Thank you for your story and questions. Unfortunately with a exam of your tissues I can can only comment based your story, however I hope you find my comments helpful.
Mastopexy involves shaping the breast, repositioning the nipple areolar complex(NAC) and when needed reducing the size of the NAC by removing excess skin that cause the sag of the breast. The nipple is left connected to the breast tissue.
Depending on how much excess skin and desired shape the three main types:
1)Peri areolar = doughnut shaped scar around NAC
2)Vertical = lollipop shaped scar
3)Inverted "t" = anchor shaped scar
Each of the above techniques involves a progressive removal of excess skin and builds on each other to lift and contour the skin "bra" to the shape of the breast desired.
Breast size will not significantly change because skin is only resected.
The nerve to the nipple areolar complex (NAC) is directly under the NAC and USUALLY not disturbed by removing the excess breast skin during a mastopexy. The surrounding breast skin may have some short term numbness but usually returns.
UPPER UPPER POLE FULLNESS
Current mastopexy techniques will not attain the "upper pole" fullness patients desire. A small augmentation can be added to create this upper pole contour and not to increase size substantially.
Scaring is always a concern. However there are various postoperative "anti scar"
programs to optimize, reduce and treat scars.
In my experience if the desired goals of shape and positioning of the NAC is obtained .... The patients rarely complain about the scars.
I suggest you you collect several "model" or "goal" photos and then make a appt. with Plastic Surgeon, who has experienced and who is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
Nicotine is only one of the ingredients that is found in cigarette smoke.
You have a right to know what the results of any laboratory tests that you consent to. So, I suggest ask your Doctor.
However of more importance is the scientifically proven detrimental effects of smoking on wound healing which can result in poor wound healing that can lead to infections, tissue necrosis (death, dehiscence of the incisions (opening of the incisions), poor scar quality, revision all surgery and a poor result.
Most Plastic surgeons recommend abstinence of smoking 2 weeks before and 6 weeks afterwards (the critical periods of early wound healing).
I trust you have chosen a experienced Plastic Surgeon who is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic
Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
R. A. Hardesty, MD, FACS
Diplomate and Certified by the American Board of Plastic Surgery
Awardee: Real Self Top 100
4646 Brockton Ave
Riverside, Ca 92506