• Mastopexy is mostly performed in combination with augmentation of the breasts, unless patients do have enough of their own breast volume to provide a decent size breast after lift alone. Since excess skin is the major problem, it can only be addressed by cutting it away, thereby leaving relatively significant scars. The scarring is exactly the same as in breast reduction surgery, since the same pattern for skin removal is used. The scars do mature over a year and are mostly hidden in the breast fold or blend in between the darker areolar and lighter breast skin. Scarring varies from patient to patient and is beyond the surgeons control. The choice lies between having saggy breasts without scars compared to more decent breasts with acceptable scars as most patients will confirm.
• The ideal nipple position is determined and the pattern for skin resection marked with a marking pen and measuring tape. Skin is resected, the remaining skin is loosened and tightened around the breast tissue thereby creating breast lift and elevation of the nipple-areola on the breast.
• Skin is sutured with dissolvable stitches, drains are inserted and the breasts covered with cotton wool and plasters. This is a day procedure unless patients are from out of town when they will need to stay overnight. On discharge a script is provided for pain killers and sometimes antibiotics.
• Drains are usually removed after 3 days and plasters after 6 days. The first 2 weeks is a sick leave phase where patients do not drive themselves and stay mainly at home. This is followed by a light duty phase of 4 weeks where patients may drive themselves and return to work, but only performing light duty activities. Full physical activities are only allowed after 6 weeks and only if the patients own body tolerates/allows it. Follow-up visits then usually occur at day 3, day 6, 6 weeks and any time in between as needed.
• Sun protection and scar products should be applied daily for a year, starting at around 3 weeks once the incisions (cuts) have healed and sealed properly.
• Breasts are mostly not symmetrical before surgery. The surgical aim is to match the two breasts as best as possible. However perfect symmetry of nipples, areolae and breasts can not be achieved.
• Breasts may sag/drop out at some stage depending on the patients own skin elasticity which is  genetically determined.
• Weight gain or loss in excess of 5-10 kg ( such as with pregnancy ) after the surgery will influence the cosmetic result negatively.
• Avoid any medication or supplements that have a blood thinning effect two weeks before the surgery. This increases the risk of bleeding . These include all aspirin containing medicines, anti-inflammatory medicines, herbal/homeopathic medicines and most vitamins/supplements.
• Stop smoking and the use of nicotine containing products for 4 weeks before until 4 weeks after the surgery. Nicotine reduces blood circulation to the skin. Nicotine also thickens the blood that increases the risk of DVT. The effect of smoking on the lungs increases the risk of coughing when waking up after the anaesthetic thereby increasing the risk of bleeding.
• There is no interference with the risk of getting breast cancer or the detection of breast cancer.

The above information, further detail and patients questions will be dealt with during consultation.