above: before and three months after breast lift and breast augmentation with Dr Sharp
What is a combined breast augmentation and lift?
Breast augmentation - also known as augmentation mammoplasty - can be a cosmetic procedure, or a reconstructive procedure in the case of breast reconstruction surgery. Breast augmentation increases the size and projection of breast, however it does not correct severely drooping breasts. Likewise, a breast lift will remove excess skin and lift the breast and nipple, however it will not fill out, enlarge or create a fullness in the upper breast; augmentation is required for this.
If you want your breasts to look fuller and to be lifted due to sagging, a breast lift - or mastopexy - may be required in conjunction with breast augmentation. This is also referred to as a breast augmentation mastopexy.
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above, left,: before and five months after abdominoplasty, mastopexy and breast augmentation surgery with Dr Sharp | above, right: before and ten months after abdominoplasty and breast augmentation surgery with Dr Sharp. These are classic ‘mummy makeover’ post pregnancy combined procedures.
What can be achieved with a breast lift and augmentation?
Common goals of breast lift surgery include
- To pull up sagging breasts (correcting breast ptosis)
- Create fuller-looking breasts, with greater projection and upper volume
- Balance or improve your figure, enhancing self-image and body confidence
- Correct asymmetric breasts
- Reconstruct a breast after mastectomy or injury
- To change the alignment of the nipple and breast or raise the nipple position in relation to the rest of the breast
- To change the size and/or shape of the areola.
Over the years, factors such as pregnancy, breastfeeding, aging, weight loss and gravity take their toll on a woman’s breasts. As the skin loses its elasticity and breast volume reduces, the breasts lose their shape and firmness and begin to sag. A breast lift is the first step of the procedure, removes excess skin, raises the nipple and tightens surrounding tissue and to reshape and support the new breast contour. An implant is then placed in the breast, usually under the muscle, to fill out the new reshaped breast. With the assistance of Dr Sharp, you would select the ideal implant for your ideal outcome. A wide range of anatomical and round implants in a variety of sizes means you can tailor your look to your idea breast shape.
Upon examination and consultation with Dr Sharp, this procedure can be done as two separate procedures or in a single procedure. Patients often want a combined procedure, to save on hospital costs and down time, however this is not always the best approach and can sometimes be more fraught with complications and suboptimal outcomes. The decision to do the two procedures at the same time must be made carefully and with all potential outcomes clearly understood.
Breast augmentation and lift as day surgery or inpatient stay
Dr Sharp can offer this procedure as either a day case - or as an inpatient with overnight stay. Dr Sharp will discuss the pros and cons - as well as costs - involved with an inpatient stay and will advise you at your consultation as to which option is best for you.
Drains after breast augmentation and mastopexy surgery
Dr Sharp may place small, thin drains during your procedure. These thin tubes remove fluid that causes swelling in the days after your surgery, and are usually removed 2-4 days after your operation, depending on how much fluid comes out of them each day. Our nurses will keep in contact with you on a regular basis to check in on your output levels and will let you know the right time to come in and have the drains removed; the drain removal itself takes a few minutes in our rooms, and most patients find it very tolerable. Drains might sound scary and painful, but remember that they are placed in an area where the nerves have been cut by surgery so the area is usually quite numb and sensation is reduced while the healing process takes place.
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Frequently Asked Questions About Breast Augmentation and Mastopexy…
What is breast lift surgery?
A breast lift, also known as mastopexy, is a procedure that raises and firms the breasts. Excess skin is removed to tighten the surrounding tissue and to reshape and support the new breast contour. The internal breast tissue is usually reshaped as well. Sometimes the areola (the darker skin around the nipple) becomes enlarged over time, and a breast lift will reduce this as well.
What breast lift surgery won’t do:
Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. An augmentation is required for this.
What is breast augmentation surgery?
Breast augmentation, also known as augmentation mammoplasty, can be a cosmetic procedure or a reconstructive procedure in the case of breast reconstruction surgery. The procedure involves silicone implants being inserted beneath the breasts to increase the size of your breasts or restore breast volume that has been lost after weight reduction or pregnancy enlarge them
Breast augmentation can:
- Enlarge small breasts
- Increase fullness and projection of your breasts
- Improve the balance of your figure
- Even up asymmetric breasts
- Reconstruct a breast after mastectomy or injury
- Enhance your self-image and self-confidence
Why have an augmentation and lift?
Breast surgery is a deeply personal procedure and you should do it for yourself, not for anyone else.
Common goals of breast lift surgery include:
- To change the alignment of the nipple and breast or raise the nipple position in relation to the rest of the breast.
- To pull up sagging breasts (correcting breast ptosis).
- To reshape the breasts.
- To change the size and/or shape of the areola.
Common goals of breast augmentation goals include:
- achieving a softer, fuller and naturally flattering breast contour
- turning around the negative effects of pregnancy, weight loss, or aging on breast shape
- repairing the disappointing effects of prior surgeries
- enhancing self-esteem and confidence.
Breast enhancement and lift surgery can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr Sharp.
Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breast lift is a surgical procedure to raise and reshape sagging breasts.
If your breasts are small or have lost volume — for example, after pregnancy — breast implants inserted in conjunction with a breast lift can increase both their firmness and their size
The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you’re physically healthy and realistic in your expectations, you may be a good candidate.
How to maintain your results
Following your post-operative instructions and wearing your support garments are integral in the early stages of healing. Good nutrition and maintaining a healthy body weight are integral to obtaining and maintaining optimal long-term results.
Why have an augmentation and lift?
The best candidates for breast augmentation and lift surgery are women who are looking for improvement, not perfection, in the way they look. If you’re physically healthy and realistic in your expectations, you may be a good candidate. Before you decide on breast lift and augmentation surgery, there are some important issues to keep in mind:
- Surgeons generally recommend waiting until breast development, child birth and breastfeeding have stopped before undertaking breast lift surgery
- Breast surgery can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr Sharp.
A breast lift may be a good option for you if:
- You are physically healthy
- You have realistic expectations
- Your breasts vary in size or shape
- One or both breasts failed to develop normally
- Your breasts are sagging and have lost their shape and fullness
- Your breasts have a flatter, elongated shape or are pendulous
- When unsupported, your nipples fall below the breast crease
- Your nipples and areolas point downward
- You have stretched skin and enlarged areolas
- One breast is lower than the other
- Remember that the shape and size of your breasts before surgery will influence the surgical procedure and the outcome.
Many women seek mastopexy and augmentation because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you’re planning to have more children, it may be a good idea to postpone your breast lift. Pregnancy is likely to stretch your breasts again and offset the results of the procedure
Any breast surgery is a very personal process and you should do it for yourself, not for someone else.
How do I choose my surgeon?
Breast lift and augmentation surgery is safe and performed frequently by plastic surgeons in Brisbane. However it is a major procedure – and therefore, choosing the right surgeon is of utmost importance. Both breast reduction and breast augmentation surgeries should be performed by a qualified plastic surgeon who is registered as a Fellow of the Royal Australasian College of Surgeons. You can confirm your surgeon’s credentials here
Dr David Sharp is a qualified plastic surgeon with a special interest in reconstructive and cosmetic plastic surgery. His personalised approach means that you receive plenty of preoperative time with him to discuss your specific body goals and any questions.
It’s normal to feel both nervous, and an excited sense of anticipation when planning your breast transformation surgery. Dr Sharp takes the time to ensure you have as many consultations as you require, to ensure your treatment is customised to suit your body and expectations – and address any concerns you may have.
Does pregnancy impact breast augmentation and lift results?
If you are planning future pregnancies, Dr Sharp recommends that you postpone having a breast lift and augmentation until you think you have completed your family.
If you have just had a baby and are considering this surgery, it’s important to give your body plenty of nurturing, patience and time to slowly find its equilibrium after birth and breastfeeding. Most women’s bodies do not return to their pre-pregnancy shape without lots of exercise and support. Ignore any external pressures to return to your post-baby shape. If you love your newfound form, that’s great! If you would prefer it to be more similar to your appearance pre-baby, that’s okay too - just make sure you are doing it for yourself. Dr Sharp has a special interest in post-pregnancy transformations - also known as ‘mummy makeover’ surgery. Click here to read more about tummy tuck and breast surgery options for restoring body shape and condition.
What kind of anaesthetic will I have?
Breast lifts and augmentations are performed under a full general anaesthetic. A specifically selected range of medications are administered during the surgery to ensure your post-operative comfort. Dr Sharp works with an experienced team of anesthetists.
Types of breast implants
A silicone envelope filled with varying amounts of sterile salt water (saline). This can affect the shape, firmness and feel of the breast. If the implant shell leaks, a saline implant will collapse and the saline will be absorbed and naturally expelled by the body.
A silicone envelope filled with an elastic gel that feels much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell or it may escape into the scar capsule (area around the implant) or even into the breast tissue. A leaking implant filled with silicone gel may not collapse.
Round breast implants
Round breast implants have a tendency to make breasts appear fuller. Higher profile options can achieve even more projection. Because round implants are the same shape all over, there is less concern about them rotating out of place.
Anatomical breast implants
Anatomical (or tear drop) breast implants main characteristics is a flatter upper breast pole and a fuller lower breast curve. An appearance that usually is associated with a youthful natural-looking female breast appearance
Smooth breast implants
Smooth breast implants are the softest feeling. These implants can move with the breast implant pocket, which may give more natural movement. Smooth implants may have some palpable or visible rippling.
Textured breast implants
Textured breast implants develop scar tissue to stick to the implant, making them less likely to move around inside of the breast and get repositioned. Texturing offers some advantage in diminishing the risk of a tight scar capsule.
How much does a breast augmentation and lift cost?
Potential costs include:
- Dr Sharp’s fee
- Anaesthetist fee
- Assistant’s fee
- Theatre costs
- Support garments
Depending on your suitability, Dr Sharp may be able to offer this surgery either as an inpatient, or as a day case in an accredited private hospital. The cost of your hospital component of the procedure will vary accordingly.
Breast augmentation and lift for cosmetic reasons is not covered by most private health insurers. However, in some cases, your surgery might be classified as reconstructive, and therefore have a Medicare item number. If so, you might be eligible to claim a rebate from Medicare, as well as your private health fund.
In these cases, after a consultation with Dr Sharp, an application for pre-approval can be lodged with Medicare - with photographs and supporting evidence – to assist with forward planning your out of pocket expenses.
After your consultation with Dr Sharp, if there’s a possibility that your surgery meets Medicare’s criteria, you will be provided with an item number, We recommend you contact your health insurance provider and ask them if you are covered for plastic surgery, particularly siting the item number provided.
It is important to understand that, in the case of complications or revision surgery, the cost of your breast augmentation and lift might extend to future surgical procedures and hospitalisations. We encourage patients to think about how they would fund further treatment beyond the immediate costs expected.
Breast augmentation and mastopexy results + expectations
It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing
The results of your breast lift and augmentation surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover from surgery. The final results of your breast augmentation and lift will appear over the next few months as breast shape and position continue to settle.
Dr Sharp will make every effort to make your scars as inconspicuous as possible. Still, it’s important to remember that mastopexy scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear most clothing and swimwear without incisions being detected.
If you are concerned about scarring, speak to us about the laser therapies available to reduce the appearance of scars.
Your satisfaction with a breast lift and augmentation is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic. You’ll be able to retain your new look longer if you:
- Maintain your weight
- Keep a healthy lifestyle
Breast lift/augmentation surgery and pregnancy
Breast surgery should be entertained after child bearing is completed. Changes that occur in the breasts during pregnancy can minimize or reverse the improvement a breast lift provides.
Likewise, significant weight loss after breast surgery can negatively impact breast appearance.
How long do the results last?
Your result will last forever (or at least as long as you do), provided you generally maintain your operative weight and don’t sustain injuries or undergo further breast surgery. Pregnancy and substantial weight gain are the two most common reasons why breast augmentation and lift results don’t last.
The surgical procedure
There are two main components of your breast lift and augmentation procedure. Whether you have them done at the same time, or staged over two operations, the following details the process involved:
Your breast lift procedure can be achieved through a variety of incision patterns and techniques. The appropriate technique for you will be determined based on:
- Breast size and shape
- The size and position of your areolas
- The degree of breast sagging
- Skin quality and elasticity as well as the amount of extra skin
Step 1 - Anaesthesia
Mastopexy surgery is performed under a general anaesthetic with a specialist anaesthetist meaning you will be completely asleep and feel nothing during surgery.
Step 2 - The incision
There are three common incision patterns:
- Around the areola
- Around the areola and vertically down from the areola to the breast crease
- Around the areola, vertically down from the breast crease and horizontally along the breast crease
Step 3 - Reshaping your breasts
The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to the higher position. The skin surrounding the areola is then brought down and together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.
If you’re having an implant inserted along with your breast lift, it will be placed in a pocket directly under the breast tissue, or deeper, under the muscle of the chest wall.
Step 4 - Closing the incisions
If you are having an augmentation is a second separate procedure, at this point in your mastopexy, all of your incision sites will be closed. Some incision lines resulting from breast lift are concealed in the natural breast contours; however, others are visible on the breast surface. Incision lines are permanent, but in most cases will fade and significantly improve over time.
Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Sutures, skin adhesives and/or surgical tape may be used to close the skin.
If you are having an immediate augmentation, the incision under the breast (inframammary) is left open at this point to facilitate the next step.
The breast augmentation component of this procedure involves the following further steps:
Step 5 - Inserting and placing the breast implant
Using the existing inframammary incision, a pocket is created for the insertion of the breast implant. The location of the pocket can be either:
- Sub-muscular: Under the pectoral muscle
- Sub-glandular: Directly behind the breast tissue, over the pectoral muscle
- Dual Plane: placement partially beneath the pectoralis muscle and partially beneath the mammary gland
Step 6 - Closing the incisions
Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to the skin. A small thin drainage tube may be left in the breast pocket to assist with drainage of any blood or fluid post-operatively.
Seeing the results
The results of mastopexy and breast augmentation are immediately visible. Bruising and swelling can take up to 6 weeks to disappear, with the breast taking up to another 6 months to ‘settle’ into its future shape.
Breast augmentation and mastopexy recovery
During your pre-operative consultations, Dr Sharp will give you specific information regarding what to expect during your individual recovery period that will help you prepare for the best possible post-operative experience, particularly regarding:
- Post-operative care; in hospital (inpatient) or at home (day surgery)
- Medication and pain relief
- Dressings/bandages after surgery
- Stitches and excision wounds
- Symptoms of complications; what’s normal, and what to look out for
- Resuming normal activity / work
You will also be given a number for our 24/7 post-operative care service.
During your breast augmentation and lift recovery, you will be taken into a recovery area to be closely monitored following surgery. If you are having the procedure as a day case, you will be discharged home; ensure you have a trusted person to collect you from the hospital and stay with you for at least 24 hours after surgery. If you are an inpatient, you will be discharged from recovery to the ward.
After your procedure, dressings or bandages will be applied to the incisions. You will go home wearing a special post-operative support bra, which we supply to minimise swelling and support your breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. This will be removed by a nurse on day 1 to 3 of your procedure, depending on how much fluid is coming out of the drain. This helps prevent swelling and haematomas from forming.
You will go home from hospital with post operative instructions, our after hours contact number and a complimentary bag which contains post op support products to help optimise your healing.
Your dressings will be checked and changed on day 7 after your procedure. A thin layer of tape will be over the incision wounds; these should remain in place to support your incisions for several weeks, so please don’t remove these until nurse indicates.
Continue to use your post-operative bra for at least 6 weeks after your procedure.
If your breast skin is very dry following surgery, you can apply a natural moisturiser such as bio-oil or coconut oil several times a day. Be careful not to tug at your skin in the process, and keep the moisturiser away from the suture areas. Your post op support bag will include a silicone gel which can be massaged into your incision lines once your tape is ready to come off.
You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides. In some patients, however, it may last a year or more, and occasionally it may be permanent.
Dr Sharp will give you detailed instructions for resuming your normal activities; this is generally safe after about 6 weeks. After that, you can resume these activities slowly. If you become pregnant, the operation should not affect your ability to breastfeed, since your milk ducts and nipples will be left intact.
Healing is a gradual process. Although you may be up and about in a day or two, don’t plan on returning to work for a week or more, depending on how you feel. Avoid lifting anything (even light objects) over your head for 3 to 4 weeks; and anything heavier than 5kg for 8 weeks. If you have any unusual symptoms, don’t hesitate to call Dr Sharp’s rooms.
You will likely experience soreness and swelling for a few weeks, and twinges of pain or pulling feelings for months after the surgery. Your final results will be visible after approximately 12 months, as your implants can take time to settle and internal scarring requires time to relax and soften.
Returning to exercise after breast augmentation and lift surgery
After 6 weeks you can gradually return to normal gym activities, adding small 2kg increments of weights and increasing length and intensity of your workout based on how body responds. Ease back if pain, swelling or any distortion is noticed. After 6 weeks you can start jogging and gentle swimming short distances – again, gradually increasing pace and distance using a supportive sports bra. Leave hard running or any sprinting to 12 weeks post op.
Breast augmentation patients who have a prosthesis in place may not be able to do regular pectoral workouts without discomfort in their breast, or shape distortion. You may need to avoid bench press, dips and flys altogether (now and in the future) if you find that these cause your PO results to change; this just requires close monitoring in the months after resuming activity. This is also something to consider if you are having a breast augmentation and mastopexy and participate in body building or use your pectoral muscle intensively in your job. Talk to Dr Sharp about this prior to your surgery as there are some considerations he can make in implant position and implant selection when planning your procedure if this is the case. It may be a trade off between having the look you desire, and the function you require.
Questions about postpartum mummy makeover surgery ethics
When women contact our patient care team to book in their mummy makeover consultations, they often feel the need to justify why they are considering the surgery. Of course they don’t need to, but this is largely due to concerns that their friends and family will perceive them to be superficial or ungrateful for the children they’ve carried and fed. Women can be very good at feeling guilty for wanting to do something for themselves - even if they’ve just dedicated a significant portion of their lives to doing things for others. Our director and mother of four Liz Washington, discusses body image, feminism and mummy makeover surgery here.
We don’t think women should ever be made to feel pressure to change their bodies - or not change their bodies. Women who are fit to make independent decisions for themselves should never be pressured to change their body and nor should other people make them feel guilty or selfish for wanting to make positive improvements to their body. We think most mothers have earned the right to feel great about their bodies, whatever that means to them
Our practice’s procedures are chosen under the direction of a woman; we don’t offer procedures that we deem to be unethical or irresponsible - and we don’t offer procedures that we wouldn’t have ourselves. Here are the reasons why we think it’s okay for a woman to want a breast lift, breast augmentation or abdominoplasty after pregnancy:
- first and foremost, breast lift and abdominoplasty surgery can offer life changing functional improvements for women’s bodies (see above); in many cases it’s a medical procedure that can transform lives, especially for women living with chronic skin issues, back pain, protruding hernias and core strength issues.
- for some women, carrying a baby and breastfeeding feels great; for many others though, it makes them feel disconnected with their bodies - and that’s not for anyone else to judge. The improved posture, skin reduction and new feminine curves that breast augmentation, breast lift and tummy tuck surgery provides can help restore their self image, sexuality and body confidence.
- research has proven that these procedures improve women’s sex lives.
- most of our patients have worked hard to have healthy bodies, good muscle strength and pelvic floor control before having babies; it’s okay to feel disconcerted when exercise and a healthy lifestyle fails to bring that back after having babies
- our mummy makeover patients are often women who are proactive about their bodies; they eat well, exercise and enjoy feeling proud and confident in their womanly figure; there’s a perception that women have this surgery if they have poor self esteem, and that’s usually very untrue
- mums selflessly spend years of their lives putting others first; emotionally, physically and financially. At some point, it’s healthy to start thinking about yourself, and what you want.
- it’s your body - and provided you are of sound mind - nobody else has the right to choose what you do with your own body (it’s not 1800’s folks!)