Mastopexy. (Breast Uplift) Breast Care
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1 Mastopexy (Breast Uplift) Breast Care 1
2 Contents Introduction 2 What is a Mastopexy and what are the benefits? 2 Are there any alternatives to a Mastopexy? 3 Before the operation 3 The operation 3 After surgery 4 Going home 4 Risks and complications 5 Follow-up 7 Long-term outlook 7 Further information 8 Contact us 8 Introduction This information is for women undergoing a breast Mastopexy operation and explains what happens during the operation, outlining the benefits, alternatives and risks of surgery. If there is anything you do not understand or you have further questions or concerns, please speak to one of the Breast Care Nurses or your surgeon. Their telephone numbers are listed at the end of this booklet. What is a Mastopexy and what are the benefits? This is an operation to remove excess skin from the breast in order to change its shape and lift the nipple. The aim is to change the shape of the breast without significantly reducing its volume. Whilst your bra size does not normally change, the cup size and shape of a bra that you need may be different following the surgery. This operation is available in the NHS if you have had a breast reconstruction and need to match your other breast to the reconstructed breast or if you have had funding agreed by the NHS for an operation to correct breast asymmetry (one breast is a very different shape and size to your other breast). Are there any alternatives to a Mastopexy? The alternative to this surgery is to decide not to have surgery. Wearing a correct-fitting, supportive bra can help. If you have breasts that are a very different size to each other you may be advised by your surgeon to undergo breast reduction or augmentation (enlargement) surgery to correct the difference rather than a breast uplift. Before the operation Your surgeon will carry out a detailed assessment before deciding whether surgery is the most suitable option for you. Medical Photography will be arranged. If you are a smoker it is important to stop smoking, to reduce the risk of surgical complications. If you are taking the medication Tamoxifen, at a pre-operative assessment appointment, you will be advised to stop taking it one month before your operation. If necessary, blood tests may be arranged together with a chest X-ray and/or ECG. You are advised to bring in a soft supportive bra to wear following the surgery. The operating surgeon and anaesthetist will see you on the day of your operation. The surgeon will make some markings on your breasts. The operation There are three main types of operation to uplift the breast. Each results in a different pattern of scarring on the breast. Your surgeon will advise on which type of operation is most suitable for your breast and the pattern of scarring that you will have after the operation. The three patterns of scarring are shown on the diagrams below: The first leaves a scar around the areola (pigmented area around the nipple), the second leaves a scar around the areola and vertically down from the areola, and the third leaves scarring in the shape of an anchor. 2 3
3 Excess skin is removed, breast tissue is reshaped or removed and the nipple is repositioned higher to suit your new breast shape. The skin and breast tissue is then closed with stitches. Whilst it is unusual to place a tube drain into the breast to drain off the blood and fluid that collects during the healing process, it may be necessary. breast this will ease over the next few months. The breast will be swollen and your nipple sensation may be altered. The swelling and bruising subside in a few weeks but it can take 12 months for the scars and shape of the breast to settle. You are advised not to have sex for the week following the surgery. Allow only gentle contact with your breasts for about six weeks. If you feel unwell with a temperature, vomiting or notice significant redness of the skin on or around the breast you may have an infection and need antibiotics. You should contact your General Practitioner (GP) or, if out of normal hours, the emergency GP on-call service. After surgery You will need to take regular painkillers following surgery. We will encourage you to get up and move around after the surgery on the same day. If you have a drain in you breast, it will be removed when the fluid from the wound is minimal. The majority of women will be able to go home on the day of surgery, however some may need to stay in hospital for one night. Going home You will go home with some dressings in place and wearing a soft supportive bra (no underwiring). This helps prevent the weight of the breast pulling on the wounds and affecting the healing process. There may be some slight discharge from the wounds. You should wear the supportive bra for six weeks, only taking it off to shower. If you go home with a drain in your breast, we will arrange for you to come into the breast unit to have it removed. You are advised to avoid strenuous exercise for a minimum of six weeks. The length of time you need to take off work depends on the nature of your job but you will need at least to plan for two weeks. You may experience some pain in the Risks and complications All surgery carries some element of risk. Common sideeffects can include nausea and vomiting following general anaesthesia. As mentioned earlier, the breast will be painful, swollen and bruised following your operation. Specific complications Haematoma This is bleeding into the tissues following surgery and can occasionally lead to women returning to theatre to stop the bleeding or remove the blood. Wound infection This can occur after any type of surgery and may need treatment with antibiotics or further surgery. Deep venous thrombosis This can happen after any operation and general anaesthetic. Risks are reduced by wearing preventative stockings (TEDS) and returning to normal mobility as soon as possible. Delayed wound healing This is most commonly at the point where the vertical scar meets the horizontal scar (the T-junction) if the scarring is in the shape of an anchor. The blood supply to this area is at 4 5
4 its poorest. The skin may fail to heal, and separates, leaving a raw area. Occasionally, this can be extensive and will need regular dressings for several months until the wound is fully healed. Nipple complications The operation by its nature partially disrupts the blood supply to the nipple. There is a small but definite risk of nipple loss from this type of surgery, either total or partial loss. Your nipple sensation may be lost or altered and this may be a temporary or permanent symptom. Asymmetry There may be some lasting differences in the size and shape of your breasts following surgery. Most women are asymmetrical prior to their operation. Breastfeeding Breastfeeding is not usually possible after breast uplift surgery although some women do successfully breastfeed following this type of operation. Scarring Initially, the scars will be fine, bright red lines; in most cases the scars will usually heal satisfactorily and soften, becoming much paler and less obvious after 12 months or so. Some patients have a tendency to form red and lumpy scars (hypertrophy) or keloid scars, which are broad raised scars. The scarring will be permanent. Pregnancy The breasts change during pregnancy so if you are planning a family it may be wiser to postpone surgery. Fat Necrosis This is a common complication and in this type of surgery the risk depends on the relative amount of fat and breast tissue within your breasts. This usually presents with firm or hard nodular areas within your breast which may occur several months after surgery. Occasionally these can become inflamed with reddening of the skin and a burning sensation and discomfort and mimic infection. This usually responds to anti-inflammatories but occasionally can necessitate further surgery to remove the area of concern. Cosmetic Problems It is difficult to predict how your breasts will look after the surgery. Wrinkles and folds in the creases of your breast are common after the surgery but tend to settle down with time. You may occasionally need a second operation to correct differences in the size and shape of your breasts. Smoking or being overweight adds to any risks. Losing weight and stopping smoking will reduce your risk of complications. Speak to your General Practitioner for advice on giving up smoking and losing weight. Follow-up You will be given an appointment to return to the hospital 7-10 days following your surgery. During this appointment, the dressings will be removed and your wounds inspected. You will also be given an appointment to see your surgeon 6-8 weeks later after your wounds have had a chance to heal. Long-term outlook Breast uplift surgery is usually successful. Self-confidence may be increased and your breasts should be more symmetrical. Most women are pleased with the results of their surgery. The shape of your breast will change with time, particularly with pregnancy, changes in body weight and ageing and the results of surgery therefore will alter as you get older. Whilst the upper part of your breast will initially be full, that fullness usually disappears within six months. 6 7
5 Further information The American Society for Plastic and Reconstructive Surgery American Society for Aesthetic Plastic Surgery British Association of Aesthetic and Plastic Surgeons Further information and support regarding breast health is available from: Contact us Consultant Surgeons Mr. J A Gill FRCS Secretary: Ms A L Thorne FRCS Secretary: Advanced Nurse Practitioners Miranda Nicholls Sara Orton Breast Care Nurses Sharon Pike Lisa Graham Jane Boobier Louise Gardiner Emma Champion J Gill/Dec17/review Dec20 8
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