A breast lift can enhance your appearance and your self-confidence. The best candidates for mastopexy are healthy, emotionally stable women who are realistic about what the surgery can accomplish. Some women initially think that the breasts can be somehow tightened without scars and this is, of course, not possible. However, in cases in which the breasts are relatively small and the sagging limited, a lift may be achieved by performing a breast augmentation, limiting the scar to the small incision through which the implant is inserted.

The best results are usually achieved in women with small, sagging breasts. The results may not last as long in heavy breasts. Like some face lifts the procedure may need to be repeated in a relatively short period of time because of stretching of the thin skin and supporting tissue (which is the reason for needing a breast lift in the first place). The revisions of mastopexies on the other hand tend to last a long period of time because the tissues have already been previously stretched.

PLANNING YOUR SURGERY

In your initial no-fee consultation, it''s important to discuss your expectations frankly with Dr. Smith who will examine your breasts and record measurements. Dr. Smith will discuss the variables that may affect the procedure -- such as your age, the size, shape, and weight of your breasts, and the condition of your skin -- and whether an implant is advisable. He will also discuss where the nipple and areola will be repositioned.

THE PROCEDURE

Breast Lifts usually take between one to two-and-a-half hours. The number and length of the scars vary with the technique, which depends on the degree of sagging and other physical features of the breast.

The most common procedure involves an anchor-shaped incision following the natural contour of the breast with three conjoined scars-one around the nipple-areolar complex, one from the nipple to the crease, and a third along the crease. In some cases the scar may be limited to the circular incision around the nipple-areola complex, sometimes referred to as the doughnut mastopexy. The incision(s) 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 together to reshape the breast.

AFTER YOUR SURGERY

After surgery, you''ll wear a soft surgical bra over gauze dressings and sometimes an elastic wrap. Drains may or may not be required. Your breasts will be bruised, swollen and uncomfortable for a few days, but most patients do not complain of much pain with this procedure. You will be given adequate pain medication to make you as comfortable as possible.

Any skin sutures will be removed in a couple of days. Brassieres with metal under-wires can be worn after six weeks at which time there are no limitations on your activities. Patients are routinely followed for at least one year.

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