- Though no surgical procedure is without potential complications, breast lift surgery complications are relatively uncommon.
- A board-certified plastic surgeon can assess your individual risk factors and help to minimize potential complications during and after surgery.
For most people, cosmetic breast surgery is synonymous with breast implants. In fact, the breast lift is actually gaining popularity at a much quicker rate than breast augmentation surgery.
According to the American Society of Plastic Surgeons’ trends report, the number of breast lifts performed annually has almost doubled since 2000.
Regardless of how common a procedure is, it is always important to know potential risks before undergoing any surgery. In this article, we look at what can go wrong and how to lower your risk of complications.
What is a breast lift?
A breast lift, also known as mastopexy, is a plastic surgery procedure that involves removing excess skin and breast tissue, and then pulling or “lifting” the remaining tissue upwards. Women usually consider this procedure when they notice that their breasts have begun to sag or lose their well-defined shape.
There are multiple options to consider when undergoing this procedure; you and your plastic surgeon can decide which technique is right for you.
It is important to know that a breast lift will not increase the size of the breast — in fact, there may be a slight loss of volume. If you would like to add volume, you may consider breast augmentation instead or a combined breast augmentation and mastopexy.
Depending on your aesthetic goals, mastopexy can also be combined with breast reduction surgery.
No surgery or medical intervention is completely devoid of the possibility of having something go wrong, and mastopexy is no exception.
According to Newport Beach, CA plastic surgeon Dr. Eugene Elliott, immediate breast lift complications include bleeding, infection, nerve damage, and impaired circulation. Long-term complications include poor healing, scarring, and misshapen breasts. If a breast implant is inserted during the same procedure, it can also lead to additional problems.
Some of these complications, like bleeding, infection, and delayed healing, are not specific to breast lift surgery and may happen after any kind of surgery.
Poor aesthetic outcome
There are a lot of variables that dictate how the breast will look after the healing process is complete. In some cases, unequal volume distribution may produce breast asymmetry. This may take the shape of wrinkling, different nipple shape or position, and breast skin irregularities after scar healing.
If the asymmetry is significant enough, additional surgery to correct it may be required. However, when the breast lift procedure is performed by an experienced plastic surgeon, patients generally report high satisfaction with the results.
“Although they’re not typically considered complications, conventional techniques tend to yield flat ‘pancake’ appearing breasts with extensive scars and poor volume distribution, particularly in the top of the breast,” says Miami plastic surgeon Dr. Rian Maercks.
To avoid this, Maercks prefers a technique called “pectorals sling mastopexy,” which retains tissue that’s usually discarded at the bottom of the breast and transfers it to the top of the breast, circumventing the flat appearance.
“I would say the most common complication is slow incision healing, especially along the bottom portions of the breast,” says Cincinnati, OH based plastic surgeon Dr. Donna Krummen. This can give rise to other problems, such as the stitches coming apart or a higher risk for infection and tissue death.
People who have had previous breast surgery, have undergone radiation, and smokers have a greater risk for wound healing issues. Revisional surgery to remove non-healing tissue may be required in some cases.
This can be overt bleeding with blood coming out of the wound or bleeding under the skin called a hematoma. Hematomas usually occur within three weeks after surgery and appear alongside pain, swelling, and bruising.
Being active too soon after surgery can increase the risk of postoperative bleeding. People who are taking blood thinners should consult with their physician regarding the risk of bleeding during and after the procedure.
Post-surgical infections may be identified due to skin discoloration or pus oozing out of the wound, but some infections may be more difficult to recognize. Treatment options include antibiotics and surgical drainage of the infection site.
If a breast implant is present and an infection occurs, the implant may need to be removed.
Resuming normal activity too soon after the operation can lead to fluid accumulation and swelling in the breast.
Following surgery, blood circulation to the breast may slow down, which can delay healing and, if the impairment is severe enough, cause tissue death or necrosis. A dusky discoloration of the nipple or the skin could signify that the tissue is not getting enough blood supply.
Fat tissue within the breast can die due to trauma during surgery or interruption of blood supply. This can cause areas of lumpiness and irregularities in the breast.
Blood clots are most commonly a concern in the deep veins of the legs in people who are bedridden for prolonged periods of time after major surgery. Blood clots are a serious issue and can even be life threatening.
While rare following a breast lift, blood clots may occur in the veins surrounding the breast. When they do occur, they usually resolve on their own. Women who are taking oral contraceptive pills or those who have blood clotting problems are at an increased risk for this complication.
A scar is virtually unavoidable with a breast lift. However, an experienced surgeon will be able to minimize the scar tissue and make it as inconspicuous as possible.
According to Dr. Adam Basner, a plastic surgeon based in Baltimore, MD reduction or loss of sensation in the nipple and the area around it — namely the areola — can occur following mastopexy.
“The nerves in the breast are rarely injured during the surgery. However, traction on the nerves from the lift can cause some loss of nipple sensation,” adds Basner.
This is usually temporary and no treatment is necessary. However, in rare cases, it may be permanent.
Problems with anesthesia
Breast lift surgery can be performed with IV sedation or under general anesthesia. Some people may experience allergic reactions or other anesthesia complications that can, in rare cases, be fatal.
Mastopexy and breast augmentation
Patients who want to get both a breast lift and breast implants may get them both at the same time or one after the other. Those who choose to have both operations at the same time may be at an increased risk for complications than if either operation was performed alone.
However, most studies have concluded that performing both operations at the same time is a more effective approach than performing one followed by the other. Although the rates of complications and the need for revision surgery is higher than either operation, they are still within the acceptable range.
One study that involved 150 breast lift patients revealed that the most common complications were poor scarring and fluid collection (6% and 2.7%, respectively), and no major complications were reported.
Another review of 250 patients reported the incidence of two cases (less than 1% of patients) of areola skin necrosis and generally echoed similar results. Interestingly, this study also noted that delayed wound healing occurred more in larger breasts.
Overall, mastopexy is considered a relatively safe operation. “It is really quite unusual to have a complication that requires hospital admission or additional surgical procedures,” says Krummen.
Signs of trouble
After the operation, any increased pain, swelling, or bleeding should be communicated to your physician. Leg pain and swelling — particularly if more in one leg — and chest pain or shortness of breath are signs of a blood clot, which can be a serious complication. If this happens, you should immediately report to the nearest emergency room.
You should also let your surgeon know if you still have diminished or altered breast sensation more than six weeks after the procedure.
Are you at a higher risk of complications?
Having one or more of the following conditions can predispose you to a higher risk of complications than the general population:
- Collagen vascular disorders
- Peripheral vascular disease
- Heart disease
- Poor general health
- Multiple previous breast surgeries
- Use of certain medications like blood thinners or estrogen-containing contraceptive pills
“All these factors must be taken into consideration by the surgeon to determine if the patient is an appropriate candidate for a breast lift,” says Elliott. “There certainly are patients that want a breast lift but are deemed too risky because of comorbidities and are therefore not a candidate for surgery,” he adds.
How to avoid complications
A board-certified plastic surgeon with adequate training and experience will be able to determine if you are a good candidate for surgery and mitigate the risk of complications with proper technique and careful post-op monitoring.
The most important thing you can do to reduce the risk of complications after the procedure is to follow the advice of your physician and avoid overworking yourself.
According to Dr. Norman Rowe, a plastic surgeon based in New York City, topical medical-grade silicone, vitamin C, and arnica can assist with poor wound healing. Injectable steroids, laser devices, and microneedling treatments can also help with the healing of particularly irregular wounds to minimize scarring.
When deciding whether to undergo a surgical procedure, you and your physician should always ask this question “do the benefits outweigh the risks?”
In the case of mastopexy, the risk of experiencing serious side effects or having a poor outcome is low when the procedure is performed by an experienced surgeon at a well-equipped facility. However, it is important to be aware of potential problems and to work with your doctor before and after the procedure to reduce the risk of complications and to treat them if they do occur.
» Speak with a board-certified plastic surgeon about the benefits and risks of breast lift surgery. Meet our Medical Review Team and get consultations on Breast lift surgery.