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The female breast can sag due to various factors such as excess weight, not wearing a bra, age, increase and subsequent reduction in volume during breastfeeding, pregnancy and weight changes. Candidates for this operation are women who are generally satisfied with the volume of their breasts, but unhappy with the sagging and the position or size of the nipple.
There are different surgical techniques that attempt to lift the breast (pexy). In each case, the surgeon should adopt the one he considers most appropriate and, above all, the one he has mastered best.
The aim of the operation is to lift the breast as a whole, reducing the volume in the lower pole, increasing it in the upper pole and achieving the appropriate height of the areola-nipple complex. The projection of the breast is particularly important; a sagging (ptosic) breast is very flat, so the doctor must take great care with the appearance of the projection. In some cases, the diameter of the breast is also greatly increased, so it should be reduced.
As the aim of this surgery is not to remove volume, the surgeon must preserve as much of the gland as possible and remove the remaining skin with minimal scarring. Older techniques didn’t worry too much about scars and these were of considerable size.
The most modern techniques try to avoid horizontal scars whenever possible, as they heal worse and can be seen with cleavage.
The incision outlines the area where the breast skin will be removed and defines the new location for the nipple. When the excess skin is removed, the nipple and areola are moved to a higher position. The skin surrounding the areola is then brought down and the breast is restructured.
The Liacyr-Riveiro surgical technique modified by us is performed following the steps specified:
1. Careful marking.
2. Careful anesthetic infiltration.
3. Periareolar deepidermization.
4. Individualization of the inferior pedicled flap.
5. Retail migration.
6. Glandular and cutaneous closure.
Anaesthesia can be general or local with sedation. At Clínica Luso Espanhola we opt for sedation with local anaesthesia whenever possible; the reason is that the patient won’t feel any pain in the immediate post-operative period. The use of modern local anaesthetics such as ropivacaine with or without vasoconstrictor guarantees a long period of anaesthesia of the operated area, so that the surgery can be performed on an outpatient basis.
In trained hands, the procedure lasts between 2 and 3 hours. If haemostasis is carried out carefully, drains will not be necessary. This detail depends on the technique used during the surgical procedure. Hospitalisation can vary between 6 and 24 hours, depending on your general condition and the extent of the intervention.
A suitable dressing and bra should be worn for the first few days. We usually recommend wearing a bra for 3-4 weeks. Stitches should remain in place for a minimum of 14 days in the case of intradermal sutures.
The scars are disguised over several months and can take up to a year. It’s worth pointing out that scars never disappear, but over time they become very well disguised.
It’s a very rare complication, but it’s possible with any breast surgery.
In principle, there should be no problem.
It depends on the type of surgery and each person’s ability to heal. If everything goes well and the work isn’t heavy, between 15 and 30 days is a reasonable time, of course it all depends on whether your work requires a lot of physical effort or not.
A breast augmentation operation can be associated with breast suspension surgery or even afterwards.
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