Mastopexy (Breast Uplift)

A mastopexy is performed under a general anaesthetic (you will be fully unconscious). Providing there are no complications, you can expect to go home on the day of surgery.

Incisions are necessary to sculpt the breasts into a smaller and perter shape. The incisions are made around the areola, vertically down from the areola to the breast crease and horizontally in the breast crease under the breast.

Excess breast tissue and skin are removed. The entire breast is reshaped with the nipples lifted to a higher and more youthful position. The incisions are closed with sutures that are hidden under the skin and dissolve themselves. Sutures will not be visible; therefore, scarring is reduced to a minimum.

The surgery takes between two and three hours to complete.

Having cosmetic surgery should be a very positive experience. Decisions about this surgery should never be rushed.

Complications are infrequent and usually minor. However, all surgery is not without risk, and it is important that you are aware of possible complications. All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss them.

These risks can be divided into the risks specific to the surgery and the risks of anaesthesia.

General Anaesthetic risks: An anaesthetic is very safe, however, should a complication arise, the relevant medical expertise is immediately available to deal with this.

The risks increase if you have certain medical problems, which will be discussed at length during the consultation. The risks include:

• Unintended intraoperative awareness, which is very rare
• Dizziness and nausea
• Sore throat
• Damage to teeth or mouth
• Nerve injury due to body positioning
• Allergic reaction or anaphylaxis
• Malignant hyperthermia, which is a rare life-threatening condition

The anaesthetist will go through associated risks in more detail prior to your surgery.

Scars:  The scars are usually hidden in the crease under the breast, around the areola and vertically down the middle of the breast, from the lower areola border to the crease under the breast. They normally settle remarkably well, so that the scars are barely perceptible. However, some patients heal with thick, thin or stretched scars, which can be noticeable.

Bruising and swelling: A degree of swelling and bruising is normal, and this may take approximately 3 weeks to settle.

Haematoma: This is clotted blood that collects in the breast. It occurs in between 1% to 4% of women who undergo breast reduction or mastopexy. It tends to occur within 4 to 6 hours post-surgery.

Any increase in swelling or pain should be reported immediately for assessment. Should the haematoma be significant, it will have to be washed out in theatre and any bleeding vessel(s) identified and cauterised. This does not normally delay your recovery or affect the cosmetic result.

Infection: The risk of infection is inherent with any surgical procedure, albeit very uncommon in elective breast procedures. Antibiotics are administered during surgery and for 7 days after surgery to minimise the risks. Less than 1% of patients develop an infection post-operatively and rarely require any intervention, apart from further antibiotic treatment.

Numbness, reduced sensation or oversensitivity:  A reduction in nipple sensation may occur, which may improve to some degree with time. However, this may never completely return to normal. Occasionally, patients feel that their nipples become more sensitive.

Wound healing problems: These are rare but can happen around the nipple or at the T junction (where the horizontal and vertical scars meet). These healing difficulties can range from minor problems, such as small scabs or areas of wound separation, to major issues, such as skin or nipple loss. Although very rare, this situation may require a skin graft to close the wound, meaning further surgery.

Patients who have diabetes, smoke, are obese or elderly are at an increased risk of delayed healing.

Asymmetry: Each breast is slightly different and will continue to be following surgery; Remember, “they are sisters and not twins”. However, if you have noticeable asymmetry before your surgery then this will be corrected as part of the surgery and will be discussed with you.

Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE): Following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and travel to your lungs. If the blood clot is large enough, it could prove fatal.

The overall risk for cosmetic surgery is less than 1%, but to reduce any risks of a DVT/PE, you will be provided with special stockings to wear in bed together with a blood thinning injection, if you are not mobile or have previously had a DVT or PE.

Fat necrosis: Sometimes areas of fat within the breast scar form hard lumps called fat necrosis. Usually, no specific treatment is required, and the problem settles down over a 12-month period.

Breastfeeding: Not all patients will be able to breastfeed after breast surgery, reduction or mastopexy. If you have further family plans and wish to breastfeed then this procedure should be delayed.

All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with me. Do not rush a decision about cosmetic surgery and do some personal research.

Your incisions will be closed with dissolvable sutures that do not need to be removed. I use a glue and tape dressing (Prineo®), which is waterproof and can be peeled off 2 to 3 weeks after surgery, when it starts to lift at the corners. You can shower as soon as you like after surgery and do not require any dressing changes.

I recommend that patients wear a support bra for 6 weeks and that you purchase 2 bras, so you have one to wear and one in the wash. These are worn day and night for approximately 6 weeks post-surgery, before returning to any bra of your choice. You will need to purchase these prior to your surgery, and I will provide the relevant details in clinic. Details can also be found in the compression garment guide below.

Before you leave the hospital, you will be given a follow up appointment to see the nurses at one week to check your incisions and an appointment to see me in 2 weeks. You will not be able to drive yourself home from hospital and, ideally, you should have someone to stay with you for a few days to assist you. If you have any concerns during this period, do contact the clinic for advice.

Scar advice
Once the dressings are removed, I recommend that you massage the incisions, using small circular motions at least twice a day for 5 minutes. You can use any moisturising cream of your choice and apply firm pressure until it blanches.

The scars will also benefit from Silicone scar gel (ScarAway® or Kelo-Cote®) twice a day, which will soften and fade them, as well as applying sunblock for 12 months to provide sun protection. ScarAway® can be purchased from Healthcare Pharmacy at Governors Square in Grand Cayman.

When you get home, you should take things easy for the first week or so. Most patients take 1 to 2 weeks off from work. You should be able to drive from 2 weeks, return to the gym for lower body work at 4 weeks and begin upper body exercises at 6 weeks.

You will need to wear your support bra day and night for 6 weeks to help shape and support the breasts as they settle.

A mastopexy is considered a cosmetic procedure unless it is performed as part of a breast reconstruction, and it is therefore not covered by health insurers. For self-funding patients, surgical fees are a combination of the hospital costs, the surgeon and anaesthetic fees, and any consumables such as breast implants.

Mastopexy Patient Information

Mastopexy - Nicotine and Surgery

Mastopexy - Pre-Op Instructions

Mastopexy - Post-Op Instructions