A rose by any name...

tjra,

I suspect that all of the terms that your question involves are interchangeable.  Although, only one is recognizeable to me as such, circumareolar.  This term is synonymous with periareolar.  Subareolar and semiareolar are not recognized names for breast lift or mastopexy procedures.  At any rate, don't get caught up in terminology.  Make sure that you are dealing with a board certified plastic surgeon.  He/she will know what procedure is best for your needs, no matter what the procedure is called.  Good luck!

There are many different types and degrees of droopy breasts.

For this reason, one technique cannot treat all the different conditions. Different approaches may be required depending on the position of the nipple, the amount of extra skin, the amount of breast tissue, and the degree of droopiness.

The procedures can be summarized as follows:

• Very small degree of droopiness can be treated with an implant alone
• Small to moderate droopiness may require only an incision around the nipple
• Moderate to severe droopiness may require an incision around the nipple and straight down the breast. Also known as  "the lollipop incision" since the incision is in the shape of a lollipop.
• Severe droopiness may require an incision around the nipple, straight down the breast, and transverely under the breast. Also known as "the anchor incision" since the incisions are in the shape of an anchor.

Your plastic surgeon usually has videos and other aids to help you understand the procedure clearly.

IMPORTANT: When selecting a qualified plastic surgeon, make sure that they are certified by "The American Board of Plastic Surgery". This is the only board recognized by "The American Board of Medical Specialties" in the field of plastic surgery.

Unfortunately, there are many unqualified individuals out there posing as plastic surgeons, who prey on uninformed consumers. Checking their credentials is the best way to protect yourself....

Good luck with your procedure.

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Dr. Placik explains the differences beautifully. Each procedure is useful, depending on the distance the nipple needs to be elevated. In some cases, a vertical scar is added when the distance is greater than that which is easily accomodated by a peri-areoar or crescent skin excision. Many patients do not want a vertical scar. However, if the nipple has to be elevated more than about 1.5cm, and if no vertical incision is used, the peri-areolar scar can end up looking like a "sunburst". 

This is permanent. The addition of a vertical scar will help prevent this. In addition as Dr. Placik explained, peri-areolar techniques can flatten the breast. Your surgeon should discuss the pros and cons of each method with you and you can decide together what is the best thing for you, given your particular anatomy. There is not one right method that can used in every case. There IS an ideal choice for you, given your needs. Hope this helps.

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The most important thing is not to skimp on the incision for fear of the scar. Why have a shorter scar, but a misshapen breast. If the nipple-areolar complex needs to be moved, then it is best to do a full peri-areolar or circum-areolar incision with a vertical and, most likely, a transverse incision as well. Good luck with your surgery.

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Hi!  I hope these thoughts help you:

1)  There is no sub areolar lift.

2)  A semi areolar lift gives you very little correction and I usually use it only for tiny problems.

3)  Implants alone will correct slight sagging.

4)  A circumareolar lift (scar all around the nipple)  is good for medium sagging, and I often use this, with or without implants.

5)  For serious sagging, you may need a good internal lift with a "lollypop" scar.

6)  Those are the options.  See a board certified plastic surgeon, ask him what he thinks, and ask to see lots of before and after pictures.  Then get another opinion.

7)  I have been doing this for over 20 years, and can tell you that it can be hard to come up with the best plan for a particular woman.  One needs to have a good eye and one needs to spend a lot of time and effort.  So what you need to decide is, who do you really trust to do the best for you.

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