Breast Lift Scars: Where They Come From and How They Heal

Among the questions one Houston practice suggests patients bring to a breast lift consultation, the first on its list concerns scars. The placement makes sense. A breast lift, or mastopexy, works by removing skin, and a surgeon cannot remove skin without incisions.

The practice belongs to Leo Lapuerta, MD, FACS, a triple board certified plastic surgeon with more than 30 years of experience. Its guidance on breast lift surgery in the Houston area covers the incisions, the care they need and the way they change over time, and it shows that much of what happens to a scar depends on decisions made before surgery and habits kept after it.

A lift requires incisions

Breasts lose their position for several reasons the practice lists: aging, pregnancy, breastfeeding, weight changes and genetics. The skin stretches and loses elasticity, and heavy implants can add to the drooping. A lift restores shape by removing excess skin, repositioning the breast tissue and tightening the skin that remains.

The size of the change drives the size of the incisions. If a patient needs a significant lift, the nipple and areola may have to move to a higher position for a natural look, and stretched areolas can be reduced in size at the same time. In general, the more skin a surgeon has to remove and the farther the nipple has to travel, the longer the incision lines.

Dr. Lapuerta discusses this at the consultation. According to the practice, he shows patients where he plans to make the incisions and how much lift they can expect once swelling goes down. He places incisions to minimize visible scarring, and the practice credits his experience with thousands of breast lifts for helping him keep scarring to a minimum.

The first days

The surgery is an outpatient procedure under general anesthesia and takes three to five hours, longer if other procedures are added. Patients spend at least an hour in recovery before going home, and they need someone to drive them and, if possible, stay with them for the first day.

Tenderness, swelling and bruising around the incision sites are normal. Many patients take prescribed pain medication for the first 24 hours and then manage with Tylenol. The first 24 to 48 hours tend to be the least active, and the practice suggests preparing meals and a comfortable resting spot in advance.

Caring for the incisions

The practice’s recovery tips center on the incision sites. Patients are asked to:

• Keep the incisions clean and check them every day.
• Report changes such as increased redness or swelling at a time when the sites should be improving.
• Watch for possible signs of infection.
• Avoid smoking and alcohol, both of which can slow recovery.
• Keep moving with light walks while resting enough, drinking plenty of fluids and eating nutritious meals.

About a week after surgery, Dr. Lapuerta sees patients for a follow-up appointment to check the incisions and confirm healing is on track. Most patients can return to work within a week, and the office answers questions by phone during recovery about what is and is not allowed.

Weeks six to eight, and the years after

Strenuous exercise such as running and weightlifting waits until the doctor releases the patient, which the practice says is around six to eight weeks after surgery. Swelling and bruising fade over the first several days, and the full result takes several weeks to appear as the breasts settle.

With proper care, the practice says, scars fade over time. Breast sensation is preserved in most cases, according to the practice, though temporary numbness can occur while the tissue heals.

The practice calls a breast lift permanent, but aging continues to change the lift and shape of the breasts. The practice puts the typical lifespan of a breast lift result at between 10 and 15 years on average, and it ties longevity to proper care and a healthy lifestyle.

Questions about your own scars

Because the incision plan depends on how much lift a patient needs, the scar discussion belongs at the consultation, when Dr. Lapuerta reviews medical history, examines the breast tissue and skin elasticity, and maps the incisions. Patients who plan to add implants, remove implants or combine the lift with a mommy makeover should raise that early. The practice notes that adding implants means placing them under the chest muscles and tightening the surrounding skin and tissue, and that removing implants means removing the excess skin left behind.

The practice also advises patients to ask any surgeon how long they have practiced, how many breast lifts they have performed and where they are accredited. Its before-and-after gallery, which the practice says gives patients an idea of how the surgery changes appearance, is the place to study healed results on women who started with a similar degree of sagging.

This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.