Mastopexy (breast lift) and augmentation (breast implants) are two cosmetic surgeries that change the look and size of the breasts. Mastopexy helps reshape breasts that have lost their firmness and sag or droop. Augmentation involves putting breast implants above or below the chest muscle, to make the breasts larger. Together, these procedures change the look and size of the breasts. This sheet tells you more about these surgeries and what to expect. Note: Sometimes these surgeries are done together. But depending on your body and your needs, your doctor may suggest two separate surgeries, so you can heal in between.
Breast implants are made of a silicone shell. The shell may be filled with saline (saltwater) or silicone (gel). Different implant sizes, shapes, and textures are available. There are benefits and drawbacks to each type of implant. You and your doctor will discuss which type is best for you.
Prepare for the surgery as you have been told. In addition:
Tell your doctor about all medications you take. This includes herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery.
Do not eat or drink during the 8 hours before your surgery, or as directed by your surgeon. This includes coffee, water, gum, and mints. (If you have been instructed to take medications, take them with a small sip of water.)
Mastopexy with augmentation takes about 3 to 5 hours. You may go home the same day. Or you may stay overnight.
Before the surgery begins:
An IV line is put into a vein in your arm or hand. This line delivers fluids and medications.
You will be given medication to keep you pain free during surgery. This may be general anesthesia, which puts you into a state like deep sleep. (A tube may be inserted into your throat to help you breathe.) Or you may have sedation, which relaxes you and makes you sleepy. If you have sedation, local anesthesia will be injected to numb the area being worked on. The anesthesiologist will discuss your options with you.
During the surgery:
For the breast lift, the doctor makes incisions in the skin around your breast. You and your doctor will have discussed incision sites prior to surgery. The doctor moves the breast tissue higher on the chest. Breast skin is tightened to hold the tissue in position. Any excess skin is removed. The areola (dark skin around the nipple) and nipple are moved higher on the breast. If the size of the areola is being decreased, skin is removed. The areola is stitched (sutured) into place. The process is then repeated for the other breast.
For the breast augmentation, the doctor forms a “pocket” to hold the implant. This may be above or below the chest muscle. The doctor then inserts the implant through the incision and into the pocket. If the implant needs to be filled with saline, that’s done now. The implant is then moved to the right place. If both breasts are being treated, the process is then repeated on the other breast.
When both stages are done, incisions are closed with sutures, surgical glue, or both. A tube (drain) may be placed into an incision before it is closed. This drains excess fluid that may build up as the wound begins to heal.
You will be taken to a room to wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. You will be given medication to control pain. When you’re ready, you will be able to go home with an adult family member or friend. Or, you may be taken to a room to stay overnight.
Once home, follow any instructions you are given. Your doctor will tell you when you can return to your normal routine. During your recovery:
Take any prescribed medications exactly as directed.
Wear the special bra or Ace bandage you were given before discharge as directed by your doctor.
Care for your incisions and the dressing (bandage) over them as instructed by your doctor.
Follow your doctor’s guidelines for showering. Avoid swimming, bathing, using a hot tub, and other activities that cause the incisions to be covered with water until your doctor says it’s OK.
When you shower, gently wash your incision sites. Then pat the incisions dry. Don’t apply lotions, oils, or creams to the incisions until after they are fully healed.
Don’t raise your arms above breast level for 10 days. And don’t lift, push, or pull anything heavier than 10 pounds for at least 7 days.
Don’t drive until you are no longer taking prescription pain medication and your doctor says it’s OK. When riding in a car, carefully position the seatbelt so that it doesn’t compress your breasts.
Be aware that breast swelling may last for 3 to 5 weeks. If advised by your doctor, use a cold pack wrapped in a thin towel to relieve discomfort and control swelling. It’s important not to leave the cold pack on for too long, or your skin could be damaged. Put the pack over your bandages for no more than 20 minutes at a time. Then, leave it off for at least 20 minutes. Repeat this as often as needed during waking hours until swelling starts to improve. Don’t fall asleep with the cold pack on. If you’re not sure how to safely use the cold pack, ask your doctor.
Call the doctor If you have any of the following:
Extreme chest pain or trouble breathing (call 911 or other emergency service)
Severe swelling in one or both breasts
A fever of 100.4°F (38.0°C) or higher (or as directed by your doctor)
Bleeding or drainage through the special bra or Ace bandage
Symptoms of infection at an incision site such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage
Pain that is not relieved by medication or pain that gets worse
More soreness, swelling, or bruising on one breast than the other
Breast that is very warm to the touch
You will have follow-up visits so your doctor can see how well you’re healing. If needed, stitches or drains will be removed at one of these visits. If you have any questions about your recovery, let your doctor know. And tell your doctor if you notice any changes in your breasts during or after your recovery. This may include injury to the breast or dimpling of the skin of your breast or nipple. If the implants leak or break, they will need to be removed or replaced. Also, be aware that your breasts may sag again over time. If you have any concerns about your surgery results, talk to your doctor.
Risks and possible complications include:
Bleeding or infection
Capsular contracture (scar tissue squeezing the implant)
Breasts that are not the same shape or size
Excessive or visible scarring
Changes in breast or nipple sensation (temporary or permanent)
Rupture or leakage of an implant
Wound healing problems
Death of fat cells deep in the skin (fat necrosis)
Potential for breasts to sag again
Not being happy with cosmetic result
Risks of anesthesia