Weight gain and subsequent weight loss, pregnancy and breastfeeding with subsequent deflation of the breasts are a reality of life for most women. Many women attribute this to sacrifices that a woman needs to make as she ages, has babies and raises a family. However, this need not be true! One of the commonest complaints that we have in our clinic are women who come in after multiple births, suffering from sagging deflated breasts or breasts that have become too big and saggy. When they finally do come in to see us, many of them acknowledge that they have made enough sacrifices for their families and now it is time to take care of themselves. The other common misconception is that the ladies are doing this for their husbands, but interestingly, many ladies actually tell us that the main motivating factor is a desire to feel better about themselves instead.
So what can we offer someone who has sagging breasts? There are a few common reasons for sagging breasts. These include post pregnancy volume loss, excessively large breasts or excessive skin laxity.
1. Post Breastfeeding/ Pregnancy Volume Loss
During pregnancy, breastfeeding, the breasts are engorged with milk. After lactation has stopped, the milk ducts shrink and the breast reduces in size. However, the skin is already stretched and therefore the breast is no longer as perky as before. In this situation, all that is needed to give the breast the much needed breast lift is to replace some volume into the breast. This breast volumizing can be done using different methods. The two most common methods are either with breast implants or fat transfer.
Fat transfer is a day surgery procedure where fat is typically harvested from either the abdomen or the thighs via mini-incisions. Thereafter it is injected into the breasts after processing. Patients can usually expect about half to three-quarters bra cup size increase with each session of surgery.
Breast implants are inserted via small incisions at the inferior fold of the breast. We only use FDA approved Mentor implants.
If the excess skin is not too much and the problem is mainly volume deflation, this is all that is needed to restore the breast to a very attractive shape.
If there is too much excess skin, then a breast lift or mastopexy is the treatment of choice. Here, the nipple-areola is lifted back to its ideal position with either a "lollipop" or inverted-T incision. This can be combined with either fat injection or breast implants if desired.
2. Excessively Large Breasts and skin laxity
Breast reduction and lifting involves the removal of excess fat, skin, and breast tissue from the breast region. The procedure is generally done as an outpatient under general anesthesia or intravenous sedation.
The surgery time varies from 1.5 to 4 hours depending on the size of the breast. Various incisions may be used. This includes the peri-areolar, "lollipop" or the inverted T incision. Sometimes drains are inserted for 1-2 days to allow drainage of excess body fluid.
Depending on an individual basis, this procedure may be medisave or insurance claimable.
Patients are required to wear a support bra for up to 6 weeks, in order to protect and help with the contraction of the breasts as advised by the plastic surgeon. Usually stitches will be removed two weeks later, covered with a good secured dressing over it, in order for patients to shower comfortably. The breasts will be swollen and bruised, and also likely to have some pain and discomfort, which will be alleviated with pain medication. Full recovery will require around 2-3 weeks.