Depending on your age as well as your general health pre-operative tests may be ordered, such as blood tests, or an ECG.

It is important that you avoid taking vitamin E, anti-inflammatories or aspirin products for 2 weeks prior to surgery. These products are anti coagulants, and could lead to hematoma formation and bleeding during the surgery.

Most patients who have sedentary jobs plan to take 2 weeks off work. If your job involves a great deal of physical activity Dr. Van Laeken can advise you as to how much time you should take off.

Procedure
Dr. Van Laeken operates at several different hospitals, but generally performs Mastopexy surgeries at False Creek Surgical Centre or the Vancouver Plastic Surgery Centre. These are both state of the art, fully accredited private surgical facilities.

The operation is usually carried out as a day care procedure under a general anaesthetic.

Mastopexy surgery does not remove any breast tissue, but may involve the removal of skin to re-position the nipple and lift the glandular tissue on the chest wall. In some instances, patients request having their breasts augmented as well as uplifted. There are many variations on the Mastopexy procedure. The time required for the surgery varies from one to two hours, depending upon the extent of surgery required and whether or not an implant is placed. The cost will also vary depending upon the nature of the procedure. Each case is taken on an individual basis. Patients are examined and recommendations are made based on the patient's breast shape, size, skin tone, age and cosmetic desires. If the patient chooses to have breast implants placed at the time of the lift, then information regarding breast augmentation will be given to the patient at the same time.

Each of these techniques involved some degree of scarring. These scars will be covered by your brassiere and should diminish with time.

Recovery
Following your surgery your breasts will be swollen. This swelling will last approximately 2-4 weeks. You will be given a prescription for pain relievers, take as directed. Immediately post-operatively you will be placed in a compression bandage, which is not to be disturbed until you are seen in the office 5-7 days after surgery. When you arrive home after surgery Dr. Van Laeken recommends that you rest in bed. Placing ice packs on your chest will help reduce bruising, swelling, and help keep you comfortable.

The first follow-up appointment is in the office 5-7 days after surgery. The dressing is removed at this visit. You may notice some numbness around the breast once the dressing is removed. This is normal.

Bring a jog bra or aerobics top to the first post-op visit. You will wear this after the dressing is removed. You will wear this day and night for 4 weeks.

The second follow-up visit is at 10-14 days. Sutures will be removed at this time. If an implant has been placed then instructions will be given as to how to massage the implant and keep it soft. You will then wear the jog bra for another 4 weeks, but only during the day. Following this period you may purchase a bra of your choice, but a bra without under wire will probably be more comfortable and less irritating to the incision lines.

Your next follow-up appointment is in another 6 weeks, then at 6 months and 1 year after surgery.

Potential Complications
The overall complication rate is low. Some complications are serious; most are not. Some complications interfere with the final desired result and others have no effect on the final outcome.

Hematoma - is an accumulation of blood trapped below the incision. It is the most common and most troublesome complication. If the hematoma is very large, it may require another operation to open the wound to remove blood and stop bleeding. If a hematoma is left untreated, it can enlarge to cause death of the nipple plus other skin areas because it interferes with their blood supply. It can also cause abnormal scarring.

Nipple Loss - means that the nipple in its new location has inadequate blood supply and the area may blister and a small portion of the nipple may be lost over the ensuing several weeks. If this occurs it can be repaired by corrective surgery, which often involves skin grafting. This is an extremely unusual complication but it can occur and it is particularly possible in a situation where the nipples were positioned well below the breast mound so that manipulation and the location involved movement of more than 15cm upwards.

Skin Slough - Usually any area of skin slough (death of tissue) is limited to lcm or less in size and occurs along the incision. These heal by themselves as your incisions heal. If there is too much scarring, your incision can be redone at a later date, but the scars from mastopexy frequently cannot be made as fine as in other types of surgery.

Death of Fatty Tissue Under the Skin - Death of fatty tissue under the skin of your breast is usually due to dissection that can destroy too much of the blood supply to the fatty tissue. Usually this will drain for several weeks or months after the surgery. Sometimes a hard, scarred area may result.

Infection - of breast tissue is uncommon, but it does occur. It heals with antibiotics and drainage.

Nipple Retraction - This means the nipple, in its new location, is pulled into the breast by scarring underneath it. If withdrawal is severe enough to deform the breast, it may require surgery to release it. As long as the blood supply is adequate, corrective surgery will be successful.

Wrong Position of Nipple - Sometimes, it is difficult to place your nipple in exactly the right position. Usually the problem is that the nipple looks too high on the breast. A common cause of this is the breast tends to slide down and out from under the nipple placement. Corrective surgery is difficult.

Scars - You may heal by forming a keloid, which is a thick, unsightly, heavy scar. Cortisone cream or cortisone injections will usually improve its appearance, but it can also be surgically redone, if necessary, to try to improve its appearance.

Cysts - sometimes occur in your breast due to blockage of the milk glands and ducts. These cysts usually resolve themselves spontaneously and disappear. Some may drain spontaneously.

Sensory Loss - You may lose sensation over areas of your breasts after mastopexy, especially if breasts were large and required extensive dissection. Your nipples may lose their erectility and some of their sensitivity. In many cases, sensation returns but in others the loss is permanent. Women with extremely large breasts often have lost much of the sensitivity even without surgery.