Breast Lift

What Does the Breast Lift Procedure Involve?

The breast lift procedure typically requires general anaesthesia; however, most patients can return home on the same day as the surgery. There are a number of breast lift techniques that can be utilised; Dr. Layt will determine the technique that will be necessary based on the level of breast ptosis you are experiencing and what is best for your unique needs and goals. In most cases, the breast lift will involve incisions that begin in the areolar regions and extend downward to the inframammary fold. Excess tissue will be removed and Dr Layt will then tighten the remaining skin. The breasts and nipples will be quite literally “lifted” to a higher position and carefully shaped and smoothed.

It is important to note that any surgical or invasive procedure carries risks. We will explain all of the potential risks, however rare they may be, during your initial consultation. Before proceeding, you should seek a second opinion from an appropriately qualified practitioner.

What are the Potential Risks of Breast Lift Surgery?

Risks and Complications

Surgery is not an exact science. Incisions and scars are part of any surgery and the location and extent of the incisions will be discussed with you. Every effort is made by the surgeon to minimise scarring. Scars may fade over time, but they are permanent. They can also become hypertrophic or keloid. Scars vary from person to person and are related to each individual’s skin type, genetics and the ability of their skin to heal.

Every surgical procedure involves certain risks and complications (as per the ASPS brochure) including, but not limited to:

Asymmetry is evident physically in every person.  No two sides of the body are ever exactly symmetrical in shape, position or size and the surgeon will make every effort to achieve as close to symmetry as possible but some asymmetry is normal.

Delayed Healing, Infection and Suture Reactions can all be possible healing issues and may require antibiotics or in some cases surgical exploration.

Bleeding, Haematoma or Seroma Collections may resolve themselves but, in some cases may require further surgery.

Loss of Sensation and Numbness may also be experienced. In most cases this will improve over time on its own. In some cases this can be permanent.

Bruising and Swelling may also be a short term effect from surgery and will usually settle in one to two weeks.

Allergies to dressings, medical lotions, sutures or other materials can occur with some patients. You will be advised to cease the use of the dressing, lotion or material that is causing the reaction. In some cases anti-inflammatory medication may be prescribed.

Breathing Difficulties may be due to a general anaesthetic or breathing tube during the operation which has caused some swelling, noisy breathing or discomfort.

Blood Clots can also occur in some surgeries and may require urgent treatment and hospitalisation.

Pain thresholds vary from patient to patient. This may lead to different pain management and/or different recovery times to resume normal activities.

Achieving satisfactory results with minimal risk is a joint effort. It is important to disclosed to the surgeon and clinic and understand the following:

Full disclosure of your medical history including: allergies, personal, physical and mental history, previous surgeries, current medications and co-morbidities (including but not limited to, smoking, vaping, diabetes, prescription and illegal drug addictions, blood or heart disease, obesity or anorexia).

Co-morbidities may impact on outcome and healing post surgery.

Smoking, vaping, or taking recreational drugs must be ceased in the 6 weeks prior to some operations and during the healing phase. Failure to do so may increase the risk of complications, decrease your healing ability and affect your surgical outcome.

You should not take aspirin based prescription drugs 14 days prior to surgery and during the healing phase of the operation unless advised otherwise by the surgeon.

As per the Australian Health Practitioner Regulation Agency (AHPRA), all non-rebatable (cosmetic) procedures require a validated screening of Body Dysmorphia to be undertaken.

If Dr Layt is concerned about your mental state or physical state prior to the procedure, he may request evaluation by a psychologist, psychiatrist, general practitioner or other specialist. This referral is to assess your suitability, increased risks during surgery or any underlying physical or psychological problems which may affect your recovery or mental health.

In some cases this may require surgery to be postponed or cancelled by the doctor in his primary role to consider your care and personal well-being.

Complications with Breast Implants

Pregnancy may cause breast enlargement, cause the breast tissue to stretch, and a degree of ‘drooping’ of the breast tissue. This may require the breast to be surgically lifted; however, some poor skin integrity may have a tendency to stretch and continue to ‘drop’.

Capsular Contracture (less than 1%) occurs when the scar surrounding the implant thickens and tightens around the implant. This can make it feel hard, look unnatural, feel uncomfortable and may occur months to years later. Should this occur, a capsulectomy and a remove and replacement of implant(s) may be required in the future.

Implant Rupture can occur after injury or years of repetitive action in the same part of the implant.  MRI is the gold standard to assess this as Ultrasound shows a false positive reporting for rupture in approximately 30% of cases. A ruptured or leaking implant will require surgery of removal and replacement of the implant.

Implant ‘Wrinkles’ and Palpability  can also be noticed. All implants ripple to a degree. If there is reasonable tissue coverage this will not be noticeable. If there is little overlying breast tissue and fat this is more likely.

Anaplastic Large Cell Lymphoma (ALCL) is a rare tumour of lymphoid cells in the breast which has recently been found to have an increased incidence in patients with textured breast implants. ALCL relates to a patients genetics, a textured implant and bacteria being present.  This may present as a unilateral swelling of a breast due to fluid accumulation. When detected early, this is treated by removing the fluid and the implant. Dr Layt has and continues to perform this procedure utilising the 14 point plan to minimise the risks of ALCL, capsular contracture and other complications relating to using an implant.

In summary, the risks of bleeding, haematomas, capsular contracture, ALCL, infection, asymmetry, scarring, seroma, pain, palpable implant, loss of cleavage, sensation, implant malposition, implant rupture/leakage and breast feeding are discussed through the ASPS and The Layt Clinic information on Breast Augmentation. Implants may be removed and replaced over time and they are not lifetime devices. Implants used are registered with the Therapeutic Goods of Australia (TGA) and patients will be sent Patient Information Leaflet (PIL) regarding the implants chosen.

All surgery carries risks and it is important to understand these.

Every patient is an individual and therefore final surgical results will vary from patient to patient. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified practitioner.

Modern surgery has developed over the years and the safety of surgery has improved greatly. There is however no such thing as “risk-free” surgery. The important thing is to understand any potential risks and minimise their occurrence by appropriate planning and management. Some specific possible risks include a lack of nipple sensation and asymmetry of the breasts after healing. Obviously, there will be some scars, and we will discuss how to minimise signs of them. At your consultation, the risks and potential complications of breast lift surgery will be explained and you will be given detailed information on the procedure.

Breast Lift Pre-Operative Instructions

WASHING:
Wash the evening prior to surgery and the day of surgery, paying particular attention to the breast region. This decreases the bacterial count and should decrease the risks of infection.

PRODUCTS:
Do not apply moisturisers, make-up, perfume/deodorant, nail polish, or hair products after washing. Remove all jewelry.

CLOTHING:
Wear loose, comfortable clothing and footwear. A shirt with a button or zipper opening is ideal for removal.

SMOKING:
Smoking and vaping increases the risks of complications significantly and should be ceased 6 – 8 weeks prior to surgery.

FASTING:
You should have nothing to eat or drink for six hours before your operation. If you are required to take medication during this time, please mention this to us to check if this can be taken before the six-hour fasting period or after your procedure.

MEDICATION:
If you are having the operation as a day case, you will be given a script for antibiotics and pain relief tablets that you will need to purchase from the chemist and bring with you on the day of your procedure. Do not take these prior to surgery. The nursing staff will advise you and your carer after your procedure on how to administer them.

Certain over-the-counter products and prescription medicines can cause complications before and after surgery. They can reduce the ability of your blood to clot and could increase your tendency to bleed during and after surgery. Do not take any medication containing or related to aspirin two weeks prior to your procedure. This includes NSAIDS, anti-inflammatory medications, and blood thinning medications. Please see your doctor regarding if and when to cease this medication. Ibuprofen, Nurofen, and Aspirin are common medications that thin the blood. *This is not an all-inclusive list*.

Also avoid Vitamin E supplements and red wine. Stop all herbal medications before surgery. The most common herbs used are Echinacea, Ephedra, Garlic, Ginseng, Ginkogo, Kava, St. John’s Wort, and Valerian. They may adversely affect anaesthetic drugs, prolong bleeding, and impair healing after surgery. Please consult your physician before ceasing any medication.

ADMINISTRATION:
Unfortunately, paperwork is a necessary evil. Each theatre complex has its own procedures. We have attempted to make it all easy by providing a simple series of steps to follow titled “SURGERY CHECKLIST” specific to the surgery centre you are attending. Please follow these instructions. If you have any queries about this or anything else don’t hesitate to contact us on (07) 5597 4100.

Breast Lift Post-Operative Instructions

POSITION:
For the first week after surgery, try to sleep on your back if you can instead of your side. Obviously, try not to sleep on your new breasts. This will help reduce swelling. (It is more important for you to sleep than to rigidly adhere to this suggestion).

DRESSINGS & DRAINS:
Drains are rarely/if ever required. You may have ‘splash proof’ dressings over your suture sites. Your pain will be controlled by oral medications. You will have an appointment to see us 24 – 48 hours after the operation for review of dressings, medications, and exercises. You will also be seen approximately seven days post-surgery to change dressings and review your surgical progress. Light activities can be resumed as tolerated. Aerobic activities can be started in about three weeks. We are always available to help should concerns arise. We would love to see you for a three month and 12-month follow-up appointment. If distance is a problem, we can often address this over Skype, FaceTime, or phone.

You will be fitted with a support bra and when we see you post-operatively we will check that it fits well and supply a second one. You should wear one of these day and night for two weeks after surgery. (You may, of course, remove it to shower and launder.) After two weeks, you may sleep without the bra. You should not go braless during the day for 4 – 6 weeks after surgery. Once the swelling has decreased you can buy new bras to fit your new size. This usually takes three months.

SHOWERING:
You may shower, remembering that your dressings are splash proof rather than waterproof. If water gets underneath the dressing it is best to change it. It is fine to take off your bra while you shower.

DRIVING AND ACTIVITIES:
You may take a gentle walk the day after your surgery. It is advised to try to get up and move about as soon as you feel you can. Do not return to aerobic exercise for three weeks. You may drive when driving does not cause you pain, and your vision, reflexes, and thought processes are not impaired and you are confident in your driving ability. This usually occurs in 4 – 6 days if you have a car with power steering.

SUTURES:
The sutures used in the operation are usually dissolvable and don’t require removal.

SUNLIGHT: Scars take at least one year to fade. During this time, you must protect them from the sun. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. Wear a sunscreen with a skin-protection factor (SPF) of at least 30 at all times when in the sun. Be extremely careful as areas of your breast skin may have reduced sensitivity.

TAPE:
Dr Layt advises taping the wounds with Fixomull® initially, then Siltape® for 8 – 12 weeks after your operation for optimal scar healing. Our nurse will change these dressings one week after your operation. You will be given a pack of Siltape that will usually last until your 3-month appointment. Further Siltape is available for purchase.  If any redness, itchiness or heat is noticed around the edges of the tape or wound please contact our clinic. Some patients may require to use different taping or silicone gels due to allergies to particular adhesives in some tapes.

TED STOCKINGS:
You may be required to wear TED stockings for compression to prevent DVT (blood clotting) post-operatively. If required, these will be fitted at the hospital on your admission day. The nursing staff will advise you on how long you’ll need to wear these.

MEDICATION:
Take your pain relief and antibiotic medication as directed. Any medication you ceased prior to surgery must not be taken after your surgery until you are completely healed or as directed by your physician.

Additional Frequently Asked Questions About Breast Lift Surgery

Will insurance cover breast lift surgery?

Mastopexy is typically categorised as a cosmetic procedure and generally not covered by medical insurance policies. Medicare may cover some mastopexy procedures and have a strict criteria which must be met. Once the surgeon has clinically assessed you, we will know if you meet the criteria and if you are entitled to a Medicare rebate.  However, there are many options that can provide individuals with convenient ways to bring this treatment into their budget. Please visit our financing page for more information.

Will I need breast augmentation with my breast lift?

If a patient desires larger shaped breasts in addition to addressing concerns relating to breast ptosis, it’s quite common to perform an augmentation mastopexy. However, a mastopexy with breast augmentation is much more complex, so this procedure should always be under the care of a qualified and credentialed plastic surgeon, such as Dr Layt. During the initial consultation, Dr Layt will discuss the patient’s aesthetic goals and perform a breast examination to determine if augmentation mastopexy is a favourable option.

How painful is a breast lift?

Mastopexy procedures are performed under general anaesthesia, so the patient should be unaware of any discomfort during surgery. Most patients do experience some degree of soreness, swelling, and tenderness in the breast areas near the incisions in the days, or possibly weeks, following the procedure. These symptoms should subside gradually during the recovery process and can typically be well-managed with oral pain medication as needed.

How can I reduce swelling after a breast lift?

Swelling is the body’s natural response to incisional surgery, so this side effect is to be expected. There are a few ways to help minimise swelling, including wearing a compression garment, restricting salt and alcohol intake, eating a healthy diet of antioxidant-rich and anti-inflammatory foods, staying hydrated, getting plenty of rest, and taking light walks under the guidance of post-procedure clearance.

What type of bra should I wear after breast lift surgery?

A surgical support bra or compression garment should be worn immediately following the breast lift procedure and for several weeks thereafter. This will help protect the incisions as they heal and ensure the breasts stay in the proper recovery position. Once cleared by our surgeon, a soft support bra can be worn, but patients should avoid underwire bras for at least eight weeks. Once the breasts have fully healed, it is imperative to continue wearing a supportive bra on a regular basis. This helps to prolong the rejuvenated, lifted outcome and resist the gradual effects of the natural ageing process that will eventually continue in the breast area.