AESTHETIC MEDICINE AND SURGERY
The natural ageing process contributes to a progressive loss of skin elasticity, causing the breasts to sag and lose their more youthful appearance. Factors contributing to breast descent may be exacerbated by pregnancy, breast-feeding and weight loss. If, following these changes, the remaining glandular and adipose components of the breast are sufficient, so as to reassemble a breast with an appropriate volume, a mastopexy (uplift) is advised.
Mastopexy aims to uplift the breast and the nipple-areola complex, moulding the breast in a higher position. Breast uplift involves the excision of excess skin and concomitant glandular moulding.
An accurate pre-operative examination allows the surgeon to select the most appropriate technique, based on the severity of the defect:
- Circumareolar mastopexy technique
This technique, used only in cases of minor breast ptosis, aims to uplift the breast and the nipple-areola complex by removal of a skin strip from around the areola. In this case the scar is circumferential and lies along the areolar border. Only deep dissolvable sutures are used.
- Short scar mastopexy technique (vertical or “J” scar).
This technique, used in case of moderate/severe breast ptosis, provides excellent results in terms of breast uplift by removal of a skin portion from around the areola and at the lower breast. More importantly, breast uplift is attained through glandular moulding: the gland is anchored in a higher position with deep sutures. In this way, better-defined roundness is obtained in the upper mammary region and the nipple-areola complex is uplifted. Again, scars are minimal: circumferential along the areolar border, with a vertical extension, or “J”, in the lower pole of the breast. However, the resulting scar can be hidden by a standard bra. Only deep, dissolvable sutures are used.
Alternatively, if the remaining glandular and adipose tissues are diminished and not sufficient to reassemble a breast with an adequate volume, a breast augmentation with concomitant uplift (breast augmentation and mastopexy) is advised.
After the surgery, breasts are excessively high, more swollen in the upper region and stretched and square in the lower pole. Gradually, in the following weeks, they settle and achieve the appropriate shape.
Breast uplift with mastopexy is performed under general anaesthesia (the patient is asleep) with a one-night hospital stay after the surgery.
Careful administration of pain-killers during and after the surgery ensures that post-operative pain and discomfort are kept to a minimum.