Persistent Lower Pole Fullness

This is the most common complication of a breast lift or reduction. It is usually caused by inadequate removal of breast tissue from the lower pole of the breast, so that there is a persistent bulge of the lower pole, which one surgeon colorfully calls the "mastopexy-wrecking bulge." This problem is common among patients treated with "skin-only mastopexies" because the skin stretches readily and cannot hold the breast shape. It is also commonly found in patients treated with "periareolar" or "donut mastopexies" because these techniques do not allow removal of breast tissue from the lower pole. They do avoid a vertical scar, leaving just the scar around the areola, which is the appeal of these limited-incision techniques, but this benefit is outweighed by the inability of these techniques to adequately tighten the lower pole and provide a lift.

Infection

As in any surgery, infection is a risk. Patients take antibiotics for 24 hours, starting on the day of surgery. They start bathing as soon as the dressings come off.

Hematoma

A hematoma is signaled by marked discomfort and swelling, usually on one side, almost always occurring within the first 24 hours after surgery. Recognition is the key. If the patient returns to the operating room promptly for treatment, she is unlikely to have any problems from this.

Skin Loss/ Delayed healing.

Because skin circulation is partially interrupted by raising skin flaps, avoidance of smoking is important to reduce the risk of loss of skin along the wound margins. This is true in any procedure which involves raising skin flaps (facelift, abdominoplasty, and breast lift/reduction). If some loss along the wound edge does occur, the patient is reassured and instructed to keep the open area clean with soap and water, apply antibiotic ointment and a light gauze dressing. The wound is allowed to heal in on its own. Because wounds contract in from the sides and shrink as they heal, the resulting scar is often surprisingly small, and usually requires no treatment. Scars that widen as they heal may be treated later with a scar revision. The vertical technique has an advantage because thin skin flaps are avoided and the risk is reduced.

Although rare, it is possible to lose portions, or all, of the areola and nipple. Anything that interferes with circulation to the skin such as excessive tightness, an underlying hematoma, pressure on the skin, or smoking (due to nicotine), can lead to this complication, which is obviously best avoided. Smoking cessation patches and gum also contain nicotine, the substance which causes the small blood vessels to tighten, so these also need to be avoided.