Breast lift

Sagging breasts cause aesthetic and personal discomfort because of the importance of the breast in the image of femininity and the female psyche.

This sagging of the breasts (ptosis) is sometimes associated with a certain degree of asymmetry and, in some cases, with shrinking skin around the areola.

The aim of the operation is to raise and reshape the shape of the breasts, correct any asymmetry and restore tension to the slackened skin to achieve a shape in harmony with the patient's physical shape and in accordance with her wishes.

One problem correction should not create another and the surgical procedure should leave as few marks as possible, in particular, with the smallest and most discreet scars possible.

Conventional cosmetic breast surgery sometimes leaves extensive scars (around the areola, vertically under the areola, and horizontally in the fold under the breast). This is why, in an effort to reduce the scarring often associated with traditional breast surgery, I have developed the “Round Block" technique, which leaves only a simple scar around the areola, an area where healing is usually of good quality and not very visible because the scar blends with the edge of the areola; this is due to differences in colour and relief between the skin of the areola and the skin of the breast, without vertical scarring under the areola or in the sub-mammary fold.

The tone that is regained in the breast curve is a factor in balance and self-confidence, whether the body is naked or clothed.

This operation is used for women whose breasts have collapsed as a result of pregnancy, significant weight changes, or due to tissue ageing.

If the breast sags but has a satisfactory volume, the curve of the breast is supported by remodelling the sagging gland in the shape of a cone.

On the other hand, if the gland lacks the ability to produce a sufficiently curved glandular cone, breast augmentation using breast prosthesis or injecting your own fatty tissue (lipofilling) are procedures that can be used.

Each person arrives with a request for the correction of a particular defect that is particularly troublesome to them. The objective of the operation will be to correct this defect as a priority by assessing whether it may be appropriate to correct other associated defects to have a well-balanced, natural result that meets expectations.

So, depending on the insights gained during the first consultation, the operation could possibly be combined with another procedure, notably breast augmentation, correction of the inverted nipples, and areola reduction. These can be carried out during the same procedure or at another time.

During the first consultation, it is essential that you openly express what bothers you and what you would like to improve. Do not be afraid to ask any questions, including expressing your fears and expectations. Everyone has a different body shape, psychology and expectations. These are not the same and there is no standard to apply.

After you have explained your motivations, I will examine you and offer one or more solutions, taking into account your expectations, your anatomy, respecting your identity and the harmony of your physique.

During the first consultation, I will evaluate the technique I will use and any volume increase to achieve.

The "Round Block" technique that leaves only a small scar around the areola will be used in cases where your anatomy allows.

So you can visualise the desired result, I will show you photos of surgical results from cases similar to yours to enable you to understand the objective of the intervention.

It is essential that you and I have a good understanding when deciding to operate and to determine the technique to use from among those I can offer.

I will then give you all the information on the techniques proposed along with the information sheets from the Société Française de Chirurgie Plastique Reconstructrice et Esthétique (French Society of Plastic, Reconstructive and Cosmetic Surgery) as well as a detailed estimate of the costs for the options chosen. You will then be able to move your project forward and get ready for a second consultation when you will be able to ask any additional questions to help you make a decision and prepare for the operation.

Pre-operative examinations should be carried out:

• Breast ultrasound and/or mammography to check breast health. These will allow any anomalies to be picked up and these may be treated during the operation or may possibly lead to additional pre-operative examinations.

• A blood test, if necessary, depending on the type of anaesthesia (local or general).

In the case of a general anaesthetic, you will need a consultation with the anaesthetist in the weeks preceding the operation and at least 48 hours before.

You will be prescribed a bra to buy, which is specifically suited to post-operative restraint. You must bring this on the day of the operation to be worn the end of the operation.

No medications containing aspirin or anti-inflammatories can be taken within 10 days of the procedure.

For general anaesthetic, you will have to fast strictly for 6 hours before the operation (do not eat anything, chew gum, eat sweets or smoke).

Tobacco consumption should be stopped or reduced as much as possible during the month before and month after the procedure. Tobacco can cause scarring problems.

Your stay in hospital is usually limited to the night following the operation. Same-day discharge is also possible after a few hours of monitoring following the operation. During the night, painkillers and analgesics are given by drip if you are staying in hospital or can be taken in tablet form at home. Leaving the next day, you can go home with a restraint using a special support bra.

The duration of the operation is about 2 to 3 hours.

In most cases, the operation is performed under general anaesthetic.

Before you go to the operating theatre, in your room, I will go over the precise goals with you as we agreed during the consultations. You can then always make recommendations and ask any questions. I will then draw the lines and marks on your skin to guide the operation and the lines of the incisions.

The procedure involves remodelling the glandular tissue, repositioning and possibly reducing the areola, and tensioning the skin.

Several techniques can be used, which will leave different levels of scarring.

The technique leaving the shortest scar is the "Round Block" technique, which makes it possible to limit the scar to simply the circumference of the areola, an area where healing is usually good and not very visible because the scar blends with the circumference of the areola; this is due to differences in colour and relief between the skin of the areola and the skin of the breast and does not leave any vertical scarring under the areola or in the sub-mammary fold.

But, when the subsidence is very severe, it may be necessary to add a vertical scar between the lower pole of the areola and the sub-mammary fold. However, the "Round Block" technique avoids a horizontal scar in the sub-mammary fold that conventional inverted T techniques produce. When classic inverted T techniques are used, the excess skin is essentially repositioned downwards and into the sub-mammary fold, while the periareolar "Round Block" technique using a vertical sub-areolar scar means that all excess skin can be repositioned upwards using this periareolar and vertical sub-areolar scar, without having to create a horizontal scar in the sub-mammary fold.

Deep internal stitching, which prevents enlargement or deformation of the areola, a major disadvantage of old periareolar techniques, is placed using a deep periareolar binding wire ("Round Block" technique) which provides long-term support to the diameter of the areola and optimises the skin positioning around the areola, leaving only a simple circular periareolar scar.

The stitches on the surface of the skin are made with threads placed in the skin’s thickness (intradermal stitches) and these are invisible. These stitches are absorbable so they do not need to be removed.

At the end of the operation, suction drainage is used to limit hematoma formation, a bandage is applied to the scar, and a support bra is put in place.

During the night and the days following the operation, there may be a painful sensation of tension in the area that was operated on, including aches and pains, which may impede your mobility. These pains are moderate in a resting position and may require analgesics that are given through a drip during hospitalisation or are taken as tablets at home. These post-operative pains will diminish and disappear within a few days of the operation.

The drainage will be removed the day after the operation.

The dressing will be completely removed during the first post-operative consultation, about a week after the operation and replaced by a waterproof adhesive dressing, allowing you to shower. This should be changed every 8 days.

The stitches used are absorbable so they do not need to be removed. Placed internally within the skin’s thickness (intradermal stitch), they are invisible.

Swelling (oedema) and bruising in the chest area are usually very moderate and it takes about ten days for them to disappear almost completely.

You will need to take about 4-5 days off work after the operation in most cases.

In addition to wearing the support bra day and night for 1 month, a waterproof dressing must be worn when showering. This should be worn for 1 month, changing it every 8 days.

You will need to attend a follow-up appointment about a week after the procedure, then after 15 days, 1 month, 3 months, 6 months, and 1 year.

• Do not raise your arms too high and avoid heavy physical exertion.

• You may resume sporting activities 1 month after the operation while wearing the support bra and limiting yourself to painless movements.

• The recommended rest position is lying on your back, slightly raised if possible. You may lie on your side, but not on your stomach.

• Exposure to the sun: no direct exposure before 1 month then exposure is allowed using a sun protection cream with a maximum sun protection factor. No exposure as long as there are bruises or the scar is pink.

• Pregnancy and breastfeeding: Breastfeeding is possible but it is best to wait 6 months before considering pregnancy so that the breasts have settled into their final form.

• Do not raise your arms too high and avoid heavy physical exertion.

Read the information from the French Society of Plastic, Reconstructive and Cosmetic Surgery.

The cost of the operation will depend on the procedure to be carried out, the duration of the operation, the type of anaesthetic and any hospital charges.

If the reason for the operation is purely aesthetic, you may not be reimbursed by Social Security. On the other hand, if this is part of a reconstruction, you may be covered by Social Security and, if applicable, by your mutual insurance company.

A detailed estimate is given to you during the first consultation following the options you have chosen. You then have a minimum legal period of 15 days to consider your options and move your project forward.

The first consultation costs €50. The follow-up consultations before and after the operation are free.