Breast Augmentation and Simultaneous Mastopexy.
The added benefit of the combination of a lift with implants is that the results of the lift are more prolonged with the placement of the implants. Breasts generally remain full and perky for a longer time.
Risks associated with the implant are covered in a separate informed-consent document on breast augmentation, according to the type of implant selected (please read this document too). In general risks of complications are all higher with combined mastopexy and augmentation- eg capsular contraction, wound infection, loss of the implant, hypertrophic scars, delayed wound healing, asymmetry, nipple or skin necrosis. Excessive firmness of the breast can occur after surgery due to internal scarring (fat necrosis) or scarring around the breast implant. The occurrence of capsular contraction is not predictable except that it affects 1-2% of patients per year. It can turn a soft implant into a hard round ball years after surgery. Additional treatment including surgery may be necessary.
Delayed Healing: Wound disruption or delayed wound healing is possible with simple mastopexy but is a greater risk if combining mastopexy with implants (2% risk). Some areas of the breast skin or nipple region may not heal normally and may take a long time to heal. Areas of skin or nipple tissue may die (necrosis), leaving scar tissue. This may require frequent dressing changes or further surgery to remove the non-healed tissue. Individuals who have decreased blood supply to breast tissue from past surgery or radiation therapy are at increased risk for wound healing problems and poor surgical outcome. Smokers or users of nicotine products (including Vape) have a far greater risk of skin loss and wound healing complications and should not undergo this surgery. It would likely lead to removal of the implant for 6-months.
Asymmetry: Some breast asymmetry naturally occurs in most women. Differences in terms of breast and nipple shape, size, or symmetry also occur after surgery. Additional surgery may be necessary to attempt improvement of asymmetry after a mastopexy. The shape of the areola is stretched slightly differently on each side and the areola usually looks a little different.
General disappointment: You may be disappointed with the results of surgery. In general, your starting point prior to surgery presents the surgeon with a complex array of issues that are not always predictable and tissue can respond differently from one patient to the next. Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained. Infrequently, it is necessary to perform additional surgery to improve your results, though this would be at your additional cost. For example, you may not be able to achieve adequate fullness (breast size may be incorrect for you) that you desire in your breasts without needing to wear support garments and so decide to have breast augmentation surgery or other types of surgery like lipomodelling. You may be disappointed with the results of mastopexy surgery alone despite best intentions to help you.
Asymmetry in nipple location, unanticipated breast shape and size, loss of function, wound disruption, poor healing, and loss of sensation may occur after surgery and cause disappointment. Unsatisfactory surgical scar location or appearance may occur. It may be necessary to perform additional surgery to improve your results.
Allergic Reactions: The commonest allergies are to dressings, and cause redness to the skin and intense itching. In rare cases reactions (<1% risk) to drugs used during surgery, from prescription medicines, blood products or injected agents have been reported that can cause serious systemic reactions including shock (anaphylaxis (rare risk <0.1%). Allergic reactions may require additional treatment.
Damage to Deeper Structures: There is the potential for injury to deeper structures including, nerves, blood vessels, muscles, and lungs (pneumothorax) during any surgical procedure. The potential for this to occur varies according to the type of procedure being performed. Injury to deeper structures may be temporary or permanent. (It is extremely uncommon < 0.1%)
Extremely rare risks:
Cardiac and Pulmonary Complications: Pulmonary complications may occur secondarily to both blood clots (pulmonary emboli), fat deposits (fat emboli) or partial collapse of the lungs after general anesthesia. Pulmonary emboli can be life-threatening or fatal in some circumstances. Inactivity and other conditions may increase the incidence of blood clots traveling to the lungs causing a major blood clot that may result in death. It is important to discuss with your physician any past history of swelling in your legs or blood clots that may contribute to this condition. Cardiac complications are a risk with any surgery and anesthesia, even in patients without symptoms. If you experience shortness of breath, chest pain, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
Surgical Anesthesia: Both local and general anesthesia involve some risk. There is the possibility of complications, injury, and even death from all forms of surgical anesthesia or sedation.
Additional notes about Mastopexy Surgery
Medications: There are potential adverse reactions that occur as the result of taking over-the-counter, herbal, and/or prescription medications. Be sure to check with your surgeons or GP about any drug interactions that may exist with medications, which you are already taking. If you have an adverse reaction, stop the drugs immediately and call your hospital for further instructions. If the reaction is severe, go immediately to the nearest Accident and Emergency. When taking the prescribed pain medications after surgery, realize that they can affect your thought process and coordination. Do not drive, do not operate complex equipment, do not make any important decisions and do not drink any alcohol while taking these medications. Be sure to take your prescribed medication only as directed.
Breast Disease: Breast disease and breast cancer can occur independently of breast lift surgery. Breast lift surgery does not increase your risk of breast cancer. Individuals with a personal history or family history of breast cancer may be at a higher risk of developing breast cancer than a woman with no family history of this disease. It is recommended that all women perform periodic self-examination of their breasts, have mammography according to guidelines, and seek professional care should a breast lump or thickening or swelling around the breast be detected. If you are over 40 you should consider having a screening mammogram before having your surgery.
Breast and Nipple Piercing Procedures: Individuals who currently wear body-piercing jewelry in the breast region are advised that a breast infection could develop from this activity.
Contraceptive use: It is important to inform your surgeon if you use the contraceptive pill, estrogen replacement, or if you suspect you may be pregnant. Many medications including antibiotics may neutralize the preventive effect of the contraceptive (birth control pill), allowing for conception and pregnancy.
Intimate Relations: After Surgery: Surgery involves coagulating of blood vessels and increased activity of any kind may open these vessels leading to a bleed, or hematoma. Activity that increases your pulse or heart rate may cause additional bruising, swelling, and the need for return to surgery and control bleeding. It is wise to refrain from intimate physical activities until your surgeon states it is safe, and this is usually a minimum of 3-weeks.
Future Pregnancy and Breast Feeding: Mastopexy is not known to interfere with pregnancy. If you are planning a pregnancy, your breast skin may stretch and offset the results of mastopexy. You may have more difficulty breast feeding after this operation. Your breasts may sag again significantly after pregnancy.
Smoking: Second-Hand Smoke Exposure, Nicotine Products (Patch, Gum, Nasal Spray): Patients who are currently smoking, use tobacco products, or nicotine products (patch, gum, or nasal spray) are at a greater risk for significant surgical complications of skin dying and delayed healing and additional scarring. Individuals exposed to second-hand smoke are also at potential risk for similar complications attributable to nicotine exposure. Additionally, smoking may have a significant negative effect on anesthesia and recovery from anesthesia, with coughing and possibly increased bleeding. Individuals who are not exposed to tobacco smoke or nicotine-containing products have a significantly lower risk of this type of complication.
Patient compliance: Follow all surgery instructions carefully; this is essential for the success of your outcome. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Personal and vocational activity needs to be restricted. Protective dressings and drains should not be removed unless instructed by your surgeon. Successful post-operative function depends on both surgery and subsequent care. Physical activity that increases your pulse or heart rate may cause bruising, swelling, fluid accumulations and healing problems.
Mental Health: Disorders and Elective Surgery: It is important that all patients seeking to undergo elective surgery have realistic expectations that focus on improvement rather than perfection. Complications or less than satisfactory results are sometimes unavoidable, may require additional surgery and often are stressful. Please openly discuss with your surgeon, prior to surgery, any history that you may have of significant emotional depression or mental health disorders, or body dysmorphia. Although many individuals may benefit psychologically from the results of elective surgery, effects on mental health cannot be accurately predicted.
Additional Surgery may be necessary (re-operations): There are many variable conditions that may influence the long-term result of mastopexy surgery. It is unknown how your breast tissue may respond or how wound healing will occur after surgery. Secondary surgery may be necessary to perform additional tightening or repositioning of the breasts. Should complications occur, additional surgery or other treatments may be necessary. Even though risks and complications occur infrequently, the risks cited are particularly associated with mastopexy surgery. Other complications and risks can occur but are even more uncommon. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee or warranty expressed or implied, on the results that may be obtained. In some situations, it may not be possible to achieve optimal results with a single surgical procedure.
Long-Term Results: Subsequent alterations in the breast shape may occur as the result of aging, sun exposure, weight loss, weight gain, pregnancy, menopause, or other circumstances not related to your surgery. Breast sagginess may re-occur.
For further reading see: Uplift FAQs