A Breast Lift (Mastopexy) and an Abdominoplasty are two separate surgical procedures. Both address excess, loose skin and are commonly considered by individuals after pregnancy, weight loss or ageing. For some individuals, it may be possible to combine the two procedures. This can be advantageous, as there is only one anaesthesia and one recovery, and potentially reduced overall costs. However, anyone considering this must be fit and healthy enough to undergo a longer surgical procedure and prepared for a slightly longer, potentially more challenging recovery.
This article explains the two procedures, discusses various factors to consider and outlines the pros and cons of combining surgeries.
First, let’s explore the two procedures, so you are clear about what they do and what’s involved.
Breast Lift (Mastopexy)
A Breast Lift (Mastopexy) is a surgical procedure to address breast ptosis (droop). It involves lifting the nipple, tightening the underlying breast tissue, and often increasing breast volume, particularly in the upper breast.
A Breast Lift (Mastopexy) is not a Breast Augmentation, which uses a breast implant to increase breast size. A Breast Lift (Mastopexy) is also not a Breast Reduction (Reduction Mammoplasty); the latter reduces breast size.
There are various techniques used for a Mastopexy, and the technique selected for you will be based on factors such as your personal preferences, your breast size and shape, the size and position of the areola, the extent of your breast sagging (ptosis), and the quality of your skin.
ANCHOR LIFT: This popular technique can provide a substantial lift to the breast. It leaves an anchor-shaped scar created by an incision hiding in the natural curve under the breast, a vertical line running up to the areola and a circumferential scar around the areola.
LOLLIPOP LIFT: This technique leaves a lollipop-shaped scar, with a circumferential scar around the areola and a vertical scar running down towards the breast fold.
PERIOLAR LIFT: This technique leaves a single scar around the areola and provides only a minimal lift to the breast. The technique is also sometimes used to reshape the areola.
The Breast Lift (Mastopexy) Procedure
Dr Dona performs all Mastopexy surgeries in a private hospital with the patient under general anaesthesia. During the procedure, he will create incisions in keeping with the chosen technique. Then, excess skin is removed to lift and reshape the breast. Unlike a Breast Reduction, only minimal or no tissue is removed. The remaining tissue is repositioned, then the new skin edges are joined and sewn together with dissolvable sutures.
Recovery from a Breast Lift (Mastopexy)
Most patients can return home on the same day as their Mastopexy procedure. You will need someone to drive you home and, ideally, have someone stay with you for the first week.
After the surgery, there will be some pain and discomfort, which will be managed by prescription medication. You’ll be fitted with a compression garment to help minimise swelling and promote healing. You’ll also be wearing a surgical bra to keep your breasts in position and minimise any discomfort.
During the first week, you must rest as much as possible, taking only regular, short walks around the house to encourage circulation and lymphatic drainage.
You will return regularly to the clinic for LED light therapy sessions, with the first treatment usually starting on the day after you leave the hospital. These treatments help minimise swelling and inflammation while encouraging healing. We also aim to use PRP (Plasma-Rich Platelets) treatment to encourage optimal scar healing.
Sleep on your back for the first two weeks to avoid discomfort and strain on the surgical site.
Heavy upper-body use and exercises should be avoided for the first four weeks.
Your scars will be red initially but will fade to a pale grey or silver colour over time, and will take 12 to 24 months to mature fully.
Tummy Tuck (Abdominoplasty)
An Abdominoplasty is a surgical procedure that reconstructs the abdominal wall. The procedure is often requested after significant weight loss or following pregnancy. In both cases, the abdominal skin and muscles have been severely stretched and/or damaged, resulting in a loose abdomen that can’t be tightened solely through exercise.
There are various types of Abdominoplasties, depending on the individual’s requirements.
Mini Tummy Tuck (Abdominoplasty): Suited for individuals who only have loose skin and tissue below the navel, and possibly some muscle separation (diastasis recti). They are happy with the appearance of their navel.
The incision runs horizontally, is much smaller than a conventional Abdominoplasty (slightly longer than a C-section), and is hidden in conventional underwear.
Learn more about the Mini Tummy Tuck (Abdominoplasty)>
Standard Tummy Tuck (Abdominoplasty): Suited to individuals who may have loose skin and tissue below the navel, possibly excess skin over the pubic area and muscle separation (diastasis recti).
The incision runs from hip bone to hip bone. There is also a small circumferential incision around the navel. Any abdominal wall separation and hernias are addressed.
Learn more about the Standard Tummy Tuck (Abdominoplasty) >
Fleur De Lis Tummy Tuck (Abdominoplasty): This is typically reserved for individuals who have experienced significant weight loss and have significant excess abdominal skin hanging downward. They also have excess skin on the sides of the waist. A FLD has an additional scar to the standard Abdominoplasty, running along the midline of the abdomen to the lower chest.
Learn more about the Fleur De Lis Tummy Tuck (Abdominoplasty) >
Open Book Tummy Tuck™ (Abdominoplasty): Created by Dr Eddy Dona, this technique addresses the needs of those who have undergone massive weight loss (MWL). They have excess skin and require significant reconstruction. The OBTT™ has the same scars as the Fleur-De-Lis, plus a third horizontal scar along the entire lower chest. The midline scar joins the two horizontal scars. After the incisions are made, the skin is opened out in a pattern that resembles an open book.
Recovery from an Abdominoplasty
All of Dr Dona’s Abdominoplasty procedures are performed in a private hospital with the patient under general anaesthesia. Most patients stay at least two nights in hospital. However, some individuals may choose to stay longer.
The recovery timeline for an individual undergoing a Mini Tummy Tuck (Abdominoplasty) will be considerably faster than that of a more invasive procedure such as a FDL or OBTT™. And, if the Abdominoplasty is combined with a Breast Lift (Mastopexy), this may further extend the recovery timeline.
All patients are fitted with a compression garment immediately after surgery to help minimise the risk of swelling and promote healing. There will be some pain and discomfort, particularly in the first few days, but this will be alleviated by prescription pain medication.
For the first two weeks, patients are encouraged to rest as much as possible, but to get up often to take a few steps around the house. This helps with circulation and lymphatic drainage. All household tasks should be assigned to someone else, and you should focus on resting and keeping yourself as comfortable as possible.
Typically, patients return to the clinic on the same day that they leave the hospital for their first LED light therapy session.
After two weeks, you can consider driving a car, provided you feel comfortable and confident enough to do so.
Within three to four weeks, most of the pain will have subsided, and you will be able to perform daily tasks. If your work is sedentary, you can consider returning to work at this time.
Vigorous activities or gym workouts should only commence after six weeks.
Why Combine a Breast Lift with an Abdominoplasty?
Individuals typically have excess loose skin in more than one part of the body. For example, after pregnancy, the breasts and abdomen are often affected, so it’s common for individuals to request a combined Breast Lift and Abdominoplasty.
However, pregnancy is not the only factor that can cause excess skin. Significant weight loss, repeated weight fluctuations, or natural ageing can also cause a loss of skin elasticity.
Combining these two procedures can offer some advantages, including:
- One recovery period instead of two, and resultantly, less time away from work or housekeeping duties.
- One anaesthetic instead of two, putting less strain on the body.
- Potentially saving on costs, as there will only be one anaesthetist’s fee, one theatre fee and one hospital bed fee.
Potentially Suitable Candidates for Combining Procedures
Your suitability for combining surgical procedures can only be determined after an initial consultation with Dr Dona. However, the following factors act as a guide.
You may be suitable for combining a Breast Lift with an Abdominoplasty if:
- You are at a healthy, stable weight and can maintain this
- You are deemed healthy enough to undergo two procedures during the one surgery
- You have finished creating a family
- You have realistic expectations
Considerations
While combining surgeries can be an excellent decision for some, you must weigh up the options carefully with your lifestyle and commitments in mind.
YOUR WEIGHT: You must be of a healthy weight and be able to maintain this weight if you’re considering surgery. Both a Breast Lift and an Abdominoplasty can be negatively affected if you lose a substantial amount of weight after surgery, as this can lead to more excess skin.
RISKS: When combining surgeries, you will have a longer time under anaesthesia, which can increase the chance of risks occurring. This will be discussed with you during your consultation with Dr Dona.
RECOVERY: While you will only have one recovery period and not two, you must be prepared to be significantly limited in your mobility during the first fortnight. Your abdominal region will be significantly tender and sore, and it will be hard to move around in bed, walk and perform basic tasks.
Any abdominal discomfort will be exacerbated by tenderness and soreness in your chest, and you’ll be unable to lift or do much with your arms. Therefore, you must have someone to help you during this period, and you must be mentally ready for this recovery.
Combining two surgeries into one will also lengthen recovery time compared to a single standalone surgery.
Pros & Cons of Combining Surgeries
Weighing up the pros and cons of combining surgeries is important for every individual. However, keep in mind that the right decision for you will depend on your individual circumstances.
PROS
Consolidated Recovery: You will have only one post-operative healing phase, which means less time away from work, childcare and housekeeping responsibilities.
Potentially Reduced Expenses: Combining the two procedures will usually reduce expenses, as there will be only the anaesthetist’s fee, the operating room fee, and the hospital bed fee.
One Anaesthesia Only: You will only undergo one anaesthesia instead of two, putting less stress on your body.
CONS
Longer Surgery Time: You will need more time under general anaesthesia, which can increase your risk of anaesthesia complications.
Challenging recovery: Both an Abdominoplasty and a Breast Lift (Reduction Mastopexy) can cause considerable pain and discomfort, particularly during the first week. Combining these procedures can be challenging with both pain management and limited mobility.
Multiple incision sites: Having multiple fresh incision sites can not only be more painful but also more difficult to wash and bathe.
