A firm, well-formed bust is an expression of beauty and femininity. However, it is quite normal that the skin loses elasticity and firmness over the years. This natural aging process is visible on the face and does not stop at the breasts either.
Many women find this a psychological burden. If they suffer so much that it significantly impairs their daily life and sexual activities, some consider a breast lift (mastopexy). During this operation, the doctor wants to tighten and reshape sagging, sagging breasts. Which of the different surgical techniques the plastic surgeon uses depends both on the physical conditions and on the wishes and ideas of the patient.
It is undisputed that a breast lift can significantly improve a woman’s well-being and self-esteem. On the other hand, the operation is associated with a certain risk of complications. And there’s no guarantee that the breasts will fall. For this reason, the doctor and patient should discuss the risks and expected benefits in detail in advance and should only decide on the procedure after carefully weighing up all the criteria. Also because mastopexy is almost always a purely aesthetic measure that is not medically necessary. This means that the patients have to bear the costs of 4000-6000 Euro themselves. If implants are added, the costs often increase even more. (Note: Breast lift and breast reduction due to back pain may be reimbursed by health insurance companies.
What are the reasons for a breast lift?
Ultimately, hardly any woman is spared the fact that her breasts become limper over the course of her life. This is mainly due to the fact that the skin and connective tissue lose elasticity and resilience with increasing age. However, when this process starts and what extent it takes on depends on various individually different factors.
Very large and heavy breasts, for example, cause the skin to be stretched more than with a smaller bust from the outset. In addition, some women’s skin and connective tissue lose firmness more quickly than others, which is commonly referred to as “bad connective tissue”. Pregnancies can also weaken the tissue. Since the bust contains fatty tissue, it also loses its fullness when a woman loses a lot of weight. Some women also have problems with the natural shape of their breasts or the large court of their nipples.
This is usually unproblematic from a medical point of view. However, a sagging, sagging breast can lead to the woman no longer being satisfied with her body and her self-esteem suffering as a result. Such problems are an important motive for a breast lift.
From time to time the trigger for the desire for a breast lift can also be a relationship problem or another psychological conflict. Then it should be discussed all the more precisely in advance to what extent the operation actually helps the woman.
What has to be considered before a breast lift?
The prerequisite for the operation is that the patient’s growth is complete and her breasts are fully developed. Ideally, the procedure should only be performed after pregnancy and lactation, as it can impair the ability to breastfeed or make it impossible. If the woman has just given birth, wait at least eight months after breastfeeding until the breast has returned to normal. In a detailed consultation, the doctor – usually a plastic surgeon – informs his patients in advance about the various surgical techniques and possible risks of breast lift. Conversely, the woman tells the doctor what she expects from the operation and how she imagines her “new” breasts. Both then decide together whether and with which surgical method the mastopexy is performed.
How does the breast lift work?
As a rule, the plastic surgeon performs the breast lift in hospital. The procedure is performed under general anesthesia and takes two to three and a half hours. In mastopexy there are over twenty different cutting techniques, some of which are also used for breast reduction. Which surgical method the doctor and patient choose depends on several factors. On the one hand, the wishes and ideas of the woman. On the other hand, their physical conditions, such as the size of their breasts, the condition of their skin and connective tissue and the position of their nipples. The aim is always to create a natural breast shape with as few scars as possible. To achieve this, the lifting can be combined with a breast augmentation or breast reduction, possibly combined with the insertion of implants.
The most important surgical techniques
The least scarring technique is periareolar tightening. The surgeon removes an annular strip of skin around the nipple and then closes the wound under the uppermost layer of skin with a fine thread. The method is particularly suitable if the excess skin is not too large and the breasts only need to be tightened slightly.
The greatest tightening effect can be achieved with the T-cut. Here the doctor cuts around the areola, from its lower edge vertically downwards to the breast fold and there further inwards and outwards, so that an upside down T results. The L-section runs the same until the underbust fold, but is only continued outwards there. If the surgeon does not make a horizontal incision at all, this is called a Lejour technique or i-cut.
With all these surgical methods, the excess skin is removed and usually the nipple is also moved upwards. The doctor then inserts drains through which blood and secretions can drain off and sutures the wound, whereby he raffts the skin with a special suture during the I-cut and the Lejour technique. This first results in a crimped scar, which is smoothed after a few months by the natural shrinkage of the skin. Finally, the patient receives a tight fitting bandage or a special bra that supports and immobilises the breasts.
What happens after the operation?
In the first days the breasts are often swollen and usually hurt as well. Until these symptoms have subsided, the patient can be given a painkiller. The doctor usually drains the wounds a few days after the operation. At the latest then the woman gets a support bra, which she should wear day and night for the first three weeks and afterwards for another three weeks at least during the day. If no problems occur, the patients are discharged from the hospital approximately one week after the operation.
During the first six weeks after the operation, doctors recommend that you sleep in a supine position if possible and refrain from exercising. Other physical activities that strain chest, arm and shoulder muscles should also be avoided. During this time you should also be careful with your breasts.
What complications can occur?
If a qualified surgeon with the appropriate training and experience performs the operation, the risks of a breast lift are generally considered low. Nevertheless, complications can occur – as with any surgical procedure. These include bleeding, wound healing disorders and infections. Serious sequelae such as thrombosis, embolism or the death of tissue are rare.
However, the skin in the surgical area and especially the nipple are relatively often less sensitive than before. This is due to the fact that the doctor has to cut through fine skin nerves during mastopexy. For most women, however, this feeling will return in the course of the next few months. In individual cases, however, the sensitivity disorders can also remain permanent or also result in a higher and unpleasant sensitivity.