INTRODUCTION
 
The shape and firmness of your breasts may be affected over time due to gravity, weight loss, pregnancy and breast feeding. In the case where you are happy with the breast size, but are unhappy with the shape, you may be a good candidate for a mastopexy (breast lift). In those situations where you are unhappy with the size and shape of the breast, you may be a candidate for a breast augmentation (with an implant) together with a breast lift.

The greatest advantage of this operation is the marked improvement in your self esteem. The breasts are a much better shape with a fuller appearance. Clothes are better fitting in most cases and you will then be able to wear certain styles of clothing more freely.

INDICATIONS

Certain conditions make one a good candidate for a breast lift including:
-    breasts that are pendulous, but of satisfactory size
-    breasts that lack substance or firmness
-    nipples and areolas that point downward, especially if they are positioned below the breast crease

The breasts may also have developed differently so that one breast is normal and well positioned while the other is not. There may be differences in the size of your breasts as well as their shape.

PROCEDURE

A common method of lifting the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision is horizontal beneath the breast and follows the natural curve of the breast crease.
Another type of breast lift involves an incision around the areola only but not everyone is able to have this type of breast lift.
After the incisions are made, the excess breast skin is removed and the breast is reshaped into a more full and lifted postion. The skin incisions are then closed. You may wake up with a drain emerging from the breast to drain out any fluid and blood collections. The drain is usually removed after the first few days after surgery.

The day after surgery, you will be encouraged to get out of bed for short periods of time. After several days, you should be able to move about more comfortably and you will be able to return to work after about ten days. Mild exercise can be performed after about four weeks.
You may be instructed to wear a support bra for a few weeks, until the swelling and discoloration of your breasts diminish. You may notice that you feel less sensation in the nipple and areola areas. This is usually temporary. Your breasts may also require some time to assume a more natural shape. Incisions will initially be red or pink in colour and the width of the scar may become slightly larger. This is normal for the wound healing process but the scar tends to improve with time. During this time, I will explain the scar management protocol that I like you to follow and will supply you with scar creams. Unfortunately, the scar will never disappear completely but we will make attempts to make them as inconspicuous as possible.
Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant.  However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts. If, after a period of years, you again become dissatisfied with the appearance of your breasts, you may choose to undergo a second breast lift procedure to restore their more youthful contour and appearance.

COMPLICATIONS / DISADVANTAGES

Complications from breast lifts are rare. Majority of patients are very pleased with the results.
The complications that may arise include:
-    bleeding and haematoma (blood collection) which may require surgical removal
-    infection
-    reactions to anesthesia
-    poor scars due to wound breakdown
-    asymmetrical breasts or nipple height (minor adjustments often can be made later)
-    permanent loss of sensation in the nipples or areas of breast skin may occur rarely
-    loss of the nipple and/or areola
-    inability to breast feed
If these complications are severe, further surgery may be required.

ADVANTAGES

Your breasts will be firmer and uplifted. Nipples and areolas will be in a more aesthetically pleasing position.
There will be a marked improvement in your self esteem. The breasts are a much better shape with a fuller appearance. Clothes are better fitting in most cases and you will then be able to wear certain styles of clothing more freely.
Results are generally long standing except in cases of rupture. If the breast sags with age, further breast lifting can still be performed.