Mastopexy

Mastopexy
(Breast uplift)

As a result of obesity, the fat component of the breast tissue increases, causing significant stretching and mechanical stress to the skin.  Following massive weight loss, breasts are deflated and devoid of fat tissue, resulting in multiple functional and aesthetic irregularities. The overstretched and damaged skin will have lost its elasticity and therefore its ability to adapt to the underlying tissue. Diffuse stretch marks may appear and also the deep connective structures, which link skin and gland tissue, are damaged, which causes remarkable skin laxity and breast descent. This condition may be exacerbated by pregnancy and breast-feeding. Of course, with or without weight loss, the natural ageing process contributes to a progressive loss of skin elasticity.

If, following the weight loss, the remaining glandular and adipose components are sufficient, so as to reassemble a breast with an appropriate volume, a mastopexy is advised. This surgery aims to uplift the breast and the nipple-areola complex, moulding the breast with the pre-existing tissue, in a higher position. Post-bariatric breast uplift requires a complex surgical approach: excess skin is excised from the lower pole; the gland is molded, lifted and secured to the pectoralis major muscle with deep sutures.  This manoeuvre seeks to achieve better-defined roundness in the upper pole. Finally, the nipple-areola complex is repositioned to the correct anatomical site.

Usually an inverted –“T” technique is utilised, which causes a scar in the inner inframammary fold, in contrast to short-scar techniques ( vertical or “J”). This approach allows better skin redraping and better long-term results. However, the resulting scar can be hidden by a standard bra. Only deep, dissolvable sutures are used.

Alternatively, if the remaining glandular and adipose tissues are diminished following weight loss and are not sufficient to reassemble a breast with an adequate volume, a breast augmentation with concomitant uplift (breast augmentation and mastopexy) is advised.

After the surgery, breasts are excessively high, more swollen in the upper region and stretched and square in the lower pole. Gradually, in the following weeks, they settle and achieve the appropriate shape.

Breast uplift is performed under general anaesthesia (the patient is asleep) with a one-night hospital stay after the surgery.

Careful administration of pain-killers during and after the surgery ensures that post-operative pain and discomfort are kept to a minimum.