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The best candidates for mastopexy are healthy, emotionally stable women who are realistic about what the surgery can accomplish. Breasts of any size can be lifted, but the results may not last as long in heavy breasts and the best results are usually achieved in women with small, sagging breasts.

Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. It may be a good idea to postpone the surgery till childbearing is complete as future pregnancy and lactation will offset the result.

A breast lift is not a simple operation, but it's normally safe when performed by a qualified plastic surgeon. However, as with any surgery, there is always a possibility of complications or a reaction to the anesthesia. Bleeding and infection following a breast lift are uncommon, but they can cause scars to widen. Mastopexy does leave noticeable, permanent scars, although they'll be covered by the bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in the nipples or breasts.

The surgeon will examine the breasts and measure them in a sitting or standing position and mark the incisions to be made.

A mammogram (breast x-ray) before surgery is done routinely.

Specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications are given to the patient.

The breast lift surgery is performed in a hospital, and the hospital stay is usually 3 to 4 days.

Types of anaesthesia

Breast lifts are usually performed under general anesthesia, which means the patient sleeps through the operation.

Mastopexy usually takes two and four hours. Techniques vary, but the most common procedure involves an anchor-shaped incision following the natural contour of the breast.

The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.

In some patients, especially those with relatively small breasts and minimal sagging, modified procedures requiring less extensive incisions are used. One such procedure is the "doughnut (or concentric) mastopexy", in which circular incisions are made around the areola, and a doughnut-shaped area of skin is removed.

If an implant is inserted along with the breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.

After the surgery

After surgery, an elastic bandage or a surgical bra over gauze dressings is worn. The breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn't be severe.

Within a few days, the bandages or surgical bra will be replaced by a soft support bra. This surgical bra should be worn around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two.

There can be some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting back to normal

Healing is a gradual process. Although patients are up and about in a day or two, returning to work takes a week or more, depending on the patient. Lifting anything over the head should be avoided for three to four weeks, and strenuous sports for about a month. Breast feeding is usually not affected since the milk ducts and nipples will be left intact.

Your new look

Every effort is made to make the scars as inconspicuous as possible. Still, it's important to remember that mastopexy scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. It should be remembered that a breast lift won't keep the breasts firm forever -- the effects of gravity, pregnancy, aging, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer.

The satisfaction with a breast lift is likely to be greater if the procedure is understood thoroughly and if expectations are realistic.