Drooping breasts occur in many women after motherhood and breast feeding. Significant weight loss can also have the same effect. Following the increase in breast size which occurs with pregnancy and lactation the fibres which support the breasts are weakened and stretch; the breast skin is also stretched. As the breasts shrink after pregnancy and breast feeding the breasts have lost their youthful shape and firmness and sag. This appearance is exacerbated by the effect of gravity and increasing age.
Women dislike this drooping, floppy appearance and request surgery for cosmetic reasons. Rarely the drooping breast chaffs the chest wall skin and leads to sweat rashes.

Anaesthetic - general anaesthetic

Technique

Mastopexy is an operation which can reshape, hitch up and improve the firmness of a sagging breast. Surgery aims to improve breast shape by excision and tightening of surplus skin. The nipple is lifted to a higher position and may be reduced in size; the breast tissue itself may be tightened to produce a more youthful shaped breast.

There are several mastopexy techniques. All involve an incision, and therefore scar, around the areola; different techniques uses different additional incisions and thus leave different scar patterns on the breasts.
If breasts are small as well as droopy their size can be increased by placing breast implants underneath the tightened breasts (breast augmentation). With very floppy, droopy breasts mastopexy alone may not achieve a satisfactory result; a breast implant may also be used to achieve a better appearance.

Before surgery a pattern is drawn on the breasts which correspond to the incisions used. The incisions are designed to be hidden by a bra or bikini top. During surgery a tube is placed in the breast to drain excess fluid and blood which may form - this is usually removed in 24 - 48 hours.

Length of operation - 1 - 2 hours

Time in hospital - 1 - 2 days

Postoperative discomfort/limitations

Severe pain is unusual; pain is controlled by the use of local anaesthetics at the time of surgery and pain relieving medication as needed. Dressings are usually left in place for 1 - 2 weeks after which a well-fitting sports bra should be worn until the swelling settles (4 - 6 weeks). If external stitches are used; they are remove after 10 - 14 days.

Mastopexy does not usually interfere with the ability to breast fed; but pregnancy invariably stretches the breast again - the procedure is best deferred until your family is complete.

Permanent scars are left on the breast and usually improve with time. The final scars usually settle to a white line; this may be fine or stretched. In some instances the scarring is unsatisfactory (see below).
With time the breast shape will change and some drooping is inevitable.

Time off work - 3 - 4 weeks

Risks and complications

General anaesthesia is safe; but in a tiny proportion caries a very small risk.
General complications: bruising, swelling and bleeding which may be heavy and need a blood transfusion and a return to the operating theatre to stop; chest and wound infection, unsatisfactory scarring (keloid or hypertrophic); leg vein thrombosis (clot).

Specific complications: Changes in nipple sensitivity (increased, decreased or lost); breast numbness; delayed wound healing; asymmetry in size and shape; dog-ears (prominent folds of skin which may be formed at the ends of any scar).
Several complications of mastopexy are increased in smokers and in women who are overweight.

Cosmetic surgery guide

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