Ideally, a board-certified plastic surgeon with many years’ experience doing breast surgery is usually the best. This surgeon will know how to judge what kind of implant is the best for you and where it should be placed.
You need to have your breasts examined: if your nipples are below the infra-mammary line (where your breast joins your chest skin) a lift is needed.
Lift up your breast, put a pencil in the crease and release your breast. Look at your nipple in relationship to the pencil. If it is below the pencil, then your breasts are ptotic (droopy) and you probably need a lift.
Usually not; the more ptotic your breasts are, the more you need a lift. You may need an implant too if you do not have enough breast volume.
For very mild ptosis, the incision will only go around your areola, but for most patients it also involves a vertical incision, and possibly one in the infra-mammary crease (an inverted “T”), depending on your situation. Sensation is preserved and the scars fade over time.
If your breasts are ptotic, then you have excess skin and need to have it removed.
Most women’s breasts drop over time. Breast size, pregnancies, heredity, and the gradual loss of breast tissue with age all contribute to this. Breast ptosis is normal.
I usually use a mild general anesthesia and place local anesthesia in the breast to reduce post-operative pain. You are asleep, feel no pain, and are not aware of the surgery taking place. At the end of the surgery, I use a long-acting local in the breast so you have almost no pain for 12 or more hours.
The surgery is usually done in my AAAASF-certified operating room; you rest in the recovery room for a couple of hours and go home with a companion later in the day. The only bandage is a special bra and some gauze over the incisions.
You should rest for the first day or two; there is usually only minor discomfort and you will be given an analgesic if you need it. You will be given an appointment to return in 5-7 days. You can remove the gauze over the incision after 48 hours and shower. Keep the bra on 24/7 until you come for your follow-up appointment.
On your first post-op visit, I inspect the incisions. There are usually no sutures to remove, as I put them all on the inside. Your breasts will look fuller and higher, but they will round out and drop a bit over the first few weeks. It usually takes 3 months for all of the swelling and remodeling of the breasts to occur.
It all depends on the type of work you do. Usually you can return to work within the first week. I recommend you wait 2 to 3 weeks before starting strenuous activities or exercise. There is minimal down time with a well done breast lift.