Factors such as pregnancy, nursing and the force of gravity are things to consider for a breast lift. Breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. Breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.

The best candidates for a breast lift are healthy, emotionally stable women who are realistic about what the surgery can accomplish. The results are accomplished in women with small, sagging breasts. It is hard to maintain the lift in larger breasts. Stretched skin and less volume in breast because of pregnancy and nursing is the most common reason for this surgery.

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. However, they may cause scars to widen. Following the surgeon's advice before and after surgery reduces that risk.

Mastopexy does leave noticeable, permanent scars, although they'll be covered by a bra or bathing suit. (Poor healing and wider scars are more common in smokers.) There is a possibility of unevenly positioned nipples, or a permanent loss of feeling in your nipples or breast.

Planning your surgery
At the consultation, it's important to discuss your expectations frankly with your surgeon. The surgeon will examine your breasts and measure them while you are standing or sitting. Variable such as your age, the size and shape of your breasts, and the condition of your skin and whether an implant is advisable may affect the procedure. The position of the areola and nipple needs to be discussed.

Preparing for your surgery
Your surgeon will describe in detail the procedure, risks and limitations, scaring that will result, anesthesia used, type of facility and costs involved.

You may be required to have a mammogram before surgery due to your age and family history. Specific instructions will be given to prepare you for surgery, concerning eating, drinking, smoking and taking or avoiding certain vitamins and medications. Also be sure to arrange to have someone drive you home after the surgery.

Your surgery may be performed at a hospital, an outpatient surgery center, or a surgeon's office based facility. It is usually an outpatient surgery but if you are admitted to the hospital as an inpatient, you can expect to stay one or tow days.

Usually general anesthesia is used which means you'll sleep through the operation. In particular in stances when a small incision is being made local anesthesia, combined with a sedative to make you drowsy. You will be awake but relaxed, and will feel minimal discomfort.

Mastopexy takes any where from one and a half or three and a half hours. The 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 sown 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.

Patients especially those with relatively small breasts and minimal sagging may be candidates for modified procedures requiring less extensive incisions. 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 you are having an implant inserted along with your 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
Your breasts will be bruised, swollen, and uncomfortable for a day or two, but the pain shouldn't be severe. You'll wear an elastic bandage or a surgical bra over gauze dressings. Any discomfort should be relieved with medication prescribed by your surgeon.
Within a few days, the bandages or surgical bra will be replace by a soft support bra. You'll need to wear this bra around the clock for three to four weeks, over a layer of gauze. The stitches will be removed after a week or two.

Getting back to normal
Healing is a gradual process. If your breast skin is very dry, apply a moisturizer several times a day except to the suture areas. Loss of feeling in your nipples and breast skin is commonly caused, by 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.

You may be up and about in a day or two, but you might have to wait a week or more to return to work depending on how you feel. Avoid lifting anything over your head for three to four weeks. If you have any unusual symptoms, don't hesitate to call the doctor.
If you become pregnant, the operation should not affect your ability to breast-feed since your milk ducts and nipple will be left intact.

It is 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. Also keep in mind that a breast lift won't keep you firm forever - the effects of gravity, pregnancy, aging and weight fluctuations will eventually take their toll again Your satisfaction with a breast lift is likely to be greater if you understand the procedure and if your expectations are realistic.