While all breasts have a degree of natural “droop” to them, sometimes the effects of gravity bring about unfavourable changes in breast appearance. Breasts can become longer and flatter in contour, gradually losing the round, pert shape that most women prefer. Additionally, sometimes breast sagging becomes so pronounced that the nipples begin to point downwards rather than upwards or straight ahead.
What Causes the Breasts to Sag?
Breasts can sag for a number of different reasons. Some women have breasts that droop significantly due to genetic factors that affect the structure of their breasts but, more often than not, breast sagging develops due to one of the following events:
- Weight gain and loss. Because the breasts are composed largely of fatty tissue, they tend to get larger when a woman gains weight and shrink when she loses weight. While minor fluctuations in body weight (i.e., gaining and then losing five to ten pounds) are unlikely to put much stress on the breasts, gaining twenty pounds or more forces the skin of the breasts to expand a great deal. When this weight is lost, the stretched skin remains, making the breasts appear longer and flatter. Even if a woman does not lose the weight she has gained over time, the additional weight she’s carrying in her breasts can cause them to sag as it worsens the effects of gravity.
- Aging. As we get older, our bodies produce less of a compound called collagen. This compound is responsible for keeping the skin firm and supple, so the loss of it leads to a gradual increase in skin laxity all over the body. The breasts are often particularly hard hit by this change as their weight places a great deal of strain on weakening, aging skin. Furthermore, the mammary gland tends to shrink over time (particularly after a woman goes through menopause) which can worsen breast sagging.
- Pregnancy and breastfeeding. Pregnancy and breastfeeding are notorious for their ability to wreak havoc on the breasts of even very young women. Pregnancy causes the breasts to expand extremely rapidly (it’s not uncommon for the breasts to grow 2-3 cup sizes during pregnancy) a process that puts extreme stress on the skin. After breastfeeding, the breasts usually shrink back down again, sometimes becoming smaller than they were before pregnancy (due to changes in the size of the mammary gland). These factors combine to cause sudden and sometimes severe breast sagging.
Regardless of what’s caused a woman’s breasts to droop, the best solution to this cosmetic problem is breast lift surgery. Though there are many topical products on the market today that claim to be able to improve the shape and firmness of the breasts, none of them have been shown to make a real and lasting difference. To correct flat and drooping breasts, excess skin must be removed and the nipples must be repositioned so that they sit higher on the breasts. Currently, no lotion or cream is capable of achieving these objectives.
How Can Breast Lift (Mastopexy) Surgery Help?
During breast lift surgery, an incision is made around the nipple and then down the underside of the breast. This allows the surgeon to accomplish a number of different objectives: The nipple can be moved upward so that it sits higher on the breast and points “north” rather than “south”. At the same time, the surgeon can make the areola smaller if the patient feels her areolas are too large. By making an incision around the nipple in this manner, the surgeon ensures that the resulting scar can effectively be hidden in the naturally bumpy skin of the areola.
Once the nipple has been lifted, the surgeon will remove loose skin from the breast and lift the underlying breast tissue. While one vertical incision below the nipple is often enough to allow the surgeon to do the aforementioned, patients who have a lot of loose skin may require an additional incision along the underside of the breast. Fortunately, the fold of the breast will help to hide the scar from this additional incision. This extra step is more common when the patient has very large breasts or has lost a dramatic amount of weight.
By making the alterations described above, the surgeon can improve the shape, position and contour of the breasts. The result of any successful breast lift operation is breasts that are firmer, rounder and perkier.
It’s important to be aware that in addition to treating breast sagging, breast lift surgery can correct breast asymmetry. During breast lift surgery, additional tissue can be removed from the larger breast while the breasts are being lifted, creating more even breasts. Likewise, nipple asymmetry can be improved via the removal of some of the larger areola. If your breasts are only mildly saggy but severely uneven and you don’t desire an increase in breast volume, you should talk to us about the possibility of using breast lift surgery to balance your breasts.
How is Breast Lift Surgery Different from Breast Augmentation?
During breast lift surgery no additional volume is added to the breasts. No implants are inserted into the breasts during this operation and the breasts will be slightly smaller after it’s complete owing to the removal of loose skin.
Breast augmentation and breast lift surgery are designed to meet different aesthetic objectives. Breast augmentation is used to make the breasts fuller and rounder, and it can increase the size of the breasts by one or more cup sizes. Breast lift surgery is used solely to improve the contour and position of the patient’s existing breasts, restoring them to a youthful, pert shape.
Can I Have Both Breast Lift Surgery and Breast Augmentation Performed?
Absolutely. A breast lift can be combined with both augmentation with an implant and/or with fat grafting to the breasts. Combining operations into one single procedure allows patients to both augment and lift their breasts at the same time. This approach is advantageous because it cuts down on total healing time, reduces the patient’s overall risk of experiencing complications and is more affordable. This type of operation is called combined breast lift-augmentation surgery.
During combined lift-augmentation surgery, Dr. Khanna will use the same breast lift techniques described previously, while adding one additional step: She will create a “pocket” within the breast in order to make room for an implant to be inserted, or inject the breasts with fat that has been harvested from another area of the body such as the abdomen, back or thighs.
Who Makes a Good Candidate for Breast Lift Surgery?
Generally, women with breasts that pass the “pencil test” are considered eligible for breast lift surgery. During the pencil test, a pencil is placed within the fold underneath the breast. If the pencil stays there even when you remove your hand, your breasts may have enough “droop” to warrant breast lift surgery. This does not, of course, mean that you necessarily need breast lift surgery—if you’re happy with the appearance of your breasts then you shouldn’t feel you must alter them. However, this test provides a useful general guideline for women who are unhappy with the shape of their breasts and wondering whether or not breast lift surgery is right for them.
Before you come in for a consultation, it’s important to understand that a breast lift is a major operation. Breast lift surgery is performed while the patient is under general anesthesia and it can take anywhere from one to three hours to complete. Because of the invasive nature of this surgery, you will need to be in good overall health in order to have your breasts lifted. You must be free of outstanding health conditions (such as cardiovascular disease, lung disease and diabetes) and a non-smoker in order to be a good candidate for this surgery.
Women who are currently pregnant or breastfeeding cannot have a breast lift. Furthermore, it’s usually recommended that patients wait until they are done having children to have this operation. Subsequent pregnancies (after having a breast lift) may compromise the results of this procedure.
What Should I Expect While Recovering from Breast Lift Surgery?
First and foremost, you will need to plan to have someone drive you home from the hospital and help you for the first 1-2 nights after you have this operation. Because you will be groggy immediately after your surgery due to the effects of the anesthesia, you may need help getting into and out of bed and performing routine self-care tasks. As you will not be able to lift more than 10 pounds for at a few weeks after surgery, extended assistance when it comes to looking after your children is suggested.
Breast lift recovery is not usually very painful, but mild to moderate discomfort and swelling is normal. You will be given prescription pain medication to help you control pain symptoms. You will also be given a special surgical bra in order to help your breasts heal and minimize discomfort. These garments will be removed about 1 week after you have surgery. You may also need to have a surgical drain during the first few days of recovery. This will collect any fluid from your surgical site so your body doesn’t have to work harder at healing.
While many patients who have breast lift surgery feel better after just one week, we advise our patients to consider two weeks off of work just in case the initial soreness and swelling persist beyond day seven. You will also be instructed to avoid strenuous exercise for at least one month after you have this procedure. Finally, you will be asked to adjust your sleeping and bathing habits temporarily: You will need to sleep on your back for one week after having a breast lift and you should avoid soaking in the bath tub for 4 weeks. It will also be 1-2 weeks before you are comfortable driving.
When you come in for a breast lift consultation, we will further discuss recovery strategies with you in order to ensure that you have a safe, comfortable surgical experience from beginning to end.
Getting Started: Booking Your Breast Lift Oakville Consultation
If you’re ready to start exploring your options, feel free to contact the knowledgeable staff at our Oakville office for further information about breast lift surgery. We’re located conveniently between Hamilton and Toronto, Ontario, in order to serve breast surgery patients throughout the Greater Toronto Area. You can reach us at:
Dr. Khanna is a board-certified plastic surgeon with extensive experience in the area of performing breast surgery. She will be happy to provide you with numerous examples of her work upon request.