Breast Procedures: Breast Lift

Definition

Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

Age

Breasts can sag after weight loss or pregnancy (especially with breast feeding). Sometimes they develop with poor support. Age for the procedure is from late adolescence and older.

Surgical technique

A standard breast lift has four components:

1.The areola is reduced in size.
2.The breast tissue is repositioned or suspended
3.The nipple and areola are elevated.
4.The extra skin and some breast tissue is removed and a new skin and breast tissue "brassiere" is fashioned. The final scar is T-shaped with a vertical limb extending below the areola to the crease below the breast and a horizontal limb beneath the breast. The scar continues around the new areola.

Short Scar Techniques (vertical scar and short horizontal scar)

The “old fashioned” way of doing a breast reduction involved support of the nipple on a base or pedicle of tissue from the lower part of the breast. Over time this pedicle would fall and the nipple would point upwards (known as “star-gazing”) and the breast would “bottom-out”.

Ivo Pitanguy from Rio de Janeiro pioneered the concept of using the upper breast to move the nipple whilst removing the lower breast as a “Keel” resection to prevent “bottoming-out”. Other pioneers such as Claude Lassus from Nice, France, have further advanced this technique to eliminate the horizontal scar beneath the breast or reduce its length.

This technique is ideal for the small to medium enlarged (hyper-trophic breast) and gives a “perky” shape with less risk of bottoming out over time.

Prof. Kirwan now utilizes this technique in his breast lifts and reductions. He also combines the technique with a peri-areolar mastopexy which allows more tissue to be gathered around the areola and reduce the excess in the lower part of the breast thus reducing the length of or eliminating entirely the horizontal scar in the crease beneath the breast.

In the case of a breast-lift or mastopexy without an implant, Prof. Kirwan is using the lower part of the breast as an “autogenous” (patient’s own tissue) breast implant, to give upper fullness to the breast.

For more information on Auto-augmentation see: http://www.surgicalbreastenhancement.com/autoaug.htm.

The final scar is limited either to a “lollipop” configuration alone (around the areolar and a vertical component from the areolar to the crease under the breast or to a lollipop shape plus a short horizontal component which is hidden beneath the breast and does not extend to the visible part of the décolleté or" the outer part of the chest where it might be visible as a widened scar and be impossible to hide with revealing clothing.

Dr Kirwan will present his “Lollipop Mastopexy” at the upcoming meeting of the International Society of Plastic and Reconstructive Surgery in Sydney, Australia on August 14, 2003.

Philosophy

To create a teardrop-shaped breast with thin scars that turn white and are almost unnoticeable.

Surgical time and recovery

Surgery takes 3-4 hours. There are no drains. A soft wrap is placed around the breasts after surgery. All sutures are removed by the seventh day. The patient can go back to work in 7 days. Light exercise is permitted after 14 days. Normal activities can be resumed in 21 days.

Related procedures

Liposuction to contour the shape better where it extends under the arms.