What can be accomplished by this surgery?
With small to medium-sized breasts, it is possible to achieve (temporarily) prominent full breasts just as they used to be before they sagged. However, since the skin's elasticity diminishes at a more mature age – and this cannot be modified by an operation – the skin can provide the lifted breast a lesser degree of support. The surgery must amend the nipple's height, remove the excess skin and achieve fullness at the upper portion of the breast.
Which things cannot be undone or improved by the surgery?
Stretch marks (striae) on the breast's skin. These marks (streaks), which are the result of the stretching of the skin and a reminder of every pregnancy, obesity and diet that your body has gone through, are usually located on the upper portion of the breast's skin. The surgery however, is performed on the lower portion of the breast's skin, this in order to hide the surgical marks.
At what age can I begin?
At any age in which the breast seems to droop and sag, and you wish to lift it.
What is important to know before surgery?
That the solutions vary in accordance with the degree of breast sagging. A relatively light sag can be improved by inserting a silicone implant. This operation, which is described below (see: Breast Augmentation), allows filling of the breast and improving its shape with a minimal, almost invisible scar. In cases of medium to large sags, breast augmentation is not a sufficient solution. The implant will fill the breast and enlarge it but it will not lift it. In order to lift the breasts it is usually necessary to remove the excess skin enveloping the breast.
Note: removal of excess skin scars the breast's skin. These marks will fade with time, but they will always be noticeable. The length of the scars and their location depends on the degree of sagging: the greater the sag, the larger the amount of excess skin to be removed, and accordingly with longer incisions and therefore longer scars.
What should be done before surgery?
Wash the area well with water and soap, avoid the consumption of medications contacting aspirin, and remain in a complete fast (food and drink) for 7 hours before the operation.
How does the surgeon know where and how much he should cut?
By using an indication he marked. Before entering the operation room, the surgeon will mark the operation plan on your breasts. This marking must be performed while you are in standing position. Why? Because during the operation, while you are lying on the operating table, your breasts will look different (as in any lying position), and then it will be impossible to plan the correct location of the incisions.
Where is the incision performed?
Usually at the nipple's area and sometimes even beyond it, depending on the degree of sagging and the surgeon's dexterity and expertise, which dictate the operation type chosen.
There are two types of operations designated for removing excess skin: one operation leaves an anchor-shaped scar (a straight line from the nipple to the fold underneath the breast, and another curved line below the fold). A second operation leaves scars solely around the nipple or around the nipple with an additional vertical scar descending from the nipple towards the fold underneath the breast.
What is done during surgery?
Here as well, things vary in accordance with the degree of sagging and the dexterity and expertise of the surgeon.
In a relatively light sag, a Benelli surgery is performed through an incision around the nipple. The surgeon "gathers" or "stretches" the skin towards the nipple, removes the excessive skin and then lifts and affixes the nipple at a higher position.
The advantage of this method lies in the location of the scar, which is integrated into the nipple's border.
a – Since the skin collection is performed towards the center, at the extremity of the cone and at the edge of the aerola, the breast loses its conical shape.
b – The scar's location sometimes expands and widens it.
In a medium sag, the incision is performed around the nipple, as well as vertically between the nipple and the fold underneath the breast.
During surgery, the breast's tissue is reshaped and part of the tissue is transferred from the lower sagging portion of the breast to the upper portion using stitches or a more advanced method under the large chest muscle (Graff Technique), the nipple is then raised to a higher more suitable location, and the skin is allowed to suit itself to the new shape of the breast.
Accordingly, the advantage of this method is obtaining a conical breast. its disadvantage – a scar formed on the breast's skin.
A harsh sagging of the breast, requires a full operation. That is, one which leaves an anchor-shaped scar on the breast. The incisions are performed in a right line from the nipple towards the fold underneath the breast and beneath it. During surgery not only the breast tissue is designed and shaped (using stitches) but also the chest's skin, such that it provides a bra-like structure which will support the breast tissue. That is to say, that the incisions are planned in such a manner that when the new skin rims that were created are connected, a conical shape is obtained once again. At the end of the operation, the nipple is located at a higher more suitable location. The disadvantage of this operation is of course the long scars it leaves behind.
At the end of surgery, regardless of the type of surgery, the breast is bandaged by a sports bra which supports and holds them well or by a pressure bandage wrapped tightly around the chest.
What type of anesthesia is being used?
The operation can be performed under general anesthesia. Operations meant to amend solely light sags may be performed under local anesthesia as well, and then anesthetic is injected directly into the breast itself, as required.
How long does the surgery last?
Between an hour and a half to four and a half hours, depending on the degree of sagging.