A flabby breast can be caused by many factors, such as pregnancy, breastfeeding, weight loss, gravitation, and aging. It can face downward and may be accompanied by a low-positioned nipple. Breast lift or mastopexy is an aesthetic plastic surgery procedure aimed to restore breast firmness by reducing the skin which supports the breast. This procedure will transform the appearance of the breast but does not alter the size. To increase breast size, this procedure can be done simultaneously with an implant placement or other techniques of augmentation using autologous fat transfer.
Candidates are those with flabby breast and nipple height lower than its ideal position or faces downward. The breast size is still satisfactory. They may also have wide areolar area (areola is the dark pigmented skin around the nipple). A simple examination for breast lift candidates is the “pencil test”. If you can’t clamp a pencil with your breasts, you may need a breast lift.
The surgery can last for 1.5-3 hours, depends on the technical challenge. The procedure is as follows:
General anesthesia, conscious sedation, or simply under local anesthesia
Some options of incision method are a racket-like incision (peri-areolar circular incision followed by a downward vertical incision on the lower dome of the breast) and anchor-like incision (peri-areolar circular incision followed by a downward vertical incision and curving incision all along the breast fold). The peri-areolar incision is made around the areola to produce a round scar.
The breast is refined through the incision; the areola can be reduced in size; the excess skin is removed.
Incision is closed by sutures.
After the surgery, you will need to wear a supportive bra. Swelling on the wound will resolve after 3 weeks-1 month. The final outcome can be seen in 3-9 months. You must avoid strenuous physical activity for 1 month. It is important to lead a healthy lifestyle by maintaining body weight stability and stop smoking.
Complications that may happen are bleeding, bruising, infection, and asymmetrical nipples or nipple pointing upward. This procedure does not affect breast milk production.
(Source: Prasetyono TOH. Breast shaping. Bazaar 2009 Feb;Chapter 4:57.)