MASTOPEXY SURGERY Melbourne

Professor Mark Ashton

MB., BS. MD. FRACS (Plas)
Specialist Plastic Surgeon

Professor Ashton is a Melbourne based plastic surgeon who specialises in mastopexy procedures. He is chair of plastic and reconstructive surgery at Epworth Freemasons Hospital, and former head of plastic and reconstructive surgery at Royal Melbourne Hospital (2001 – 2016) and Royal Women’s Hospital (2000 – 2016).

The following information is designed to help you understand our process for mastopexy surgery, including assessment and suitability, and will emphasise essential information to consider before proceeding with surgery.

AHPRA registration number – MED0001135718

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MASTOPEXY MELBOURNE

WHAT IS MASTOPEXY SURGERY?

Mastopexy involves re-shaping and lifting the breasts. This procedure is often explored by patients who may be experiencing drooping or sagging of their breasts.

Consultations

Our aim is to provide a comprehensive, informative and personalised patient experience. During the initial consultation process, you will have the opportunity to meet Prof Ashton, our dedicated nursing and administration staff, and our practice manager.

We encourage every patient to seek a second opinion with a qualified specialist plastic surgeon, before proceeding with any surgical procedures.

Initial Consultation

Your initial consultation with Prof Ashton will require a valid referral from your general practitioner (GP), or other qualified healthcare provider. It is preferable that your referral is from your usual GP, as they will ensure all relevant medical history is included in your referral.

During your consultation, you and Prof Ashton will discuss your treatment objectives, and with your written consent, clinical photos will likely be taken for medical purposes. Mark will assess your medical history to ensure that all suitable and relevant treatment options are thoroughly discussed with you.

Our nursing staff and practice manager will also provide additional information regarding the procedure discussed, to ensure you are well-informed and you understand your choices. You will be afforded adequate opportunity to address any remaining questions prior to leaving our rooms, we are always happy to answer questions you may have.

Second Consultation

If you decide to progress with your surgery, after having reviewed the information provided to you during your initial consultation, you will then have a second consultation with Prof Ashton for further discussion. During your second appointment, you will also meet with one of our nurses again to discuss the necessary surgical documentation, including the initial preoperative and postoperative care instructions.

Whilst you may be enthusiastic to schedule your surgery as soon as possible following your second consultation, if your procedure is determined as purely cosmetic – thus not eligible for an item number, a mandatory 7-day cooling off period must be satisfied in accordance with the current AHPRA guidelines. Following this cooling off period, you will have the ability to secure a surgical date and pay the required deposit.

Communication

Communication is one of the most important aspects of your mastopexy consultation process and surgical planning. It allows you and your surgeon the ability to ensure your concerns and the related surgical options have been adequately discussed.

Our bodies are all unique and no two people will have the same results. In our practice, we find most patients invariably have a pre-determined result in mind. Therefore, it is critical you are always afforded a platform to openly and clearly communicate with your plastic surgeon, to ensure they understand the results you are hoping to achieve, prior to your surgery.

We find one of the most effective tools to communicate your wishes is via images. We encourage you to bring screenshots or photos to your initial consultation to articulate this.

Potential Risks

It is important to understand the risks involved with any surgery. The choice to undergo any surgical procedure, elective or urgent, should be based on the comparison of the potential risks to the potential benefits. Although most patients do not experience severe surgical complications, you must always discuss the risks versus the benefits with your surgeon, to ensure you understand all the possible consequences of your planned surgery.

There are risks associated with any surgery, and mastopexy surgery is not immune to these risks. Some risks are common to all forms of plastic surgery, and others are specific to mastopexy. If any complications arise, it may be necessary to bring you back to theatre to address and resolve these concerns.

Some of the potential risks relating to mastopexy surgery are:

Infection and swelling
Seroma – the build-up of inflammatory fluid
Haematoma – a collection of blood under the skin
Change in nipple or areola sensitivity
Scarring and healing issues
Chronic pain

Further Risks

Infection
The risk of infection can occur despite using antibiotics in the post operative period. It appears to be more common in patients who continue to smoke post operatively, or who have comorbidities such as diabetes. There are other specific risks associated with surgery that you should always discuss with your surgeon prior to consenting to any surgery.

General Anaesthesia
General anaesthesia is commonly used, however, there is an array of potential complications which can occur during or after general anaesthesia. These complications can be as major as death or brain damage, or as minor as muscle soreness or pain at the site of your cannula. The most common complications are nausea, vomiting and sore throats, and all specialist anaesthetists are trained to avoid and manage complications as they arise.

One of our anaesthetists will be in contact with you the week prior to your surgery to confirm your health status, and answer any questions you may have regarding the anaesthetic and post operative pain management.

Smoking
As cigarette smoke constricts the small blood vessels within the tissue, smokers have a higher incidence of wound healing problems. In particular, smokers are much more likely to develop wound breakdown and infection. For this reason, it is critical to stop smoking 2 weeks prior to surgery and for 6 weeks postoperatively.

Deep Venous Thrombosis And Pulmonary Embolism

During surgery, there is a risk that blood may accumulate in the veins of the lower legs. Post-surgery, these clots can dislodge from the vein walls of the calves and travel to the lungs, resulting in a pulmonary embolism causing problems with breathing or even death.

Some medications can increase the risk of deep venous thrombosis; therefore, it is essential you discuss your current medications with your surgeon and your anaesthetist prior to surgery.

Please be aware this is not an exhaustive list of potential risks. Every patient responds differently to general anaesthesia and surgery.
Please ensure you always discuss the surgical risks with your surgeon prior to moving forward with any surgery.

If I Decide To Proceed, What Can I Expect When Undergoing Mastopexy Surgery?

Hospital And Admission

We perform all our surgeries at Epworth Freemasons Private Hospital in East Melbourne.

Each of our patients have a private room with an ensuite, and at Epworth Freemasons there are 12 state-of-the-art operating theatres with the latest anaesthetic machines and theatre equipment. There is also 24 hour onsite medical emergency care, with an onsite Intensive Care Unit.

You will need to fast prior to your surgery, usually from midnight the night prior. Your admission paperwork will be provided to you a minimum of 3 to 4 weeks prior to your operation so that any questions you may have can be answered well before your admission.

Surgical Procedure

Mastopexy surgery is only performed on our patients by Professor Ashton, a qualified specialist plastic surgeon, and is carried out under the administration of general anaesthesia by one of our accredited specialist anaesthetists. In addition to your general anaesthesia, local anaesthetic is infiltrated to the surgical area, which aids in minimising blood loss.

During mastopexy surgery, the nipple and areola complex is isolated on its underlying nerve and blood supply and re-positioned on the breast mound.

If only a small amount of vertical lifting is required, it may be possible that this can be fulfilled with a small incision around the upper part of the nipple and areola complex. For patients requiring further lifting, a vertical incision is made from the bottom of the areola to the bottom of the breasts. This step also addresses any excess tissue in the lower or inferior pole of the breasts.

Following the re-shaping of the breasts, dissolving sutures are used to close the incisions, and waterproof dressings are applied.

Postoperative Care

Following mastopexy surgery, you will spend time in the Post Anaesthetic Recovery Unit until you are wide awake and your pain is adequately managed, at which time you will be transferred to your room for the night.

You will be reviewed by Prof Ashton prior to being discharged from hospital, and the nursing staff will ensure your dressings are intact, and your discharge medications, usually antibiotics and pain medications, are ready for you.

You will be provided an information bag to take home which contains our afterhours details, as well as the dates and times for your follow up appointments with our nursing team and Prof Ashton. During your post-operative period, we will monitor your recovery and progress. We will also provide precise guidance on the level of activity or exercise you should engage with during your recovery.

Recognising each patient’s healing process is unique, our post-surgical care is tailored to accommodate individual needs. We will address any concerns you or we may have, and you will receive thorough post-surgical care from Prof Ashton and our dedicated team throughout your recovery.

RECOVERY FROM MASTOPEXY SURGERY

Following mastopexy surgery, we recommend you avoid tight or restrictive clothing, and you do not wear a bra until we are confident the incisions are healing appropriately. Once healing is confirmed, our nursing staff will fit and supply you with a bra.

Most patients will be able to resume light duties at work, particularly for reduced hours, approximately 2 weeks following the procedure.

Following surgery, you may experience changes in nipple sensation. In many cases, this is an increase in nipple sensitivity, and feeling tender and sore at around 2 to 3 weeks post-surgery. This hypersensitivity of the nipple and areola complex usually resolves on its own, and you can typically expect your nipple sensation to return to normal within 6 to 8 weeks following surgery.

Mastopexy surgery should not impact your ability to breastfeed. The procedure involves removal of excess skin to reshape and lift the breast and nipple areola complex; it does not involve cutting into the breast tissue.

COMBINED PROCEDURE

A mastopexy may also be combined with other surgical procedures, the most common of which is during the placement of breast implants, to provide extra volume to the upper pole of your breasts, while also lifting the breasts.

Mastopexy, combined with breast augmentation, is not a straightforward procedure, and should only be undertaken by experienced surgeons who are familiar with the risks and possible complications that may occur when combining these two operations. Your surgeon will advise you if this combined procedure is suitable for you.

It is imperative that you allow sufficient time to recover after your mastopexy surgery
It is essential you avoid any upper body exercise or heavy lifting for at least 8 to 12 weeks following breast surgery. We will discuss your post-operative instructions in detail prior to your procedure.

Delayed healing or wound breakdown
Occasionally, despite everything progressing smoothly during surgery, and despite your initial healing proceeding without incident, we find that 3 to 4 weeks after surgery, you may encounter some problems with wound healing. It is more common in patients who smoke or who are diabetic. Usually, no further surgery is required, and wound dressings are applied to the wound until such time as it heals. If the area of delayed wound healing is extensive, we may need to take you back to the operating theatre to close the wound surgically.

Smoking
We know that smoking damages and alters the blood supply in the small blood vessels surrounding the breast, nipple and areola. Even one or two cigarettes will have a detrimental effect on the blood supply to the nipple and areola, and wound healing within the breast. Smokers also have significant airway problems and higher complication rates of pneumonia or chest infections after surgery.

Breast Asymmetry
Whilst your plastic surgeon will endeavour to lift both breasts in an identical manner, there may be small discrepancies between your left and right breasts. This is further complicated by the fact that most women’s breasts have a pre-existing degree of asymmetry, which can be accentuated by undergoing mastopexy surgery.

MASTOPEXY FAQ

MIGHT THERE BE INSTANCES WHERE I MAY NEED A MASTOPEXY?

If you have experienced significant weight loss, or your breasts have enlarged considerably during breastfeeding, it is possible the supporting ligaments within your breasts have been affected, increasing the likelihood of requiring a mastopexy.

I DON’T LIKE THE SCAR

Modern surgery uses a vertical scar without the large horizontal scar underneath your breast. This technique, called a Hall Findlay mastopexy, results in significantly less scarring and a better breast shape, in comparison to the traditional Wise (anchor) pattern scar. Your surgeon should discuss the technique most suitable for you.

I DON'T WANT IMPLANTS – CAN I STILL HAVE A LIFT?

Yes

IS IT PAINFUL?

Each patient’s surgery and healing process is unique. After undergoing any surgery, it is essential you rest, and take your prescribed discharge medications. Following these instructions diligently will significantly contribute to your level of discomfort and recovery.