Dr Nicholas Lotz (FRACS) Specialist Plastic Surgeon
Dr Nicholas Lotz
MBBS BSc(Med) FRACS
Specialist Plastic Surgeon
Main Rooms
Level 1 357 Military Rd
MOSMAN, NSW 2088
Appointments & Enquiries
info@drnicholaslotz.com.au
Ph: 1300 304 209
Fax: 02 9904 0166
BREAST SURGERY

Breast Lift (Maxopexy)

The following information sheet is intended to assist patients preparing for breast lift (maxopexy)surgery with Dr Nicholas Lotz.

 

Overview

Breast Lift

In women who have lost the fullness and shape of their breasts after breast feeding, weight loss, or with age, a mastopexy can lift the position of the breasts on the chest wall.

Sometimes this procedure is performed on only one side in order to improve the symmetry between the two breasts. If you feel that you also need extra volume added to your breasts then a breast implant can be placed behind the breast tissue at the time of surgery to increase the size of the breasts and to replace the volume that has been lost. This procedure is known as an augmentation mastopexy.

A breast lift is very similar to a breast reduction in terms of scarring and recovery, except that in a breast lift the breast tissue is reshaped (not removed) and only the excess skin is removed.

If you are happy with the size of your breasts when in a bra, but you feel that they droop when you are not in a bra, then a breast lift is the right procedure for you.

Breast Lift

Before the
surgery

During your initial consultation, Dr Lotz will spend time with you discussing your general health, current problems, and what you wish to achieve from the surgery. All patients have slightly different requirements, and will require surgery to be tailored to their needs. Dr Lotz will explain in detail what is required in your case, and the relevant risks and expected recovery will be discussed. You will be shown photographs of other patients who have undergone similar surgery, so you have an idea what to expect with respect to results.

You will be sent an information pack further explaining the procedure, along with a detailed, personalised quotation which explains all the relevant costs pertaining to the breast lift procedure as well and any heath fund or Medicare rebates applicable.

It is important that you stop any blood thinning medications at least 10 days prior to surgery in order to reduce the risk of bleeding.

You should also cease smoking a month before and a month after your surgery to reduce the risk of skin healing problems.

You will have a second consultation a week or two prior to your surgery to answer any final questions you may have, and photographs will be taken to aid planning your breast lift surgery.

Breast Lift

The surgery

Dr Lotz always performs breast lift surgery under general anaesthetic, in an accredited hospital, with an accredited and experienced anaesthetist.

The surgery takes approximately three hours, and you will usually be in hospital for one night.

Prior to the surgery you will be seen by Dr Lotz to mark the planned incisions on your breasts. Dr Lotz does not use any surgical assistants, so you can rest assured that the entire operation and all of the stitching will be performed solely by him, and there will be no surprise charges from an assistant.

Surgical Procedure

In the surgery, the excess skin will be removed and the breast will be lifted and the breast tissue reshaped. This will also increase the projection of the breasts. At the same time, the nipples will be elevated.

In patients who wish to have more volume to the breasts as well, a breast implant can be placed behind the breast tissue at the same time. Dr Lotz will be able to assist you in deciding if this is required for you. The increased volume that an implant provides will often mean that the amount of skin to be removed is less.

A small tube to remove any fluid that may accumulate is placed into the breast and this is usually removed the following day. Most of the stitches are internal and dissolving which helps to minimise scarring. The final scars will be shaped like a lollipop, with an incision around the areola and straight down to the breast crease. There will usually be a very short horizontal scar which sits in the breast crease. Waterproof dressings are applied and you are placed into a specially designed bra.

Breast Lift

After the surgery

Post-operative Recovery and Care

Dr Lotz will see you the morning after the surgery, and the drain will be removed. You will be able to shower once the drain is out as the dressings are all waterproof. The surgery is not usually particularly painful, but you will be sent home with pain killers to use if needed.

The recovery period is usually about two weeks following a breast lift. It is important to rest for the first week following the surgery, and it will take up to six weeks until you are back to completely normal activity.

You are able to drive when it is comfortable to do so.

Follow-Up Care

You will be seen a week after surgery to remove the dressings and check on healing of the wounds. Dr Lotz uses all internal, dissolving stitches, so there are usually only about three small stitches to trim on each side. The scars will be covered with surgical tape and you will be able to continue showering normally. You will need to continue to wear the soft supporting bra you are given for 3-4 weeks after the surgery.

After the recovery, you can enjoy your more youthful, lifted breasts. You will need to be aware, however, that gravity and the aging process will still be in effect. As a result, breasts may begin to droop if not supported. Dr Lotz recommends all patients continue to wear supportive bras on most days to help slow this process.

Risks of breast lift surgery

Fortunately, severe complications from mastopexy are unusual, and most problems do not impact the final long-term result. Dr Lotz will explain the risks in detail during his consultation, which include:

  • Anaesthesia risks (including nausea, vomiting and allergy)
  • Bleeding or haematoma formation (needing more surgery)
  • Infection
  • Poor healing of incisions
  • Changes in nipple or breast sensation, which may be temporary or permanent
  • Breast contour and shape irregularities
  • Breast asymmetry
  • Fatty tissue found deep in the skin might die (fat necrosis)
  • Fluid accumulation
  • Potential partial or total loss of nipple and areola
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Possibility of revisional surgery 
  • Recurrence of breast droop (especially if you have more children or lose weight)

These risks will all be explained in detail to you during the consultation.

Case Example:

49 year old patient. 3 months following breast lift surgery
Before After
Breast Lift Surgery

Frequently Asked Questions

If I have a breast lift, will my breasts drop down again?

Factors which determine how quickly your breasts may move to a lower position again after surgery include your general skin elasticity, weight gain or loss, pregnancy and age. Trying to maintain a healthy lifestyle and wearing good, supportive bras will help prevent further breast sagging.

How much does a breast lift cost?

Following your initial consultation, you will be provided with an exact quotation for your surgery, which details the surgeon, anaesthetist and hospital costs. There is no Medicare item number for a breast lift as it is considered purely cosmetic.

Where are the breast implants inserted?

The most common incision sites are under the breast, around the nipple or in the armpit. Breast implants have also been described as being inserted endoscopically through the navel (saline only). 

The choice of incision site needs to be discussed with your surgeon as just with the type of implant.  All incision sites have certain advantages and disadvantages. The preferred incision for Dr Lotz is in the crease under the breast, as this offers the best visualization and the scar hides nicely in the fold.

While the armpit avoids any potential scarring on or around the breast, it makes if very difficult to accurately place the implant, and has a high revision rate. Incisions around the nipple have a higher risk of issues with loss in nipple sensation. It also risks contamination of the implant from touching the breast tissue when it is inserted, which increases the risk of ALCL.

Do you have further questions about Mastopexy Surgery?

If you would like further information or if you wish to make an appointment to discuss breast lift surgery with Dr Nicholas Lotz, please contact our rooms.

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