Aesthetic Breast Surgery,Breast Implant Revision & Fat Transfer

Mastopexy

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COSTS:
Plastic surgeon’s fee: from $10,345 - $13,700

Total approximate cost range (including hospital and anaesthetic costs): $18,300 - $22,500

Associated item number: 45558 may apply for selected patients (very strict criteria apply)

May be performed with: FAT TRANSFER
May be performed with: BREAST IMPLANT REMOVAL
May be performed with: TUBEROUS BREAST CORRECTION
May be performed in conjunction with: placement of a breast implant (in carefully selected patients)

LENGTH OF PROCEDURE/HOSPITAL STAY:
3-4 hours

Day surgery; no drains required

Key Features

“Breast lift”

A mastopexy is fundamentally designed to lift the breast. This positions the breast tissue higher on the chest & elevates the nipple position. By elevating the breast and tightening the skin, a mastopexy also lifts the breast off of the abdomen so there is no skin-on-skin contact between the breast and the abdominal skin, which decreases the tendency to sweat or chafe with exercise and in warmer weather. Many surgeons will refer to the "torso-lengthening" effect of a mastopexy as a result of exposing more of the lower ribcage.

“Tightening”

A mastopexy will also tighten the breast. The tissues can be reconfigured to make the breast firmer and more compact. For ladies who have had children and who have experienced the deflation that follows breast feeding, this tightening has a rejuvenating effect. By preserving the same volume of breast tissue within a tighter "package", the breast appears perkier and more youthful.

Areolar re-sizing

As part of the mastopexy procedure, the areola is typically reduced in size and can be reshaped. Ladies with a drooping or deflated breast may also have an enlarged areola and many patients specifically mention this as something they would like to change.

Narrowing

A mastopexy will narrow the breast. Some ladies will comment on the fact that they feel their breast is too wide, and some ladies will notice that the side of their breasts will rub against the inside of their arms when they walk. Some ladies will struggle to fit a wire cup due to the width of the breast. Narrowing the breast optimises the shape of the breast during mastopexy. Narrowing will help to support the breast in a higher position, and by shifting the breast inwards, this helps enhance the cleavage.

“Auto-augmentation”

Dr Campbell-Lloyd has a specific technique for mastopexy which involves preserving the volume of the breast tissue. This is important to note, as most surgeons will claim that a mastopexy always requires a small reduction. The auto-augmentation technique that Dr Campbell-Lloyd uses positions some of the breast tissue higher up in the breast and behind the nipple to optimise the fullness at the upper part of the breast and also the projection of the breast.

“Internal bra technique”

So-called internal bra techniques are often mentioned by other surgeons, but it is sometimes hard to understand exactly what is meant by this. Essentially, an internal bra involves some form of reinforcement of the position of the crease under the breast, using internal stitches.This technique ensures that the scar remains positioned in the crease, and it also helps to support the breast in the new, higher position. The internal bra is also responsible for some of the discomfort that patients will experience after mastopexy surgery, due to the large stitches placed internally.

"Torso Lengthening"

This has become a popular term on social media as a variety of surgeons try to differentiate themselves. It is true that a breast lift will expose more of the lower part of the chest. The consequence is a change in the visual proportions of the chest to the abdomen. As the breast is elevated, the visual impression is of a longer torso. This has the benefit of highlighting the waist line, visually slimming the abdomen, and creating a generally more youthful impression. Certainly, this is helped by postural improvements that can come from elevating the breast position.

Drainless

Dr Campbell-Lloyd does not need to use drains for mastopexy procedures. This allows for patients to go home on the day of surgery, and is associated with less pain.

Associated procedures:

Fat transfer (click for details) is commonly performed in the same procedure. This allows for the addition of greater volume to the breast at the time of the mastopexy procedure without the need for a breast implant. Most importantly, this is a totally natural technique that will not require additional procedures in the future.

Breast implant removal (click for details) will lead to deflation of the breast after previous cosmetic augmentation. Many ladies will have a mastopexy for the tightening effect it offers, performed at the time of implant removal. Dr Campbell-Lloyd uses a very specific auto-augmentation technique in ladies have breast implant removal to maximise the volume of the remaining breast tissue.

Some ladies choose to use breast implants to add volume to the upper part of the breast at the time of a mastopexy. This can be a very effective technique, however it is important to understand the risks of breast implants. Specifically, breast implants are not natural tissue and will always lead to a requirement for more surgery in the future. Dr Campbell-Lloyd chooses not to use breast implants for primary cosmetic procedures. He believes that the use of auto-augmentation and fat transfer typically creates a far more stable and cosmetically pleasing result.

There are some carefully selected circumstances in which a breast implant will be offered in conjunction with a mastopexy procedure. This will be limited to patients who have suffered the effects of significant weight loss, in whom natural tissue only procedures may not be as effective. In such cases, Dr Campbell-Lloyd will normally recommend staging the surgery (mastopexy first, then the placement of an implant 6 months later), and he will often recommend the use of a dissolving mesh to support the implant at the time of its placement.

Reasons To Consider Mastopexy surgery

Drooping (ptotic) or deflated breasts

Drooping/sagging of the breast, or ptosis, is the most common reason to consider a breast lift. In some cases this may follow breast-feeding, but for other young ladies this may simply represent the natural shape that results from breast development.

Ptosis may be a dramatic consequence of substantial weight loss. For ladies who have had bariatric surgery with resulting weight loss, any surgery requires careful planning.

Ladies with ptosis often suffer with increased perspiration and chafing under the breast due to the contact between the breast skin and the abdominal skin.

Ptosis can occur without breast enlargement.

Ptosis may also be a feature of tuberous breasts, and a mastopexy may be a key component of correcting the tuberous breast shape.

Asymmetry

Many ladies will have breast asymmetry –that is, some difference between the left and right breasts. Some minor asymmetry is normal, however for other ladies this asymmetry can be significant, affecting their ability to easily wear bras, swimsuits and other garments. Frequently, asymmetry will be associated with a degree of ptosis. A mastopexy procedure allows us to correct the difference between breasts, whilst also optimising the aesthetic appearance of the breast.

What To Expect after Mastopexy

Dr Campbell-Lloyd believes strongly in performing surgery that leaves patients with natural and long-lasting results.Therefore, we encourage ladies to consider mastopexy (with or without fat transfer) rather than breast implants when they present with ptosis or deflation.

This will allow for a totally natural, implant-free breast enhancement that does not require any form of surveillance, maintenance or additional surgery.

In a small number of cases after substantial weight loss, the dramatic deflation in the breast may require consideration for the use of a breast implant after mastopexy. In these cases, Dr Campbell-Lloyd recommends an auto-augmentation mastopexy, possibly with fat graft in a first stage. Only after this procedure has settled (a minimum of 6 months) will Dr Campbell-Lloyd consider a modest implant augmentation in this patient group.

Breast lift procedures will gradually settle over the first 3-4 months. Initially, the breast will sit very high on the chest with some tightness in the lower part of the breast. This will relax as the scar tissues soften, and the breast will take on a more natural posture.

The scars associated with breast lift procedures are important to understand and are typically described as "anchor" or "inverted T" scars. The scars are the most obvious trade-off that must be made to achieve the benefit of a mastopexy. Whilst scars are typically excellent and fade over a period of up to 12 months, there are always small risks of scar stretching or scar hypertrophy which may require revision.

All sutures are dissolving sutures, under the skin. A layer of glue is then applied to any incisions. There are no “sticky” dressings applied as this will tend to cause irritation and prevent showering.

After mastopexy surgery, patients are discharged home with a surgical compression bra which must be worn at all times for the first 4-6 weeks.

Patients are discharged with antibiotic tablets, and pain-relief medications.

Patients are discharged home with detailed instructions. The instructions include emergency contact details for Campbell-Lloyd.

Routine follow-up appointments are made for:

  • 1-2 days post-op
  • around 1 week post-op
  • subsequently on demand/ as required during the first 6 weeks
  • then at 6 weeks post-op (first post-op photos)
  • and around 4 months post-op (second set of post-op photos, when breast shape has typically resolved, although scars are still settling).

Patients are then seen every 4-6 months as scars fade. Most patients are stable and are discharged at 12-18 months post-op, however we are happy to see any of our patients in an ongoing fashion.

We do not charge for post-op consultations.

There will be some pain. Most patients will experience pain at the incision site in the crease under the breast for the first 7-10 days. Some patients will experience occasional discomforts relating to movement after that time as the healing process continues.

The nature of this surgery is such that patients should expect to require pain relief medication for at least the first 2-3 weeks. Some patients will require simple pain relief (such as Nurofen) for up to 6 weeks as they increase activity.

As mentioned above, the internal bra technique will result in some discomfort in the crease under the breast. Excessive movement and activity in the early healing period can result in exacerbation of this discomfort.

It is vital to maintain a decreased level of activity for 6 weeks after surgery to minimise risk of fluid collections and prolonged swelling.

It will take at least 3-4 months for full recovery. Final results can only be appreciated after that time, once scars have softened and relaxed. Scars may only fade after 6-12 months on the breast.

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