Physical evaluation 

At the initial consultation I will assess the width of the breast and the thickness of the breast soft-tissue. I will look at the position of the nipple and breast tissue relative to the infra-mammary crease. I will look at the overall skin quality, including stretch marks, variance in pigmentation, and scars. I will look for any breast or chest-wall asymmetry.

Assessment

I will ask you about your goals from surgery, and will take a detailed breast history: asking about bra size, changes during pregnancy, and any family history of breast disease, Patients wanting a breast volume greater than their current size may need to consider use of an implant (augmentation-mastopexy.

Patients over the age of 40: could potentially benefit from a mammogram before surgery. I would recommend that patients discuss this with their own general practitioner.

The operation

I use either a peri-areolar, vertical scar, or a “Wise” (inverted T) pattern technique. (Patients requesting more extensive lifting of the nipple and areolar are likely to need a more extensive skin resection and a larger scar). All patients have a scar around the edge of the areolar, some will have a vertical scar on the lower pole of the breast, and in the infra-mammary crease. 
The nipple is supported on a “pedicle” of soft tissue. The surgery takes approximately 150-220 minutes and usually requires a one night stay in hospital. 

Patients normally need to wear a sports-bra for 6 weeks after surgery. The hospital usually fits and supplies two appropriate sports bras.

The risks

The risks include bleeding requiring a return to the operating theatre, asymmetry between left and right breasts, changes in nipple sensation, and spread, wide, tender or lumpy scarring.

There is a small risk of blistering and delayed healing. Patients should presume that they will not be able to breast-feed after surgery. 

The risk of deep venous thrombosis and pulmonary embolism is minimized by the use of thrombo-embolic stockings, and early mobilization of the patient after surgery (getting out of bed as soon as fit enough to do so with the support of the nurses). 

The risk of sepsis after breast surgery is extremely low, however, any patient who develops a fever and feels unwell in the days and weeks after surgery, should seek urgent medical assessment and advice. (This could mean attending the emergency department of a local hospital.)

Patients who experience a rapid onset of calf pain, or shortness of breath in the weeks after any surgery, need rapid assessment (usually best carried out by a local hospital emergency department) to exclude the possibility of a deep venous thrombosis (a clot in the calf veins) or a pulmonary embolism (a blood clot obstructing a lung blood vessel. 

Return to activity
It is worth the time, effort and money, to get the best possible sports bra for you. To get the best results minimise any bounce for three months: this means that you should initially use either, an exercise bike, a road-bike, a treadmill (against a shallow gradient), or step-machine, before considering aerobics, tennis or running. Do not do any bench-press weights or abdominal crunch/curls for three months.

Longevity of results

It is very difficult to predict how long the results will last. Some patients will lose some of the shape achieved at the time of surgery. This can take the form of progressive drooping of the lower pole of each breast. If this happens, the nipple stays at about the same height, but the lower pole of each breast drops below the nipple with loss of projectiom and loss of the desired shape.

In some patients the results are durable for 10 years or more, but other patients report changes and some degree of disatisfaction at a much earlier stage. Your tissues do not improve with age, the processes that resulted in the initial loss of shape of a patients breasts can be interrupted, but not extinguished, by surgery. My impression is that results are more durable in non-smokers, with a stable body mass index, who use a good well fitting sports-bra for exercise.

More information can be found at:
https://baaps.org.uk/patients/procedures/5/breast_uplift_mastopexy