If you think of the skin of the breast as the woman's "natural bra", a fallen or ptotic breast occurs when the woman's natural bra becomes stretched out of shape. This is not much different than a B-cup woman wearing a D-cup bra. The brassier is simply providing no support, and the breast just hangs.
That is precisely the condition with a woman suffering from ptosis. Thus, operations to correct the fallen or ptotic breast must either make the breast fit the bra (implants), or the bra fit the breast (skin reduction).
Looking at the diagram, notice how as a breast develops more and more ptosis, there becomes less and less upper breast (upper pole) fullness. 1stº ptosis is nicely corrected by simply adding some volume to the breast, i.e. correction simply requires a breast augmentation. If indeed the woman truly only has 1stº ptosis, Dr. Baeke would not recommend a conventional mastopexy operation as the small lift gained by a mastopexy does not justify the more significant scar. Again, Dr. Baeke only recommends breast implants for correction of 1stº ptosis.
Correction of the higher degrees of ptosis usually require a resection of excess skin. Remember the analogy of the B-cup woman wearing the D-cup bra. To make that large bra fit, excess fabric from the bra must be removed. Thus, the mastopexy operation removes some of the excess skin. All of these operations involve an incision which will (at least) leave a scar going completely around the areola and often extend down the breast and horizontally curved along the the breast fold (similar to that described on this website for breast lift and reduction surgery).
Women with higher degrees of ptosis may only wish a lift (mastopexy) or they may desire a simultaneous increase or decrease in cup size. Any increase would again require a small implant be placed at the same operation.
Some women with higher degrees of ptosis do not want the additional scars of a lift and only agree to breast implants. Though that may not correct the ptosis, Dr. Baeke will do this, but realistic expectations are critical for the patient to be happy.
Mastopexy surgery typically takes 2 hours to perform. The same operation with implants is a more technical procedure, taking about one hour longer. Newer techniques are presently being perfected which utilize various buried skin substitutes, e.g. acellular dermal matrix (Alloderm®) which when implanted may act like an internal sling taking the weight of the implant off the lower breast, thus possibly decreasing recurrence of future ptosis.
Pseudo-ptosis, especially in cases where the a prior surgeon has lowered the IMF (point "x" in diagrams) can be corrected, but are a challenging problem.
All breasts (regardless of whether having previously had surgery) have a degree of asymmetry (i.e. right and left breasts are not mirror images). Dr. Baeke will always attempt to even out any natural asymmetry.
As with other breast surgery, Dr. Baeke performs these procedures as an out-patient in the Surgery Center. You should anticipate being sent back to your home or hotel that same day. There is little discomfort associated with mastopexy surgery, especially if no implants are added. You will be given prescriptions for this purpose.
Dr. Baeke's staff will instruct you as to a surgical bra to wear while healing.
Expect a personal house call by either Dr. Baeke or his nurse, Mrs. Baeke the following day.
Complications following mastopexy are quite rare. The most common would be minor bleeding, infection and delayed wound healing. Dr. Baeke will know how best to treat any problem. If the breast lift is combined with implants, than the same issues described in the breast augmentation section page would apply. This operation should not result in any change of sensation to your breasts.
Q. Will my insurance pay for a breast lift?
Answer: Highly unlikely.
Q. If I have a mastopexy, will my breasts fall again?
Answer: It completely depends on how well you care for your "puppies". If you have large breasts and prefer wearing fashionable attire without any bra support, then likely yes over time they will start to fall. On the other hand, if you have smaller breasts and regularly wear a properly-fitting bra, then your investment should last a lifetime.
