Breast uplift surgery

Breast uplift surgery (mastopexy) is an operation to re-shape your breasts. It can change how they look. It also aims to lift them to a higher position. Like all surgery, this major operation has risks. It’s important to find out about the procedure and choose your surgeon carefully.

About breast uplift surgery

It’s common and completely normal for breasts to become less firm over time. This may happen:

• after pregnancy 
• after breastfeeding
• as you get older
• if you put on a lot of weight and then lose it

You may feel comfortable with this. But if you want to change how your breasts look, you may consider breast uplift (breast lift) surgery. You may wish to have a breast uplift on just one breast if your breasts are uneven, or on both. How breast uplift surgery is done depends on the size of your breasts and how you wish to look afterwards. Usually, your surgeon will:

• re-shape your breasts by removing extra skin from underneath them
• tighten the skin and surrounding tissue
• move your nipple to a higher position

A breast enlargement or breast reduction procedure can be done at the same time if you also want to change the size of your breasts. These are more complex operations, so you’ll need to discuss the possible risks and benefits with your surgeon.

The timing of surgery is important. Most surgeons won’t do breast uplift surgery if you’re under 18, because your breasts may still be developing. If you get pregnant after having breast uplift surgery, it’s likely to stretch your breasts again. So if you plan on having children in the future, you may wish to wait until afterwards before having surgery.

Your surgeon may also advise that you wait about 6 to 12 months after breastfeeding before having surgery. This is so your breasts can get their shape back. Breast uplift surgery may also affect whether you can breastfeed in the future, especially if the position of your nipples has changed during your operation. This is because the milk ducts behind your nipple get partly divided during surgery to change the position of your nipple.

Breast uplift surgery will leave some scars. But your surgeon will try to keep these to a minimum and make sure they don’t show when you wear a bra or bikini top. Before you have a cosmetic surgery procedure such as a breast uplift, you’ll have a full clinical assessment. This will be done by your GP, surgeon and sometimes a psychiatrist or psychologist.

Advice about breast uplift surgery

It’s important not to rush into any cosmetic procedure, including breast uplift surgery. Remember that a breast lift is major surgery. Don’t be guided by price, and be very wary of advertising claims. Spend some time looking into it and discuss your options with your GP. They may be able to recommend a good surgeon with the right skills and experience.

Your surgeon’s qualifications

Check your surgeon is registered on the GMC specialist register in either specialist breast surgery or plastic surgery. The Royal College of Surgeons also has a list of certified cosmetic surgeons. Ask your surgeon if they belong to a relevant professional association. These associations include:

• the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)
• the British Association of Aesthetic Plastic Surgeons (BAAPS)
• the Association of Breast Surgery (ABS)

Your initial consultation

Once you’ve found a surgeon, arrange a face-to-face meeting with them to discuss what you’re hoping to gain from surgery. It’s important to ask lots of questions so you know what to expect. It’s OK to take a list of questions with you to the consultation. Your questions may include the following.

• What result should I realistically expect?
• What are the potential risks or complications?
• What’s included in the fee for the procedure – and are there any additional costs if I need treatment for a problem after surgery?
• Who will be responsible for my aftercare?

It's also important to think about how you would cope if there was a problem after surgery, or if the result didn’t meet your expectations. Don’t go ahead if you have any doubts.

You’ll have a two-week ‘cooling off’ period after your consultation before you finally decide to go ahead with surgery. If you still have questions, a second consultation with your surgeon may help. Most surgeons will offer a second appointment at no charge to go through the plans for surgery.

The hospital

Check that the hospital is registered with the independent regulator:

• the Care Quality Commission (CQC) in England
• the Regulation and Quality Improvement Authority in Northern Ireland
• Healthcare Improvement Scotland
• the Health Inspectorate Wales

Preparing for breast uplift surgery

Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed so you’re happy to give your consent for the operation to go ahead. You’ll be asked to do this by signing a consent form.

Your surgeon will ask you about your general health and medical history. They’ll also make a note of any medicines you’re taking.

If you smoke, try to stop at least six weeks before your operation. Smoking affects how you heal and increases your risk of a chest or wound infection, which can slow your recovery. Your surgeon may also recommend you lose some weight before your operation. Your surgeon may recommend that you have a mammogram (X-ray of your breasts) before your operation. They will also:

• measure your breasts and assess their shape and nipple position
• take photographs for your medical records
• mark the position where they’ll make the surgical cuts on your breasts

Breast uplift surgery is usually done under general anaesthesia. This means you’re asleep during the operation. You’ll be advised when to stop eating and drinking before your surgery. Follow your anaesthetist’s advice.

You may be able to go home on the day of your surgery, or you may need to stay in the hospital or clinic overnight. If you’re going home the same day, ask someone to stay with you overnight. The surgeon will usually give you written information or leaflets about the operation to read at home.

Breast uplift surgery

Breast uplift surgery usually takes around two to three hours to complete. Your surgeon will make several cuts on your breasts. The exact number and position of the cuts will vary, depending on the technique your surgeon uses.

Your surgeon will remove skin from the area around your nipples (areola) and/or from under your breasts. They’ll then re-shape your breasts. Your surgeon may then re-position your nipples and reduce the size of your areola to suit the new shape.

If you’re having a breast enlargement at the same time, your surgeon will insert a breast implant. This will help to make the upper part of your breast fuller. Your surgeon will place the implant directly under your breast tissue or behind your chest muscle.

When the operation is finished, your surgeon will close the cuts with stitches or skin-closure strips. They may wrap your breasts in a supportive dressing or use tape for support.

Aftercare for breast uplift surgery

After breast uplift surgery, you’ll need to rest until the anaesthetic has worn off. You’ll be offered pain relief to help with any discomfort. You may have thin tubes running out from the wound to drain excess fluid into a bag or bottle. These will be removed when the fluid or blood has stopped draining, usually before you go home. Your nurse will give you advice about:

• caring for your wounds before you go home
• what to do if you have problems
• how to care for your breasts
• hygiene and showering

They may also give you a date for a follow-up appointment.

You’ll need someone to drive you home. Try to find someone who can stay with you for the first 24 hours after your operation. The medicines used for a general anaesthetic can stay in your body for a while. Because of this, don’t drive, drink alcohol, operate machinery or make important decisions for 24 hours after your anaesthetic. Always follow your surgeon’s advice.

Recovery for breast uplift surgery

Build up your level of activity gently. You’ll probably be able to do light activities after two weeks and be back to your normal activities by six weeks. You shouldn’t have sex for two weeks after surgery. You’ll probably need at least two weeks off work after breast uplift surgery, but this depends on your job.

Don’t lift anything heavy for several weeks. Don’t drive until you feel safe and can wear a seatbelt comfortably. If you’re in any doubt about driving, contact your motor insurer to check you’re covered. Always follow your surgeon’s advice about when you can get back to activities and return to work.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask a pharmacist for advice.

It’s best to wear a well-fitting bra with no underwiring for a few weeks after the operation. This will help to stop the weight of your breasts pulling on your healing wounds. A sports bra may be suitable – ask your surgeon or nurse for advice. It’s important to look out for any signs of a wound infection. Contact your hospital or GP for advice if:

• your wound is painful
• the area around your wound feels hot and swollen
• your wound looks red or starts to form pus
• you have a high temperature (fever)

It may take several months for your breasts to settle into their new shape. You may have to wear bras with a different shape or cup size. Scars will be red at first but will gradually fade over the next 12 to 18 months.

Side-effects of breast uplift surgery

Side-effects are the unwanted but mostly temporary effects that you may get after having your treatment. Side-effects of breast uplift surgery include:

• soreness, swelling and bruising, which can take weeks to settle
• permanent scars that are noticeable at first, but usually fade over time
• a change in nipple sensation – it may be greater or less than before surgery

Complications of breast uplift surgery

Some complications can happen after any operation. These include:

• chest problems, especially if you smoke
• a risk of a blood clot, usually in a vein in the leg (deep vein thrombosis or DVT)

Complications specific to breast uplift surgery include the following.

• An infection may affect how your breasts look after surgery – this is treated with antibiotics.
• Bleeding. If blood collects under your skin (a haematoma), you may need surgery to stop the bleeding and drain the area.
• Unusual red or raised scars (keloids or hypertrophic scars) may form – these may be permanent.
• An uneven size or shape of your breasts may be caused by natural differences but can be highlighted by the surgery.
• A loss of part or all of your nipple or other areas of your breast may be caused by changes in blood supply, which can cause body tissue to die.
• Damage to deeper structures such as nerves, blood vessels, muscles and your lungs may be temporary or permanent.

Ask your surgeon about the chances of complications affecting you.

Over time, your breasts will naturally fall again. So the effects of your breast uplift surgery won’t last forever. To help maintain the shape and appearance of your breasts after your uplift, keep your weight steady with a healthy diet  and exercise.

Alternatives to breast uplift surgery

Depending on what you’re hoping to achieve with breast uplift surgery, there may be an alternative.

You may be able to lift your breasts up by wearing padded bras.

A breast reduction or breast enlargement may be a better choice if you want to change the size of your breasts.

After your pre-operation discussions with your doctor or surgeon, you may decide that you don’t want surgery at all. Ask your surgeon to explain your options to you.