the tissues with a long-acting numbing medicine (Exparel™) and pain medication will be prescribed for your comfort. Most patients require only Tylenol and Ibuprofen postoperatively. We will provide a soft supportive bra, which can help reduce swelling and ease pressure.

Frequently Asked Questions

Is there a scar with breast lift?

The incision and scar can be hidden around the nipple-areola complex or can extend down to or along the inframammary fold or crease under the breast. The scars lighten and mature over the course of the weeks to months 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 circumvertical or Wise pattern mastopexy techniques. Our goal is always to use the most limited approach to get the best result from your breast lift Boston plastic surgeons Dr. Taylor and Dr. Sullivan will spend time with you to carefully select a surgical approach that will achieve this.

Can breasts be lifted and augmented in size?

Yes, breast fullness can 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 or breast augmentation with implant.

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. The volume of fat grafting may be approximately 75 to 150 cc. Common areas to remove fat for transfer include the abdomen, love handles, and medial thighs. For a larger breast augmentation, breast implants can also be used for a simultaneous breast lift and breast augmentation.

Will nipple sensation change after breast lift?

Most patients do not experience significant changes in nipple sensation, but some women may experience increased or decreased nipple sensation following breast reduction. Sensations like numbness, shooting, pain, and burning are common during the healing process, may last several weeks, and gradually disappear. Some patients initially have nipples which are hypersensitive to touch or temperature. If the nipples are sensitive, it is best to desensitize them with gentle touch. If the nipples have less sensation, be patient as it may recover or improve with time.

BREAST SURGERY (Breast Reduction, Breast Lift or Mastopexy) AFTERCARE INSTRUCTIONS

  • In the week before your operation:
    • Consider eating pineapple, it may help reduce bruising
    • Consider supplementing with Arnica montana, it may help reduce bruising
    • Complete household chores and prepare meals for the first few days of postoperative recovery
    • 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.
    • Acetaminophen (Tylenol) 1000 mg every 8 hours, space doses 4 hours after Ibuprofen so one or the other is taken every 4 hours
    • Ibuprofen (Motrin) 800 mg every 8 hours, space doses 4 hours after Acetaminophen so one or the other is taken every 4 hours
    • Gabapentin 300 mg every 8 hours for 7 days
    • Vitamin C 500 mg daily for 50 days
    • Oxycodone 5 mg – 1-2 tablets every 6 hours as needed for pain, though most patients may not need it
    • Colace 100 mg twice daily to prevent constipation, it is important to have a bowel movement each day
    • Zofran 8 mg every 8 hours if needed for nausea
    • 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:
    • Drink water or warm liquids
    • 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.

ACTIVITY

  • 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.

GENERAL OUTCOMES

  • 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:
    • Continuous bleeding
    • Significantly more swelling on one side when compared to the other
    • Worsening pain
    • Fever, spreading redness or irritation of the skin
    • Shortness of breath

After your breast lift Boston plastic surgeon Dr. Taylor or Dr. Sullivan 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 Boston 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.

Download of Breast Lift and Breast Reduction postoperative instructions here.

Call Today 617.492.0620

To schedule a private consultation with Dr. Taylor or Dr. Sullivan, please call the office or request an appointment using our form. We welcome your visit and your questions.

300 Mount Auburn St. Ste 304, Cambridge, MA 02138

Taylor & Sullivan Plastic Surgery Boston
American Society of Plastic Surgeons American Board of Plastic Surgery Fellow American College of Surgeons American Society of Maxillofacial Surgeons America Association of Plastic Surgeons Sigill Massachusetts

617.492.0620

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300 Mount Auburn St. Ste 304, Cambridge