How it works
Everything begins with a consultation with a specialist in Plastic and Aesthetic Surgery. Your doctor will ask why you want surgery, what you are hoping for, your general health and medical history, the medications, vitamins, herbal supplements, alcohol and tobacco you use, any previous surgeries, and your family history of breast cancer along with any mammogram or biopsy results you have. The safety of your surgery depends a great deal on you sharing information clearly and honestly.
Your doctor will examine your breasts, possibly taking detailed measurements of size and shape, skin quality, and the position of the nipple and areola, take photographs for your medical record, and then discuss the options with you and recommend a plan. The technique that fits you is chosen based on your breast size and shape, the position and size of the areola, the degree of sagging, your skin elasticity and the amount of excess skin, along with what you want in terms of breast volume.
On the day of surgery, you are given medication to keep you comfortable throughout. Anesthesia is what keeps you from feeling pain during surgery; the options include intravenous sedation (medication given through a drip that makes you drowsy and relaxed) and general anesthesia (you are fully asleep). Your doctor will advise which option suits you.
Your doctor makes the incision along one of several patterns: a circle around the areola, a circle around the areola joined to a vertical line down to the breast fold (a lollipop or racquet shape), or an inverted-T shape. The doctor then removes excess skin, fatty tissue and glandular tissue where present, reduces the areola when needed, and secures the nipple and areola in a higher position. The incision is closed to create the new, higher and firmer breast shape: dissolvable sutures on the inside, non-dissolvable sutures on the outside, and sometimes surgical glue or special tape. For some cases of mild sagging, where the skin still has good elasticity and no increase in size is needed, the procedure may be done endoscopically.