Procedures - Breast Surgery

Dr. Weider's expertise encompasses both cosmetic and reconstructive breast surgery. His extensive training in both general and plastic surgery has provided him with a wealth of experience in all aspects of breast surgery. This includes breast reconstruction, breast reduction, breast augmentation and breast lift (mastopexy). In addition, he also treats gynecomastia (male breast disease).

Breast Lift (Mastopexy)

Over the years, factors such as pregnancy, nursing, and the force of gravity can have an adverse affect on a woman's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. A breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. By definition, the procedure repositions the nipple. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume--for example, after pregnancy--breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.

The Best Candidates for Breast Lift

The best candidates for mastopexy are healthy, emotionally-stable women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in larger breasts.

Many women seek mastopexy 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. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breast-feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.

Some Risk

A breast lift is not a simple operation, but it is normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications or a reaction to the anesthesia. Individuals vary greatly in their ability to heal. Therefore, outcomes are never completely predictable.

You can reduce your risks by closely following Dr. Weider's advice both before and after surgery. Mastopexy does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with unevenly positioned nipples, or a permanent loss of feeling in your nipples or breasts.

Planning Your Surgery

During your initial consultation, you will have the opportunity to discuss your expectations frankly with your surgeon. Every patient and every physician will have a different view of what is a desirable size and shape for breasts. Dr. Weider will examine and measure your breasts. He will discuss the variables that may affect the procedure- your age, the size and shape of your breasts, the condition of your skin, and whether an implant is advisable. You must also agree where the nipple and areola will be positioned since they will be raised during the procedure. Your surgeon should describe the procedure in detail, explaining its risks and limitations.

Be sure you understand the scarring that will result. Your surgeon will ask you about any medical conditions that could cause problems during or after surgery, such as high blood pressure, blood clotting problems, or any tendency to form excessive scars. Be frank, particularly about smoking and any drugs or medications you are taking - aspirin for example can affect clotting. Dr. Weider will explain fully the techniques and the anesthesia he will use, where the surgery will be performed, and the risks and costs involved. Don't hesitate to ask him any questions you may have, especially those regarding your expectations and concerns about the results.

Preparing for your Surgery

Depending on your age and family history, your surgeon may require you to have a mammogram (breast x-ray) before surgery. You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

The Surgery

The surgery is usually performed in a day surgery center, and the vast majority of patients go home the same day. Most procedures are performed under general anesthesia. Breast lifts are performed using a variety of different incisions. In general, the more sagging there is before surgery, the more incisions will have to be made to lift the breasts appropriately.


In certain situations, insertion of an implant at the same time can reduce the resultant scarring necessary to lift the breast. Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. Dr. Weider frequently performs a procedure in these situations in which an implant is placed in conjunction with a lift that only involves incisions around the areola.

After Your Surgery

You're likely to feel tired and sore for a few days following your surgery, but you'll be up and around in 24 to 48 hours. Discomfort is usually well controlled by medication prescribed by Dr. Weider. You should be able to return to work within a few days, depending on the level of activity required for your job. Within several days, the gauze dressings will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon.

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 over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting Back to Normal

You will be up and about in a day or two, but do not plan on returning to work for a week or more. Healing takes time. Avoid lifting anything over your head for three to four weeks and, if you have any unusual symptoms, call your surgeon immediately. Detailed instructions for resuming your normal activities may include no sex for a week or more, and no strenuous sports for about a month. After that, you can gradually resume these activities.

Dr. Weider will make every effort to make your scars as inconspicuous as possible. Still, it's important to remember that mastopexy scars may be extensive and are 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 even low-cut tops.

You should also keep in mind that a breast lift won't keep you firm forever--the effects of gravity, pregnancy, aging, and weight fluctuations will eventually take their toll again. Women who have implants along with their breast lift may find the results last longer. Your satisfaction with a breast lift is likely to be greater if you understand the procedure thoroughly and if your expectations are realistic.

 

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