Breast Lift Overview
INTRODUCTION
Pregnancy, weight fluctuation, gravity, and time can stretch out the skin covering of the breast, resulting in breast droop. Breast lift surgery removes the excess skin and reshapes the breast back into a youthful cone shape, with the nipple centered at the peak of the cone. Different designs may be used for the pattern of skin removal, depending on how much skin needs to be removed, what reshaping the breast needs, and whether or not breast size is going to be increased with the use of a breast implant. If the size of the sagging breast is adequate, breast lift without augmentation is probably the best procedure. If the breast is smaller than desired, best results may be obtained by combining breast lift with breast augmentation.
PLANNING AHEAD
From the time of the initial phone call, it usually takes 1-3 weeks to get an appointment for a cosmetic surgery consultation. When you are ready to schedule surgery, payment in full will reserve your chosen surgery day for you. Prices change periodically-please call the office for a current quote. Payment may be by cash, check, or credit card. Financing is available. It often takes 4 weeks from the time payment is made and surgery is scheduled until the surgery can be accomplished. TIME OFF WORK: You will need to arrange to be off work for the day of surgery. Most patients have surgery on Friday, and resume office work on Monday, 3 days after surgery. They are still sore, move carefully, and take pain medication, but are able to accomplish their usual job duties. You should avoid bending, stooping, lifting, or straining for 2 weeks after surgery. If your job requires these activities, you should plan to take a full week off work after surgery. If you have a toddler at home, I have to just ask you to limit lifting as much as possible. I realize that you will still do more than is ideal.
CONSULTATIONS
Consultations for cosmetic surgery are performed free of charge.
A personal consultation is the first step for every patient considering breast lift surgery. Appointments are available Mondays, Tuesdays and Wednesday, 9AM to 4:30PM. The consultations usually last 45 - 90 minutes. Dr. Seaberg will do a detailed medical history and physical examination, and discuss your specific cosmetic goals for the procedure. You will have a chance to review before and after photos of other breast lift patients who started out with chest measurements and breast shape similar to your own. If you have already found results that you like, on the internet or in a magazine, please bring those photos with you to the consultation. Based on your goals, your ribcage size, and your breast size and shape, Dr. Seaberg will help you select your incision location, your implant size (if needed), and any modifications that might be best for you.
Breast Lift Surgical Options
After pregnancy, nursing, major weight loss, or just after years of exposure to gravity, the skin covering of the breast may become overly large for the amount of breast tissue left inside it. The breast then sags, producing skin contact between the lower breast skin and the chest wall. The medical term that describes this situation is breast ptosis.
Ptosis (Pronounced "toe\' - sis")(The "P" is silent) is the medical word for sag or droop.
Ptosis is the noun. The adjective form is ptotic.(Pronounced "taw\' - tic")
Breast ptosis is classified by comparing the nipple location on the breast mound to the location of the lower breast skin fold on the chest wall. The degree of ptosis varies from one patient to the next, and is subdivided into 4 grades of severity: pseudoptosis, grade 1 ptosis, grade 2 ptosis, and grade 3 ptosis.
To view the designs for these breast lift operations click on the descriptions below:
Pseudoptosis may be treated by placement of a larger - than - average breast implant, or by a circle nipple lift and placement of a small-to-average size implant. (See Breast Augmentation section for more details.)
My favorite treatment for grade 1 ptosis is a circle nipple lift, with or without breast augmentation.
My favorite treatment for grade 2 or 3 ptosis is a V - lift, with or without breast augmentation.
Breast Lift Surgery Timeline
TWO WEEKS BEFORE SURGERY you should stop taking ASPIRIN, or any aspirin-family drugs like Ibuprofen or Naproxen. Take plain Tylenol instead. This will reduce your risk of bleeding during surgery, and bruising afterward. . Other herbs and medications that interfere with blood clotting include arnica, garlic and Vitamin E. Avoid them all for 2 weeks before surgery.
You should stop by the office and pick up prescriptions for the medicines you will take before and after surgery (or call our office and ask us to call them in to your pharmacy.) Mephyton 5mg is a form of vitamin K that is well absorbed orally. It is an essential cofactor for 4 of your clotting factors, and we ask you to take it for 5 days before surgery to minimize bleeding during surgery and bruising afterward. Celebrex 200mg is a strong non-narcotic pain reliever. We ask you to take it before and after surgery to minimize the amount of narcotic pain reliever you require. This will get you clear-headed and back to driving 2 days earlier than you would be able to if you weren't taking it. Soma 350mg is a muscle relaxer to help your pectoral muscles relax to accomodate your new implants (if you are having below-muscle placement of breast implants as part of your procedure.) Vicodin is a narcotic pain reliever to take for moderate to severe pain that you may have in spite of the Celebrex and Soma. Prilosec OTC reduces your stomach's acid production to minimize the risk of aspiration if you should experience nausea after surgery. It is not a prescription drug, so you won't get a prescription for it, but you should buy a small box of 10 tablets while you are at the pharmacy to get your other medicines.
5 DAYS BEFORE SURGERY start taking Mephyton, an orally effective form of Vitamin K, to "tune up" your clotting system and further reduce the risk of bleeding and bruising. (We will call in a prescription for Mephyton to your pharmacy when you officially schedule your surgery.) You should not drink any alcoholic beverages or use tobacco products during the 5 days you are taking Mephyton.
THE DAY BEFORE SURGERY a nurse from the hospital will call you to tell you what time you should come to the hospital. She will review your preoperative instructions with you:
Before supper, take 2 Prilosec OTC tablets and 2 Celebrex tablets. The Prilosec OTC will reduce your stomach acid production, thereby reducing your risk of nausea after surgery. The Celebrex is a non-narcotic pain reliever that will help reduce your requirement for narcotic pain relievers after surgery.
At bedtime, drink 2 16-oz. glasses of water. This will assure that you will be well hydrated on the morning of surgery, so it will be easy to find a vein for starting your IV.
Do not eat or drink after midnight the night before surgery.
THE DAY OF SURGERY First thing when you awaken, take 2 Priloce OTC tablets and 2 Celebrex tablets with a sip of water. At this time, you should also take any medications you take on a daily basis, such as birth control pills, blood pressure medication, etc. Take a shower with antibacterial soap, such as Dial or Safeguard. This will reduce the bacterial colonization of your skin and make the surgical skin disinfectant in the operating room more effective.Wear comfortable clothes with buttons or zippers, easy to put on and take off without requiring you to stretch or bend. DO NOT wear any makeup, jewelry, deodorant or nail polish. Have a friend or relative drive you to the hospital.
You will be asked to arrive at the hospital 90 minutes before your surgery start time. You will meet your anesthesiologist, and the plastic surgery OR nursing team. Dr. Seaberg will see you in the preop holding area before surgery, to review your procedure with you and mark your incisions. You will then be taken to the operating room. Your surgery will take about 3 hours to perform. You will awaken in the recovery room with a bulky soft gauze bandage covering your breasts. After you regain alertness, your friend or relative will drive you home. YOU WILL NOT BE ABLE TO DRIVE YOURSELF HOME AFTER SURGERY! The first night after surgery you will need someone to pamper you at home. You will feel tired due to the medications you received during surgery, and you will not feel like doing very much for yourself.
WHEN YOU ARRIVE HOME, make yourself comfortable. Relax for the remainder of the afternoon and evening. Feel free to move around, but avoid heavy exertion. You will still feel slightly drowsy (we plan your medicines accordingly) and will sleep intermittently. Start with liquids if you are hungry, and if your stomach feels fine, progress to other food, as you desire. If you are at all nauseated, be assured that the nausea will be gone in 6-8 hours. During this time, do not eat solid foods; just drink a small amount of clear liquids. You received medicine to prevent nausea during your surgery, but if it persists, call me.
Take Celebrex with food (dry cereal, or crackers, or a glass of milk, if you don\'t feel like a meal). Take the Celebrex twice a day (ideally, with breakfast and with supper). Take Soma 4 times a day to relax your pectoral muscles (you won/t need this if you didn't have submuscular breast augmentation as part of your procedure)Take two extra-strength Tylenol every four hours after surgery. If, in spite of the Celebrex and Soma and Tylenol, you have pain, take one or two Vicodin tablets every four hours, as needed for comfort.
You will have an anti-nausea patch on the skin behind your right ear. You should leave this in place for 48 hours after surgery. On the second day after surgery you should remove the patch and wash the skin beneath the patch to remove any medicine residue. You should then wash your hands to remove any medicine residue from your hands.
FIRST WEEK AFTER SURGERY
Keep the dressing around your breasts in place until you return to the office for your first checkup. You may adjust the tension if needed to control discomfort, but keep it in place. Most of your discomfort occurs in the first 24 hours following surgery and will decrease by half each day thereafter, provided you resume normal activities immediately. Normal activities including lifting your arms, caring for your hair and lifting routine objects (up to 5 lbs.). Immobility after the first 24 hours delays your recovery and prolongs discomfort. You will not harm your surgery in any way by gently resuming most normal activities immediately. However, you should avoid any strenuous athletic activity that raises your pulse and blood pressure for the first 2 weeks following surgery.
FIVE DAYS AFTER SURGERY you should come to the office for your first follow-up visit. At that time the bulky dressing will be removed. To keep the bulky dressing dry during the 5 days that it is on, I would ask that you take baths rather than take showers. After the dressing is removed, you will still have steri-strips and sutures in place, but may resume clerical work after this office visit.
TEN DAYS AFTER SURGERY you should expect to be easily tired for 1-2 weeks following your operation. I would not expect you to be able to do any work involving carrying objects heavier than 5 pounds with your arms until two weeks after your operation. 10 to 12 days after surgery, you will return to the office for suture removal and another wound check.
TWO WEEKS AFTER SURGERYyou may resume full activity, including aerobics and weight lifting, with no restrictions.
SIX WEEKS AFTER SURGERY return to the office for a checkup.
ONE YEAR AFTER SURGERY return to the office for a scar check.
Breast lifting produces a gratifying firming of breast contour that can be a tremendous boost to self-esteem, improving appearance both in and out of clothing. It maintains a steady popularity, and remains a frequently performed procedure in our practice.