What is a Mastopexy Implant?
Mastopexy implant is an operation that combines a breast augmentation and an uplift of the breast. It may also be known as a breast lift with implants. Mastopexy implant is the best solution for drooping breasts. It can be performed as a one-stage procedure or a two-stage procedure under general anaesthetic.
What To Expect During Your Consultation
You will be asked questions about your health, lifestyle and your desired outcome. Mr Ross will ask questions specific to your situation and also explain the risks and complications. You will have an opportunity to ask questions and make sure you are happy with the procedure before moving forward. The success of a consultation will depend on the patient being honest and open about their intentions.
The different kinds of mastopexy implant will be explained to you during your consultation. Mastopexy implant involves the placement of an implant under the breast to enhance the size and shape of the breast. Incisions are usually placed under the breast at the crease. Implants can be placed under the breast gland (known as subglandular placement), or behind the muscle. Where the implant is partly covered by muscle and part under the gland it is referred to as a dual plane breast augmentation. All of the options available to you will be presented during your initial consultation.
What kind of implants can I have?
There are many different types of implants. There are different sizes, different shapes and the covering and the content or fill of implants can vary. The kind of implants you choose will ultimately depend on your desired look.
All implants are made up of a shell which is then filled with silicone gel or saline. This shell may also be coated with a polyurethane foam. Most implants have a rough appearance on the silicone shell which is known as texturing.
Most patients will opt for gel-filled implants as they are most natural in appearance and tend to perform better than saline-filled implants in the long term. Saline-filled implants can occasionally develop folds or ripples and are more at risk of deflating. Occasionally, you may be offered a saline implant that can be adjusted after surgery.
Implants come in a variety of sizes and the implants are designed to fit the width and height of your chest. A sizing kit will be used to help you determine an appropriate size.
Implants can either be round or anatomical/teardrop. Round implants tend to provide more volume in the upper half of the breast of the breast whereas teardrop-shaped implants are shaped in a more natural way and aim to give a more natural result with less upper fullness.
Are Silicone Implants Safe?
Breast implants are made of medical grade silicone. They have been around since the 1960’s and there has been a lot of debate internationally about the safety of breast implants. I tend to use implants that have FDA approval. There is no association between breast augmentation and breast cancer or cancer of any other part of the body. Neither is there any proven association with any other illness.
There have been recent reports of an illness called anaplastic large cell lymphoma (ALCL) in association with breast implants, but it is sporadic and extremely rare. All risks, no matter how small, will be fully explained to you during the consultation.
Some risks associated with silicone implants include:
- Over time implants may fail and the silicone gel may leak out. Whilst this may cause symptoms and will result in re-operation to remove and replace the implants there is no evidence that a ruptured breast implant itself causes ill health.
- Small quantities of silicone may leave your implants and will be taken up in the lymph glands and possibly elsewhere. If this were to occur it is usually does not cause any problems and removal is rarely necessary and needs to be balanced against risks of surgery.
Preparing For Mastopexy Implant Surgery
All mastopexy implant procedures require general anaesthetic. Your health is a prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us.
Before undergoing mastopexy implant surgery you should do the following 6 weeks prior to surgery:
- Stop smoking, and commit to making this a long-term lifestyle change.
- Stop taking aspirin and anti-inflammatory drugs.
- Stop taking herbal supplements.
Prior to surgery, you may need to undergo some tests, so this will need to be taken into consideration if you need to take time off work. Following surgery, you will likely experience some abdominal discomfort and should aim to be off work for at least 2 weeks. This will depend on the type of work that you do, so this will be covered in your consultation.
Mastopexy implant surgery often takes between 1.5 and 2.5 hours under general anaesthetic. Incisions are placed around the areola and often there is a vertical scar from the areola to the breast crease. There may also be a need to place an additional scar in the breast crease. The breast implant is placed in the chosen pocket either under the gland, under the muscle or a combination of both. The wounds are then closed with dissolvable stitches.
Following the surgery, most patients return to the ward within one hour. Most patients are able to eat, drink and mobilise as soon as the anaesthetic wears off. Most patients don’t require a drain (small tube to remove fluids from a surgical incision) so you will be able to move around.
As the anaesthetic wears off, you may have some discomfort which will require analgesia (pain medication). The implants often feel hard and will sit higher than their final position. The skin around the implants may also feel tight. Due to the pressure of the implants, you may feel a pressure effect on your chest. You will need to wear a specialist support bra day and night for at least 4 weeks.
Most patients are able to go home on the same day. You will be given instructions to keep the wounds dry for the next week. Someone will need to drive you home after surgery and you will need home support to help you with day-to-day tasks. After one week, you will return to the clinic to have your incision site reviewed. Once the incision has healed, you should start massaging the scar as this will improve the appearance of the final scar.
How soon can I return to exercise after the mastopexy implant procedure?
Patients are advised to avoid strenuous exercise for the first week after surgery. This is to ensure the incision site is able to heal normally. However, some light exercise is recommended to improve circulation. You should continue to wear the support bra for 4-6 weeks after surgery. You should be able to return to light exercise such as walking one week after surgery. At 2-3 works, you can increase the intensity of your exercise to include uphill walks and walking on a treadmill. At 6 weeks, you will be considered fully-healed and should be able to return to your normal daily activities, including exercise.
How quickly will the surgical scars heal?
The pictures below show a patient’s journey from preop to 1 week where there is the usual bruising and swelling and asymmetry. The next picture shows the implants at 6 weeks after they have dropped and softened. As you can see, the scars are still red at 6 weeks, but this is normal. The final picture shows the implants a number of years later after the scars have faded. It’s normal for scars to take a number of months to fade.
Risks And Complications
The majority of patients are delighted with the procedure, although common complaints in the early stages include a change in the sensation, bruising and swelling. There is also the chance of slight asymmetry as the implants settle.
Uncommon early complications include:
- Haematoma (blood clot)
- Delayed healing
- Extrusion of the implant
- Seroma formation
- Thicked scars
There is also risk associated with general anaesthetic, including respiratory/cardiac arrest and deep vein thrombosis.
Although extremely rare, there is also the risk of an infection. In this scenario, the most likely course of action would be to remove the implants and allow things to settle before considering reimplantation at a later date, usually around three to six months later.
What is capsular contracture?
All implants change over time and will develop a capsule. This is a protective layer of scar that forms within 6 weeks of surgery around the implant. Over time, this scar can thicken and harden, which is known as capsular contracture. If this happens, it can lead to discomfort and pain, so you may need to have follow-up surgery. The chances of needing follow up surgery for any reason after mastopexy implant surgery are around 1-3% per year. So, after 10 years, between 10-30% of patients will need a revision surgery. Aside from a change in the size, capsular contracture is the most common reason for follow-up surgery.
If you are concerned about capsular contracture after your mastopexy implant surgery, you may want to look at breast augmentation revision surgery.
Will I have a change in sensation?
Sensation usually changes following breast augmentation and the nipples may be hyper or hypo sensitive. It is uncommon to have permanent changes in sensation but it can take a number of months to return to normal.
Other uncommon complications include:
- Although all implants can rotate within the pocket when anatomical implants rotate this can cause a change in shape. This is often self-limiting, due to the shape of the implant, but if it becomes troublesome, the implants may need to be replaced. This is an uncommon complication.
- If you are quite thin, you may be able to feel the edges of the implant. This is an inevitable consequence of the operation and will not improve with time. Over time, ripples or folds may be palpable, especially in certain positions.
- Some patients can develop intermittent swelling following breast augmentation. This usually resolves with time, but if it persists you will need to return to the clinic for further investigation.
- The scars following mastopexy implant surgery can be red for a number of weeks/months after surgery and it can take some time before the scars start turning pink/purple and then start fading into a white line. It is unusual to develop abnormal scars and unusual to have irregularities requiring a scar revision. Any revisions in the scars should not be considered for at least a year following surgery as they should be given time to settle.
- Just as the implant will age with time, so will the breast tissue. This is particularly true following childbirth. Follow up surgery may be required to tighten the tissue at a later date. Anyone undergoing any form of breast augmentation should be made aware of the potential need to follow up surgery to address problems with the implant of the skin/breast tissue.
- A combination of change to the breast and the implant can lead to the implant looking too high or too low and for the breast tissue to hang over the implant. Over time there may be a need for breast augmentation revision surgery.
What are the implications for mammograms and breast cancer screening?
Mastopexy implants push your natural breasts forward and so do not make it any more difficult to examine your breasts for lumps. You need to be aware that 1 in 10 women do develop breast cancer and if you find a discrete lump you should consult with your GP. If you find a lump or you are at an age to enter a breast-screening programme you may be offered a mammogram. You need to tell the mammography service that you have breast implants as you may require special views or a different type of scan.
Will I still be able to breastfeed after mastopexy implant surgery?
The ability to breastfeed should not be affected by breast augmentation. If one is unable to breastfeed after breast augmentation it may be that you would have been unable to breastfeed in any case.