DR. MATTIA COLLI SURGEON
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MASTOPEXY

BREAST RELAXATION

MASTOPEXY

Over the years the breast loses its tone and its original shape due to qualitative variations of the two main components that make them up: the skin (the containing) and the glandular-adipose mass (the contents). In addition, different factors variously combined such as pregnancy, lactation, important changes in body weight, the force of gravity and the natural aging processes, can cause a decrease in the thickness and elasticity of the skin.

In all these cases the restoration of the original shape is pursued by “mastopexy” surgery,  which consists in the removal of the exuberant skin, in the repositioning in the correct place of the areola-nipple complex and normally also in the remodeling of the glands.

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If, in addition to skin stretching, there has simultaneously been a decrease in the amount of glandular-adipose tissue, along with the shape, the breast volume will also have to be readjusted by inserting breast implants (breast augmentation, described in a specific section).

Mastopexy restores shape to  sagging breasts  (mammary ptosis), allowing the level of the areoles and nipples to be raised, the diameter of the breast areolas to be reduced if they are too large, and any existing asymmetries between the two breasts to be corrected, resulting from one breast “dropping” more than the other.

WHEN MASTOPEXY SURGERY IS RECOMMENDED

Mastopexy is a surgical intervention  that is recommended when the breast has a moderate or severe degree of ptosis (sagging). When the degree of ptosis is mild, mastopexy surgery is carried out only after thorough examination of the surgical technique and its results.

DEGREE OF PTOSIS OF THE BREAST

Ptosis is classified into 3 degrees: mild, moderate and severe. The transition from one degree to another is established by increasing the distance between the nipple and collarbone. Pseudoptosis, on the other hand, presents a regular maintenance of this distance, with loss of trophism of the glandular and adipose tissue of the breast that gives a sagging appearance.

To find out whether or not in your clinical case there is a need for mastopexy surgery, you can book a visit or request a consultation online. In some cases, in fact, other alternative procedures may be suggested.

MASTOPEXY – MEDICAL SURGICAL EXAMINATION

The first step to reshape the sagging breast is the visit with the Surgeon. During the consultation, the surgeon will show you if your clinical case is suitable for mastopexy surgery and if the anatomical conditions exist to achieve a valuable and admirable result. The advice is always to prepare questions and any doubts to be asked to the surgeon, before undergoing mastopexy surgery.

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During the medical examination you will be given a detailed description of the modern techniques that will be applied to your clinical case, possible risks and complications and scarring outcomes, which may occur during mastopexy surgery.  Modern HD programming techniques can also allow you to visualize the desired result.

Before mastopexy surgery, all blood tests and ECGs listed and proposed at the first visit should be carried out to demonstrate that your degree of physical health is compatible with mastopexy surgery. They are designed according to volumetric requirements, bras and elastic bands to measure.

Numerous HD images will be taken for planning an increasingly personalized course of treatment before undergoing mastopexy.

MASTOPEXY – INFORMED CONSENT

When the patient has clarified all doubts and decides to undergo liposuction-breast lipostructure (mastopexy) surgery, he or she is guided in filling out the informed consent document, drafted according to his or her clinical case.

 

MASTOPEXY – CLINICAL INVESTIGATIONS

 

The patient must carry out the clinical examinations prescribed by the Surgeon to certify and demonstrate the suitability of the state of health before undergoing mastopexy surgery, for the total safety and tranquility of the patient, which must always be the first concern. In the event that any pathologies are discovered or the examinations record abnormalities, it will be the surgeon’s concern to inform about the state of health and to be able to plan the mastopexy surgical intervention  with other anesthesiological techniques to avoid any risk connected to them.

Before and after

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HOSPITALIZATION OF THE PATIENT

The patient is hospitalized in the morning on an empty stomach, from midnight the night before. The pre-operative program of mastopexy surgery is again reviewed and validated a second time, as well as clinical examinations (double check).

Subsequently, the surgeon calculates centimeters and millimeters using anatomical findings and a sartorial tape measure; he draws anatomical lines on the patient’s breast that will be of fundamental guidance during mastopexy surgery. The patient is prepared in his or her own dedicated room and transferred to the operating block.

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ANAESTHESIA

Dr. Mattia Colli has decided to abandon general anesthesia  with the related dangers: mastopexy surgeries are performed with the most modern anesthesiological techniques of deep sedation (local anesthesia + intravenous anesthesia), so that fear and the sensation of pain are completely canceled while the unconscious is invaded by dreams and pleasant images.

Local anesthesia, during mastopexy surgery, occurs through the introduction of anesthetic at the level of the mammary nerve plexuses in order to effectively eliminate the sensation of pain. The insertion of this so-called solution also takes place with a vasoconstrictor (adrenaline) to avoid bleeding, because it reduces the blood supply in the area to be treated allowing the operating surgeon to work better and gently, while maintaining a better view of symmetry.

Another advantage is to have an immediate return to social life without having to endure classic situations of fatigue, dizziness and exhaustion typical of the disposal of general anesthesia drugs.

 

MASTOPEXY – SURGERY

 

There are different variations of mastopexy depending on the skin incisions and scars that one wants to design to achieve the final result. Dr. Mattia Colli has decided to abandon the old surgical techniques that involved numerous scars around the breast and to adhere to the more modern ones that see as few incisions as possible in order to preserve the breast in its naturalness without visible incisions; to date, in fact, mastopexy allows you to raise a breast with a very small scar at the level of the areola. The breast must be guarded, preserved as much as possible in its skin integrity precisely to avoid the existence of unpleasant or noticeable scars.

The scar, although totally hidden by the bra, is always followed in its natural evolution: the most recent regenerative techniques make it possible to give the scarring a soft effect, re-establish the skin color from the first months and be able to let the tissues heal optimally. At Dr. Mattia Colli, scientific research is always placed in the foreground: in addition to the methods of regenerative micro-surgery, the patient can find creams specifically designed for stimulation and scar re-generation; this programming in following the patient during the healing phase, allows to obtain results of the highest level: the scars are very thin, flat and the initial rosacea color is brought to fade fulfilling the expectations and happiness of the patient.

At the end of mastopexy surgery, compression dressings are carried out with special disinfectants and local antibiotics that must be maintained for the following days. Medications to be taken in the postoperative period after mastopexy surgery are described, as well as how to behave with regard to rest, movement, and nutrition.

POST-OPERATIVE MASTOPEXY

During mastopexy surgery, the detachment of tissues and the elimination of excess skin that no longer supports the breast creates inflammation; it is therefore normal that a few days after the mastopexy surgery you can notice swelling and any bruises.

To enable optimal results at all times, Dr. Mattia Colli does not underestimate the post-operative course, but the patient is monitored at best for the days following the mastopexy surgery.

Specially designed and dedicated dressings on the individual clinical case will ensure that the swelling fades quickly; tailored bras and headbands will be dedicated in order to protect the scarring area from random trauma, sudden movements and give the final result a harmonious and “teardrop” appearance.

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Dr. Mattia Colli will prescribe all the drugs that will accompany the patient from her discharge from breast augmentation surgery. During her recovery she will be personally followed by Dr. Mattia Colli and his team for any doubt or clarification on the dosage and timing of taking the drugs.

In the post-operative mastopexy, it is necessary to avoid for physical exertion for a few days that can stretch the scar and slow down the healing process. A few days after mastopexy surgery, the patient will be able to lift weights, as well as be able to drive and move freely, always maintaining a certain degree of attention on the dressing of wounds. Sports, competitive or amateur activities, saunas and Turkish baths must be suspended (about 7 days) to prevent sweat from infecting or delaying the healing of the wound as well as wide and abrupt movements with open arms in order to allow a healing without traction and therefore more linear and thin.

After mastopexy surgery, temporarily a greater or lesser sensitivity of the nipples may occur, which in any case is part of the sensory normality at the end of the healing process.

Pain in mastopexy surgery is non-existent or mild. In some special cases, pain medications are provided and prescribed to patients.

In the stage of surgical wound closure in mastopexy surgery, the surgeon performs special and innovative suturing techniques in order to approach the skin flaps and make the scar as less visible as possible.

The healing phase, after the mastopexy surgery, is not abandoned to the natural evolutionary course, but the patient is followed even at this time with a completely personalized path that involves the use of the most recent discoveries of regenerative medicine: the cells used in this area, especially in mastopexy, allow a very rapid healing, fighting the danger of being able to form keloids and making the scar thinner and softer in texture.

MASTOPEXY – RESULT

After mastopexy surgery, the breast finally returns to take on a toned, stable shape, regaining its anatomy and architecture; the areola and the nipple return to dominate a central role in the physiognomy of the breast, the upper pole and the profile return to being “full” and round, so as to bury the memory of the hollowed out and sagging appearance.

The end result of mastopexy surgery is permanent when no further events occur that produce sagging skin. The particular surgical sutures and the well-followed healing of the scars allow a valid support of the breast even against senile decay that unfortunately is prescribed within our genetics. Increases and weight loss in rapid time and pregnancies can instead put considerable strain on the scars and slightly change the new shape.

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The sagging of the breast tension tissues (Cooper’s ligaments) and the sagging of the skin is a process of natural and prescribed aging that however is influenced and accelerated by factors such as excessive exposure to sun damage (especially during peak hours), volumetric changes in the body due to weight changes, possible pregnancy and lactation. All these factors accelerate the natural rate of sagging of the skin.

The patient should be aware that the volume of the breast is mainly given by the adipose tissue and the mammary gland and that the changes in volume are reflected precisely on the latter.

MASTOPEXY AND BREAST VOLUME INCREASE OR REDUCTION

Mastopexy surgery lifts and restores shape to the breast without changing the internal volume. If the patient also wants a volumetric increase, an insertion of a prosthesis in the same surgical intervention  (additive mastopexy) or of her own adipose tissue must be planned at a later operative time. When, on the other hand, the requests are for volumetric reduction, a reductive mastopexy is carried out.

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LACTATION AFTER MASTOPEXY

 

Mastopexy is a procedure that displaces the nipple areola complex. By Dr. Mattia Colli the advanced and modern methods used for this type of surgery allow in the vast majority of cases to maintain the ability to breastfeed precisely  because all the glandular tissue is preserved and as a whole moved but not affected. If the new surgical methods could not be applied, the ability to breastfeed can be partially or even entirely compromised: for example, in rare cases, when the breast is very saggy and the nipple could suffer the high weight it must support, it is preferred to carry out an areola-nipple transplant without the possibility of recovering the ability to breastfeed.

 

CAUSES OF BREAST RELAXATION – WHY IT IS IMPORTANT TO INTERVENE WITH MASTOPEXY SURGERY

The factors that affect the fall and sagging of the breast are of different nature:
  • Senile Decay: the natural and programmed (we mean at the genetic level) aging process involves a reduced production of elastin, that elastic spring that allows tissues to stay toned, young and taut. Here, then, as the years go by, the skin tissues give way, no longer supporting their own weight and unable to counteract the force of gravity. This is very evident on the neck and cheek area of the face and at the level of the inner thigh.
  • Sudden changes in weight: gaining weight and losing weight in a short period of time first puts the skin tissues in mechanical traction, traction that tries to be compensated by the elastin of the skin and secondarily stimulates a sagging of the skin. Over time, the repetition of these two opposite and opposing physical stimuli causes elasticity to decrease and the skin to collapse.
  • Pregnancy: during pregnancy and later in the lactation phase, the breast changes its volume, increasing in size. Subsequently, the exact opposite occurs, that is, the breast loses volume in a branded manner; this is due both to a change in glandular adipose tissue that, after pregnancy slightly modifies its own tissue, and to the emptying of the glandular component that has finished providing breast milk. The phase of increase and reduction of the volume of the breast is very sudden and the skin is affected with great stress remaining loose.
  • Weight of Gravity: Gravity is the force against which elastic tissues oppose. As the tissues change, the force of gravity always remains the same and therefore plays a decisive role in the fall of the skin.

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