The female breast is formed only by glandular tissue, fat and skin. As it has no bone or muscle support, its fixation is guaranteed solely by the suspensory ligaments of the breast. In cases where the breasts are very voluminous or heavy, support is more difficult and, as such, in these cases, either after breastfeeding or in women over 30 years of age, the breast begins to sag.
In this sense, Mastopexy or Breast Lifting is the surgery indicated for the treatment of breast flaccidity. Through this surgical technique, we are able to elevate the areola and nipple and eliminate excess skin, promoting a final effect of a firm breast.
Mastopexy can be performed with or without the application of breast implants, and this decision will depend on a number of factors. The placement of prostheses is usually indicated for patients who, in addition to the lifting effect, wish to gain more projection. Mastopexy without prostheses is indicated for patients who already have a lot of breast volume or who just want a lifting effect.
However, in most cases, the application of prostheses is advised, since the implants help to support the breast, allowing the lifting effect to last much longer.
At Clínica Baptista Fernandes, before the surgical procedure of Mastopexy or Breast Lifting, there is a whole preparation and planning that are fundamental for the definition of the surgical plan. This process is divided into 4 steps and they are:
1 – Conversation with the doctors
The first step consists of a consultation during which Dr. João Baptista Fernandes or Dr. Fátima Baptista Fernandes will gather all the patient’s information to understand her motivation and goals. In addition, measurements and photographs are taken to define the surgical plan.
2 – Choice of prostheses (in cases of Mastopexy with prostheses)
There are several types of breast implants and to define which will be the most suitable for each case, it is necessary to take into account at least four elements: size, weight, shape and coating type. These elements will directly influence the results of the Mastopexy and, therefore, taking into account the patient’s wishes, the doctor will advise which type of prosthesis is most suitable.
Size: Breast implants can range from 100 to 1000 cc. Therefore, advice from the doctor on the ideal size is essential to obtain the desired results.
Weight: Depending on the size, the weight of the implant will vary. However, there are conventional prostheses and B-lite prostheses. B-lite prostheses are 30% lighter and, in some cases, are more recommended, especially when the patient wants greater projection.
Format: Breast implants can be round, anatomical or conical. Each format promotes a different end result. For example, when the objective is a more natural result, as a rule, anatomical prostheses are used. For those who want more projection of the breast in the upper part (of the neckline), round prostheses are usually used. However, each case must be evaluated individually for the right choice of format.
Type of coating: There are several types of coating for implants. There are implants with a smooth surface, textured, microtextured and with polyurethane coating and the choice will depend on what the doctor thinks is most advisable.
3 – 3D Simulation
If Mastopexy is performed with prostheses, the third step involves the 3D simulation of the intended results. After all the information gathered, a 3D simulation is performed using the Crisalix software. In this simulation, the patient will receive at least three demonstrations of results with different types of prostheses. From these simulations, the patient will be able to choose the option she wants.
4 – Exams and doubts
The last step is to carry out tests to find out if you are fit to perform the surgery. After that, you can make a new appointment to present the test results and to clarify questions you may have regarding the procedure. From there, it proceeds to surgery.
Mastopexy or Breast Lifting is performed through an incision that can result in two types of scars. If it goes from around the areola to the mammary fold, it will be a Vertical Scar. If, in addition to the areola and the vertical line to the fold, a horizontal line is also made in the breast fold, it will be an inverted-T scar.
This type of scars depend on the size and the implantation base, that is, the bigger and wider the breast, the bigger the horizontal scar will be.
After making the incisions, excess skin is removed and the breast tissue is repositioned. At this stage, and in cases where you want to reduce the size of the breast, breast tissue is also removed. In cases where it is intended to promote more volume, breast implants are placed. Finally, the incisions are sutured to position the breast in the proper place.
Regardless of the surgical technique used and the application or not of prostheses, Mastopexy always leaves a scar, as excess skin is removed. However, with proper post-operative care, the scars are barely noticeable after full recovery from surgery. In the case of removing breast tissue, the histological examination is mandatory, since, in addition to detecting any pathology, it defines the type of breast tissue in question.
Mastopexy is performed under general anesthesia or sedation and lasts for 2 to 3 hours. The surgery does not require hospitalization, but after the surgery the patient is under observation for about 8 hours, the time necessary for analgesia and ice.
After being discharged, the patient leaves the clinic with an elastic bra placed over compresses that must be removed two days after starting the lymphatic drainage sessions. If it was necessary to place drains, these will also be removed at the same time. The stitches will be removed after 8 to 10 days, and the post-surgical bra will have to be used for one month, avoiding the use of underwired bras in the three months following the surgery.
The patient will not be able to sunbathe during the first month or use a sauna during the first 3 months. On average, working life can start from the seventh postoperative day and physical activity after one month.
The scars, in addition to being treated by the therapist during the lymphatic drainage sessions, require certain subsequent care to become imperceptible, such as moisturizing the chest skin well, applying healing cream and silicone or polyurethane tapes, and using elastic compression for a few weeks. (normally the bars of the bra itself are enough).
Prior medical examinations are mandatory as there may be health conditions that prevent the surgery from being performed. It is mandatory to perform a breast ultrasound and a mammogram to have a record before the breast architecture is modified. If you are a smoker, it is important to refrain from smoking two weeks before and two weeks after the surgery. You should inform the surgeon and the anesthesiologist about the medication you are taking.
The final result is only definitive after 4 months and the scars only stabilize after 6 months.
At Clínica Baptista Fernandes, all drainage sessions are included in the cost of the surgery, as the recovery process is essential for the success of the Mastopexy. That’s why we have a team of therapists specially trained to carry out the drainage and, if necessary, ultrasound sessions and LED light therapy for a quick and healthy recovery. In addition, each patient receives direct contact from the doctor who performed the surgery so that they can contact him to clarify any post-operative doubts.