Breast Lift

ANAESTHESIA

This procedure is always performed under general anaesthesia.

SURGICAL TECHNIQUE

Mammary Ptosis involves the breast’s skin becoming loose and sagging. The Breast Lift procedure consists of the removal of excess skin to a lesser or greater extent.

The most important phase of the procedure occurs prior to surgery: using a dermographic pen the doctor will mark the lines delimiting the patches of excess skin to be removed .

The scar size will depend on the amount of resected skin and how far the nipple-areolar complex must be displaced. Its placement can be:

• Periareolar (around the areola).
• Periareolar plus vertical scar
• Periareolar plus inverted T-shaped scar, where the horizontal branches of the ‘T’ are placed in the breast crease (submammarial fold). There are alternate techniques, whereby instead of a ‘T’ it results in an L-shaped scar. To provide the breast with projection and ensure long-lasting results, it is necessary to reshape the glandular tissue, anchoring it to the fascia of the chest muscle with suture stitches.

Whenever the sagging breasts are associated with a significant loss of breast volume the procedure can be combined with a mammary prosthesis implantation.

In order to close the incision, careful and delicate stitching is applied on all planes, ending the procedure with an intradermal suture.

If necessary the surgeon can place drainage tubes in the area to be removed two or three days later.

Once at home the patient must observe partial rest for four to five days and take the analgesics and antibiotics prescribed by the doctor.

PROCEDURE DURATION

Breast Lift surgery takes from one and a half hours to two hours.

RECOVERY

In most cases the patient can go home on the same day as the surgery. Nevertheless, she will need to observe a week of partial rest before returning to her usual daily activities, being careful not to exert herself too much.

POSSIBLE COMPLICATIONS

The probability of complications after the procedure is very low. Those are:

• Haematoma: an accumulation of blood that occurs when a clot blocking a blood vessel detaches itself. In the case of moderate, though continuous intraoperative bleeding, drainage is usually applied. If after this, the haematoma continues to occur, it would be necessary to remedy it with a new surgical intervention.
• Infection:nowadays the risk is very low since it is preventable with antibiotic treatment. Even so, if it does happen to occur, and depending on the intensity, it could affect the appearance of the scar and the general results of the intervention.
• Widening of the scar: an uncommon complication that can occur on skin which is very thin or has many stretch marks, or after insertion of a breast augmentation implant. In this case the scar and mammary tension are stabilized and a few months later the scar is reduced in an outpatient-type intervention using local anaesthesia.
• Hypertrophic scars and keloids: la cicatriz puede ser de mala calidad, gruesa y lenta para blanquearse (hipertrófica), circunstancia que depende de la naturaleza del paciente y de su edad.
• A Keloid is a pathology in the wound healing process in which the scar shows a disproportionate growth. It is quite infrequent among white women, although less rare among black women.
• Scar hyperpigmentation, can be due to the patient’s physical constitution, premature exposure to sunlight, or the use of certain medications. To solve the issue there are creams, depigmenting skin peels and laser treatments that all offer good results.

POSIBLES COMPLICACIONES

Aunque con una frecuencia muy baja, pueden aparecer la siguientes complicaciones:

Hematoma: es la acumulación de sangre que se produce cuando el coágulo que tapona un vaso se desprende. En los casos de sangrado intraoperatorio moderado pero contínuo, se dejan drenajes. Si a pesar de ello se produjera un hematoma, es necesario reintervenir para evacuarlo.

Infección: el riesgo de infecciones hoy en día es muy bajo, ya que se previenen con tratamiento antibiótico. Aún así, si apareciera, y según su grado de intensidad, sus efectos podrían afectar el aspecto de la cicatriz y el resultado en general.

Ensanchamiento de cicatriz: No es frecuente encontrar ensanchamiento de las cicatrices, aunque según tipos de pieles finas o con muchas estrías, o cuando se ha colocado un implante mamario, puede darse el caso. Si esto sucediera, después de estabilizada la cicatriz y tensión mamaria, se reducen éstas unos meses después y con anestesia local y ambulatoriamente.

Cicatrices hipertróficas y queloides: la cicatriz puede ser de mala calidad, gruesa y lenta para blanquearse (hipertrófica), circunstancia que depende de la naturaleza del paciente y de su edad.

El queloide es una patología de la cicatrización, con un crecimiento desmesurado de la misma. En la raza blanca es infrecuente, sin embargo, en la negra no es raro su aparición.

Hiperpigmentación de las cicatrices, bien por la propia naturaleza del paciente, por exposición prematura al sol, o por ingesta de algunos medicamentos. Para resolver esta complicación se utilizan cremas y peeling despigmentantes además de tratamiento con láser, obteniéndose buenos resultados.