My breast size is 34D. I have Grade 2 ptosis MAYBE grade 3. I want to get a breast lift, saline implants & an areola reduction. I DON'T want the vertical scar under my breast so the lollipop lift is really not appealing to me. I got a tummy tuck in '06 & my scar still looks horrible. What other alternatives is there other than having to get a full mastopexy? Would the periareolar lift benefit me?
Is There an Alternative to a Full Mastopexy for Grade 2/3 Ptosis?
Doctor Answers (14)
The Ultimate Breast Lift is a new alternative for lifting breasts without a vertical scar
There is a new technique for lifting breasts called the Ultimate Breast Lift. This technique was developed using engineering principles to provide a more lasting lift without the unsightly vertical scar. Breasts are elevated using internal 'straps' made from your own tissue to attach the newly formed breast permanently to your chest wall. Unlike, other techniques that do not provide upper pole fullness, this one allows you to have the look of implants without the extra cost. Women finally have a better alternative than the anchor technique which was developed in 1957. Do your homework!
Limiting breast lift incision - the right thing to do?
This question is asked a lot by women who desire lifting and augmentation. If you have significant sagging that will not lift adequately with an implant alone, then using incisions to remove and tighten skin will be necessary. The periareolar lift done well does provide a nice result, but only in cases where there is not Grade 2/3 ptosis. The vertical scar tends to heal beautifully - it's a very forgiving scar typically. Over time scars will fade dramatically.
Breast Lifting Technique?
Without physical examination or viewing pictures, my suggestions are based on your description only (and are general recommendations). Patients with Grade 2 or Grade 3 ptosis generally do not do well with circumareolar breast lifting. This procedure provides a for very limited breast lift and/or change in breast shape.
Although your concerns regarding scars are very understandable I would suggest that their first concern should be obtaining the best results possible (scarring concerns should be secondary). Most patients undergoing this procedure will accept scarring as long as their overall goals in regards to size, shape, contour and symmetry are met. In other words, if surgeon selection is based on the offer of a “limited scar” procedure you may be disappointed with the results.
After careful consideration, if you feel that the necessary scars will be unacceptable to you then it will be better for you not to have and procedure performed ( then be displeased with the end results).
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Periareolar or lollipop breast lift?
Without seeing photos, it is hard to give specific advice, but in general: there are trade-offs to every surgery. Having more scars in your case usually means that the shape of the breast will be improved more dramatically. Scars tend to fade over time, but a less-than-ideal shape, skin puckering, or poor nipple positioning can be permanent. I would advise seeing a couple board-certified plastic surgeons if you are unsure about your options so that you really understand the issues.
Breast lift and implants
Without an exam it is difficult to say, but some patients can do very nicely with an implant and an aroela lift.
4 options to lift sagging breasts
Basically, there are 4 options to lift (aka mastopexy) sagging or ptotic breasts:
1. Breast implants - least amount of lift, but incisions can be very small and hidden very well
2. Periareolar mastopexy - more lift than just breast implants, but the incision goes all the way around the areola
3. Vertical (lollipop) mastopexy - great lift option that also restores projection to your breasts, but the incision goes around the areola as well as extending down from the 6 o'clock position on the areola
4. Wise pattern (anchor) mastopexy - greatest amount of lift achieved, but the incisions go around the areola, straight down vertically, and along the inframammary fold underneath the breast
It's difficult to give you the best option for your without seeing you in person, but beware that only a limited amount of lift can be achieved with implants only with a periareolar incision. Typically, I place the implants in first and then perform the lift. If I can stay away from the vertical portion then so much the better, but I do explain to my patients that several decisions can only be made in the operating room once the implants are placed. This is because it can be difficult to determine how the skin and breast tissue will react to the implant and different types of mastopexy. Either way, good luck and I hope your procedure is an "uplifting" one for you!
Short scar breast lift (mastopexy): emerging options
For this amount of ptosis, you will likely get significant periareolar rippling or gatthering or pleats with a short scar technique. If you find this preferable to a vertical scar. Other adjucnts include lower pole liposuction with upper pole fat grafting but this is not an established technique and should be discsussed with an experienced surgeon.
Generally, there is a limited amount of lift that can be achieved with the periareolar approach. That is why surgeons often need the other incisions (lollipop, anchor). It will likely be difficult to do a good job without the correct incision. I would discuss this very carefully with any surgeons that you see for consultation.
Breast lifts entail additional scars
You have a stated bra size of 34 D and are considering implants and a lift. Any implant that is placed likely will, at a minimum, make you a DD cup. If you are OK with going up in size, an implant and a circumareolar incision may do it. Do not, however, expect much of a lift. You will still be able to hold a pencil under your breast fold. Sometimes it is better not to have any operation than to pick the wrong one because it has fewer scars. Be sure to have a couple of separate opinions and view photos of patients who are similar to you ahead of surgery.
The best lift for grade 3 breast ptosis
Breast lift is all about nipple position and the lift should hold the nipple up front and center over the breast. For breast ptosis, which is referred to as grade 3, the nipple is dependent and almost pointing floor-ward. The ptosis will be accentuated by the breast implant so it is important to accept a lift which will raise the nipple the necessary distance and hold it there without relapse. The vertical lift will be your best option without question.
Best of luck,
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.