The search for physical beauty is not a phenomenon of modern times. Throughout history, people have used various methods to enhance their appearance and conceal what they believed to be imperfections. For many women, the size, shape and contour of their breasts are of particular importance. Today, women who are disturbed by sagging or loose breasts as a result of pregnancy, weight loss or natural aging can be helped by a remarkable surgical technique called breast lift or mastopexy. This procedure is designed to elevate and reshape the breast. The size of the areola, the dark, pink skin circling the nipple, can also be reduced through the procedure. Mastopexy is often performed in conjunction with surgery designed to enlarge the breasts.

Before Surgery
Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient. A thorough examination of the breasts is also made to determine the most effective surgical approach. The physician describes the type of anesthesia to be used, the procedure, what results might realistically be expected, and possible risks and complications.

Mammograms or x-rays, as well as photographs may be taken before surgery. Preoperative instructions often include the elimination of certain drugs which contain aspirin in order to minimize the possibility of excess bleeding. Birth control and other estrogen containing hormones may also be discontinued temporarily for the same reason. Antibiotics may be prescribed prior to surgery to prevent infection. Women who anticipate breast-feeding after surgery should discuss this with the physician as the ability to breast-feed after mastopexy varies with each individual.

The Procedure
A breast lift is usually performed in a hospital or an outpatient surgical facility under general anesthesia with the patient asleep. The physician may choose from a variety of procedures. depending on what changes are desired, Prior to surgery, premedication to relax the patient is administered, and breasts are carefully marked to indicate where incisions are to be made.

One of the techniques most frequently used involves incisions made on both sides of the breast and around the areola. A keyhole shaped incision is then made directly above the nipple. The surgeon works through the incisions to remove excess skin from the lower part of the breast. The nipple, areola and underlying tissue are then repositioned into a new, higher location and the skin form both sides of the nipple is brought down and sutured together to reshape the breast.

A modified procedure can be done on patients who have minimal sagging. This involves the removal of skin form the areola and surrounding areas. When breast augmentation is performed in conjunction with mastopexy, an implant is placed in a pocket created under the breast tissue or the muscle of the chest wall. The surgery can last two hours or more, depending upon the procedure.

Following Surgery
Following surgery, the patient wears either bandages or a special garment. This is usually replaced with a surgical bra which is worn for several weeks. Patients who are operated on in a hospital are released the same day or after an overnight stay. Pain connected with the procedure is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection. Instructions for the day of surgery include bed rest with limited activities. The physician determines when normal activities can be resumed; however, strenuous exercise and overhead lifting must be avoided for several weeks.

Sutures are removed in about seven to ten days. Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from the incisions, although permanent, will fade significantly in time.

Complications of infection and blood clots are rare; however, there are certain inherent risks connected with every surgical procedure which should be thoroughly discussed with the physician. Patients can minimize complications by carefully following directions given by the physician. Following mastopexy, there may be slight variations in the size or shape of the breast; however, these variations are common even before breast surgery.