After pregnancy and weight loss breasts can sag and droop. The medical term for this is ptosis. Characteristically, the upper parts of the breasts become hollow, stretch marks may form around the edges of the breasts and they may no longer be the same size as before.
Breasts can be lifted back up on the chest wall by removing excess, stretched breast skin. Alternatively, the excess skin can be taken up by enlarging the breasts with implants. Sometimes, both an implant and skin excision are required.
The aim of a breast uplift (mastopexy) is to restore the shape of the breasts, lifting them up on the chest wall and removing any slack breast skin. How this can be achieved will depend on the laxity of the breast skin, the cup size of the breast and the degree of breast ptosis. Sometimes, it is possible to achieve the desired breast size and shape with a single operation. Occasionally, to get the best results it may be necessary to have two separate procedures approximately four to six months apart to firstly tighten the breast skin, then increase the breast volume.
These procedures take between two and three hours and are carried out under general anaesthetic. Any excess breast tissue can be removed by a variety of techniques which all involve surgical incisions around the periphery of the areola (the pigmented area around the nipple) and vertically down from the nipple to the fold under the breast. Occasionally, an incision may need to be made in the fold under the breast as well. If the volume of the breasts needs to be increased, implants are usually inserted through the same incisions.
If you are overweight, Mr Watts may ask you to lose weight before surgery. This helps to minimise the risks of poor wound healing after the operation. You should also stop taking the contraceptive pill for six weeks before surgery to reduce the risk of blood clots and/or give up or cut down on smoking to reduce the risk of chest infection and speed up wound healing.
The operation will require a stay of one to two nights in hospital and you will need to take two to four weeks off work to recover.
You should not lift any heavy weights or exercise vigorously for one month after the operation.
Sutures will be trimmed after about a week and you will need to wear a firm supportive bra continuously for about four weeks after the operation to reduce swelling.
Minor wound infections are quite common after this procedure, but in most cases they settle with a course of antibiotics. Occasionally, a bleeding blood vessel or a more serious infection may require a return to the operating theatre. The blood supply to the nipple and areola are preserved during the operation, but after the procedure the level of sensation to the nipple may be reduced.
If you were to become pregnant after a breast reduction your breasts will increase in size in a normal fashion. However, it may not be possible to breast feed a child as the level of milk production may be reduced.
Other risks include poor wound healing, damage to the blood supply of the nipple and areola and reduced sensation more widely over the breast.