By Dr. Rosenblatt
What qualifications should I look for in a surgeon to do my breasts?
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.
Do I need a lift (mastopexy) or will just implants do?
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.
How can I tell where the infra-mammary line is?
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.
Can I get the lift from implants alone?
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.
Where are the incisions?
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.
Why would I need a T incision?
If your breasts are ptotic, then you have excess skin and need to have it removed.
Why did my breasts sag?
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.
What kind of anesthesia do you use for breast surgery?
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.
How long is the surgery and do I stay in a hospital?
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.
What can I expect after I go home?
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.
What is the recovery like?
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.
When can I go back to work or the gym?
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.