Over time skin eventually loses its elasticity and consequently, breasts lose their shape and firmness and ultimately sag. Mastopexy is the medical term for what we generally describe as a breast lift. This surgery can correct the effects of gravity, pregnancy, nursing, and other factors that contribute to loss of elasticity in the breast skin.
This surgical procedure raises and reshapes sagging breasts by removing excess skin and relocating remaining tissue and nipples. If breast tissue has depleted over time, implants can be inserted (see Breast Augmentation for further details), with the combination of a breast lift. The result of the surgery can increase breast size along with enhancing the appearance of the shape and position of the breasts. Patients can receive a breast lift with or without implants. A breast lift can also reduce the size of the areola which is the darker skin around the nipple.

The Best Candidate

Before you consider a breast lift, it is important to think about your expectations and goals of the surgery. Good candidates for a breast lift must be emotionally stable, healthy women. If you wish to become pregnant in the future, it is advised that you defer the surgery until you no longer wish to bear children, since pregnancy often stretches the skin. If you do choose to get a breast lift prior to breast feeding, your ability to breastfeed will not be affected since the milk ducts and nipples are left in place. However, pregnancy can affect the size and shape of your breasts. Those with small, drooping breasts often receive the best results. Breasts of any size can be lifted though the results may not last as long in larger breasts. You may be a good candidate for a breast lift if your breasts lack firmness or if your nipples and areolas point downwards. It is best to wait until breast development has stopped.
The patient should be in good health and physical condition, stable psychological state, and have realistic expectations of the surgery. As with any cosmetic procedure, the surgery will help to improve the overall appearance of the problem area, but it may not live up to your preconceived ideal. The surgery cannot stop the natural aging process, but it can help to make you more self-confident and happy with the appearance of your breasts. Be sure to discuss your expectations with Dr. Heddle, as well as your support network.

The Office Visit

During your initial consultation, Dr. Heddle will ask for your detailed medical history, including information that could cause complications during the surgery, such as, uncontrolled high blood pressure, blood-clotting problems, or the tendency to develop large scars. Be sure to tell Dr. Heddle if you smoke or are taking any drugs, medications, vitamins or herbal supplements. Also during this initial visit, Dr. Heddle will ask questions about your emotional and psychological outlook on the surgery.
You should inform Dr. Heddle of any mammograms you have taken and the results of them including any history of breast cancer in your family. While the surgery is ultimately a deeply personal decision, help and advice is available for you, so feel free to ask questions and express your concerns.
Dr. Heddle will examine your breasts, measure and possibly photograph your breasts for future comparison. Your age, the size and shape of your breasts, and the condition they are in, will affect the surgery and whether or not an implant is suitable. Dr. Heddle will discuss this with you during this initial meeting. Dr. Heddle will explain to you how your nipples and areolas will be repositioned. Any other changes in your breasts you would like to see should be mentioned during this time. Dr. Heddle may recommend that you stabilize your weight if you plan to lose a large amount, as your breasts will sag or become smaller during the weight loss process.

Preparing for the Surgery

Dr. Heddle will give you specific instructions on how to prepare for the surgery, including what you should/should not eat and drink, smoking and avoiding certain vitamins and medications prior to the procedure. It is very important to follow these guidelines in order to make the surgery go smoothly.
Dr. Heddle may ask that you have a mammogram before surgery depending on your age and family history along with another mammogram after surgery. This is a precautionary method which looks for any changes in breast tissue. You will still be able to perform a self breast exam after surgery.
Plan to have someone with you on the day of the procedure who can drive you home afterwards and stay with you for the first 48 hours if needed.
An additional precaution is to set up a mini-recovery area in your home before the surgery. This recovery area may include: plenty of ice or cold compresses, clean towels, two to three medium-filled pillows for elevation, a thermometer, ointments or creams recommended by Dr. Heddle, magazines and books.

How the Surgery is Performed

General anesthesia will be administered before surgery, therefore, you will sleep through the operation. If the incision is small, a local anesthesia combined with a sedative will leave you awake, relaxed, and no feeling of pain.

	The surgery generally takes one to three hours to complete. The most common procedure is the anchor-shaped incision which follows the outline of the breast. The incision outlines the skin that will be removed and defines a new nipple location.
	At this time, the nipple and areola are placed in a higher position. The skin around the areola is brought down to reshape the breast.
	Stitches are located around the areola and in an upright line which extends down from the nipples and along the lower crease of the breast. Dr. Heddle will have placed the stitches under the “latradermal” level to avoid skin suture scars. Those with smaller breasts may require a different procedure known as the “doughnut mastopexy”. This involves a rounded incision around the areola and single incision running downwards and laterally to the intramammary fold where the excess area of skin has been removed.

You will be taken to a recovery room and monitored once the surgery is over. Drain tubes may be placed in your breasts in order to avoid a buildup of fluids. A surgical bra or gauze may be placed on your breasts to help the healing process. Depending on your condition, you may be able to return home after a few hours.

After the Surgery

After surgery you will be encouraged to get out of bed for short periods of time. To avoid pressure on your breasts you will be instructed to sleep on your back. It is common to see bruising and swelling in the breasts. After a few days, the surgical dressing will be replaced by a soft support athletic bra, which Dr. Heddle will instruct you to purchase prior to surgery. It is normal for the breasts to be uncomfortable for a day or two following surgery, however, the pain should be bearable. Stitches will be removed over a period of three weeks. Surgical drains will also be removed shortly after surgery. A lack of sensation on the nipple and areola is common and the feeling will resume to normal as the swelling subsides. It may be six months or more before you begin to see the full results of the surgery as your breasts take on a more natural shape. The colour of the incisions will fade over a period of months.

Getting Back to Normal

You will be able to return to work within a week after surgery depending on the intensity of your job. Mild exercise can be resumed after several weeks. A feeling of mild discomfort is normal, however, severe pain should be reported to Dr. Heddle. One to two weeks is the amount of time that sexual activity should be avoided, though Dr. Heddle may advise longer. You should not lift anything above your head up to four weeks. If you have any further concerns after the surgery please do not hesitate to contact Dr. Heddle.

While surgery may not live up to your preconceived ideals, a breast lift can help to increase your self-confidence, leaving you happier and more fulfilled.