After two kids, I don’t love my breasts anymore. I just don’t feel like “me.” I was reading about yet another celebrity having her boobs “done,” and it made me wonder — is surgery really an option for a normal (non-celebrity, non-socialite) person? How long is the recovery? Will it look natural? Do I need a breast lift or implants? — Sagging in Sudbury
Great question! When it comes to breast surgeries, I know to hand the mic to Toronto cosmetic surgeon Dr. Jacqueline Rose Makerewich. She is great at breaking down not just the nitty gritty details of cosmetic surgery (she posts surgical journeys on Instagram at @realdrrose) but the emotions behind it, informed by her feminist philosophy.
“To me, body positivity is achieving harmony and a positive relationship between your body and your mind,” Makerewich says. “I firmly believe that people have a right to their own bodies and should be able to love themselves in whatever way they personally deem best.” For some, that means accepting our bodies as we age and not trying to change them. For others, it means making peace with lingering stigma around cosmetic procedures. “I hope that the movement will continue to grow and will one day embrace surgical scars as an acceptable and shameless body attribute, too.”
In answer to your question about whether “normal” people seek surgery, Makerewich describes her patient range: “My patients range in age from teens to 70s! My patients are pilots, exotic dancers, lawyers, women in the military.”
The initial consult is where Makerewich probes for what a person really wants from surgery and why. “Surgery is life-changing, there are risks, and recovery is a commitment,” she says. “Being emotionally fit for surgery is just as important as being a healthy candidate physically.”
Restoration of confidence is something many of her patients cite, but she needs to make sure they understand it isn’t a quick fix for all that ails them. “Cosmetic surgery may have the effect of improving confidence, but you shouldn’t pursue cosmetic surgery to give you confidence or to restore confidence — that has to come from within.” Red flags include people who want surgery to please, or find, a lover.
A better reason to pursue breast surgery is wanting to restore your breasts to their pre-childbirth shape. Many moms “feel fit and healthy, and their deflated and loose breast tissue doesn’t feel harmonious with the rest of their body,” Makerewich says. A patient with realistic expectations for surgery will have a good understanding of their body and will be able to describe in detail the specific change they would like to make.
So here are the hardcore details. First, the breast lift. “The general idea with a lift is to remove skin and reshape breast tissue to create a perky breast and correct droop,” says Makerewich. There are two common scar patterns for this: a vertical lift creates a lollipop scar, where the incisions travel around the areola and in a vertical line down to the bottom of the breast. With an anchor scar, there is an additional scar in the breast fold, which allows for more skin removal and a “powerful” lift.
There are more technical enhancements possible from there, including liposuction and a reinforcing “internal bra” or suturing. But to achieve a lift, note that the nipple always has to be moved. “A breast lift alone is best for patients who want a natural teardrop-shaped breast and would be happy with a breast that looks perkier and slightly smaller.”
If you are looking for any lifting effect, know that implants alone will lift the breasts very minimally. Rather, they are used to add volume. Implants vary by fill material, profile and volume. The two options for fill material are silicone and saline (salt water). There are many different shapes available, ranging from low profile (more natural-looking) to extra-high profile (a round-looking breast with more projection and upper pole fullness).
In terms of cost, this is an investment for sure: a breast lift typically ranges from $9,000 to $12,000. Implants add extra expense. The addition of lateral chest wall liposuction for contouring can also increase surgical time and therefore cost.
There is a time investment to surgery, too: major recovery occurs during the first week. Most patients can return to sedentary work or activities after one to two weeks, and to exercise and heavy lifting after six weeks.
That’s for physical recovery. But the emotional side of healing is a particular research interest of Makerewich’s. “Immediately after surgery, patients feel excitement and relief,” she says. “They are in survival mode, managing pain, surgical dressings and garments, the awkwardness of not showering. Between three weeks and four months is when patients struggle the most emotionally.” That can include sadness, worry and anxiety. “There is a shift in sense of self and self-image, where the mind is trying to accept and love the new body, but in the early post-op months the results have not settled yet.” Swelling distorts shape, scars are fresh and obvious, and implants take months to settle. “By six months, most women love the results.”
Makerewich prescribes a supportive bra to maintain the perkiness from breast surgery long term. “I am a strong advocate of wearing a supportive bra day and night,” she says. “This helps transfer the weight of the breast and implant to the bra and not to the skin, preventing breast drooping over time.”
How big are women choosing to go? “Often I find that women are looking for a natural enhancement that complements and balances their figure. They want to feel feminine but not fake,” she says. There is still an appetite for serious cleavage, but that’s not the only option. “Women looking for a more noticeable enhancement tend to be less shy about sharing their results on social media — this can create a false perception that breast implants have to be large and noticeable.”
We are saturated with images of “ideal” breasts in the media and on social media, which can distort reality for even the most educated consumer. “I deal with reversing unrealistic expectations created by photoshopped images frequently during the surgical education process,” says Makerewich, “but the effect is so much broader than that and really has global, ageless and genderless reach.”
On that note, transgender affirmation surgery is an active part of Makerewich’s practice. Cisgender men are also clients. “Surgery for men (to remove) breast tissue is often performed through very small discreet incisions around the areola,” she explains. “Surgery for excess chest skin after weight loss, creating the look of a deflated breast, is a different operation where excess skin is removed and masculine chest contour is restored. Incisions are hidden around the areola and in the shadow of the pec muscle. Both of these surgeries can be quite life-changing.”
Shop the advice
Supportive bras help to maintain the results of surgery — and are always a good idea.
Goddess Keira Full Cup Banded Bra, $58, Secrets From Your Sister SHOP HERE
Lift, shape and support for band sizes up to N and cups up to 44, with a pretty print and sheer strip at the top of the cup for understated elegance.
Natori underwire sports bra, $99, nordstrom.ca SHOP HERE
A brilliant underwire sports bra with four-way stretch and moulded cups for extra support without sacrificing breathability or comfort.
Wacoal T-shirt bra, $88, barenecessities.com SHOP HERE
Lightweight spacer fabric gives the smooth effect of foam without bulk. Support for sizes up to 46G.
Knix bra, $72, knix.ca SHOP HERE
The popular Knix Wing Woman style effortlessly smooths the sides of your bra to ensure a sleek finish with full support.
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