Sagging of the breast, often with loss of volume, may occur naturally with time but is often associated with changes after pregnancy, with or without breastfeeding.
Mastopexy is the operation to deal with this and involves raising the breast to a higher level on the chest (including the nipple-areolar complex – N.A.C.) and then excising all the excess skin before stitching up. This results in a firmer more youthful appearance to the breast: the scar runs round the N.A.C. and then vertically down to the fold under the breast. Often the scar is extended horizontally for some distance either way in the breast fold.
If a larger sized breast is also desired, a breast implant can also be inserted (see Breast Augmentation). Whilst this can be done at the same time as a mastopexy, there is an increased risk of complications and it is best carried out as a second step procedure after about 3 – 4 months. Quite often, the result of the mastopexy is so good that nothing further is wanted or necessary.
Mastopexy is carried out under general anaesthetic (asleep) and, like breast reduction, requires careful pre-operative mark-up. Mr Matthews would do this in your room with you sitting up. In the operating theatre, the markings are carefully followed and, at the end of the uplift, the skin is carefully sewn up and dressings applied. A drain (see Breast Reduction) is only necessary occasionally.
After a one night Hospital stay, it is usually possible to go home, where you must take life more gently than usual. Any stitches needing removal would be dealt with at 2 weeks. You should allow 2 – 3 weeks off work and only reintroduce energetic exercise gradually.