After having a child my breasts are no longer a perky 32D and my areolas are huge. I'm interested in getting them lifted without implants. I'd like to know if I would need to get a "lollipop" cut and if I will I need implants as well. I definately don't want that fake Barbie look, but I do want a nice high, full appearance again with a natural drop. I also don't want the "baby fat" look that I've seen in most fat transfers to the breast. I don't know if this happens in only flat chested women.
Which is the Best Breast Lift Option for Me?
Doctor Answers (21)
Mastopexy Will Help
Your photos suggest you would benefit tremendously from a breast lift (mastopexy).
Experts will probably differ somewhat on their preferred technique for you, but you would certainly have incisions around the areola and a vertical scar down to the breast crease. The breast crease incision may vary by technique.
Right after surgery, you will have some upper pole fullness, but the breasts will settle a bit over the weeks and months after surgery. Since you have so much laxity/loss of elasticity in your tissues, your breasts will not maintain the position first achieved by the surgery. Though mastopexy will produce a tremendous improvement in the shape and position of your breasts, don't expect a full round breast as a result.
Mastopexy without implant after children
Based on your photos, it appears you are a good candidate for a superior pedicle mastopexy. I would estimate that you would need a lollipop scar plus at least a short horizontal scar in the inframammary fold; the inframammary fold (crease) scar might have to be longer rather than shorter as your nipple looks like it needs to be lifted a significant distance. I usually perform a lot of work to create an "internal" bra so that your lift will have as much longevity as possible and to create upper pole fullness. You are an excellent candidate for a lift alone; I do not believe you need an implant and would discourage one as it will adversely affect the longevity of the lift. You might be slightly smaller than you want but you have to decide what is more important, size or longevity of the lift. Hope this helps.
Tracy M. Pfeifer, MD, MS
Breast Lift Surgery For Your Goals
It’s not unusual for women to develop breast sag following pregnancy and breast feeding. Your pictures demonstrate significant breast sag in the presence of enlarged areolas. Surgical correction of this problem will require lifting the breast into normal position while reducing the size of the areolas. Although your pictures are helpful, a physical examination is necessary to determine which breast lift option is best for you.
Because of the severity of your breast sag, a procedure that addresses the excess tissue in both the vertical and transverse dimensions is necessary. At a minimum, you will need at least a lollipop incision. It’s even more likely that you will need a more extensive anchor incision.
The anchor mastopexy utilizes an incision that extends around the border of the areola. This incision has a vertical extension that connects with an incision located in the inframammary fold. This approach is utilized when patients have severe sag. It addresses sag when there is excess skin in multiple dimensions.
It’s important to note that breast implants can be utilized with this approach. When patients want increased breast size or more upper breast fullness this is an excellent option. When volume is adequate, most patients don’t require breast implants.
If you’re considering this type of procedure, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to help you formulate an appropriate surgical plan for correction of your problem.
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Lollipop Breast Lift Plus Implant in Mommy Makeover
With your degree of sagging and with less than optimal fullness on top you will most likely need a Short scar Vertical Breast lift (lollipop technique).
Without an exam and learning from you more information about your wishes it is hard to give you a definitive answer but your photos are pretty revealing.. The answer to your question lies in letting you surgeon know specifically what you would like to look like following the surgery. For example, how perky do you want to be, what shape do you want to have, etc.? However from the one photo you provided it would appear that a lollipop type lift would be best for you. periareolar lift. Here is a rule of thumb that works for most patients. If you nipple is above your lower breast crease then often a periareolar lift will be sufficient for most patients. If your nipple is at or below your crease then a vertical lift (lollipop lift), inverted T or anchor pattern may be required.
Breast augmentation and mastopexy
Thank you for the question add your picture.
Based on your anatomy and the goals that you have listed I think you will benefit from a full (inverted T) mastopexy along with breast augmentation. This procedure may be done in a single or 2 stage fashion.This is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision to do the operation in a single or two staged fashion becomes a judgment call made by a surgeon after direct examination of the patient. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
I hope this helps.
Best breast lift option for you
Thank you for the photos, they are very helpful in evaluating you. The first question I always ask patients is are they happy with the volume of breast tissue when they are in their bra. If they are, then they don't need an implant. Second, is to see where their nipple is in relation to the fold under their breast. The nipple is supposed to be at or slightly above the level of the fold. Most people with ptosis like in your phot, have their nipple well below the fold. Third, if the distance from the bottom or the areolar to the fold under the breast is too long, ie >5.5 - 6.5cm then that distance needs to be shortened. Your photos appear to have good volume for your body proportions, nipples well below the fold under your breast, enlarged areolars and a long distance from the areolar to the fold under the breast. A full mastopexy, with an anchor incision will correct all those problems, giving you a lifted, better shaped breast, with a correct sized areolar and proper positioning of the nipple. This will give you the most natural look.
Breast lift options
Based on the photos you provided, you will likely need a vertical lift and possibly a full anchor-type incision (wise-pattern mastopexy). Since you state that you do not desire implants, I would use your current tissue and reposition it in such a way to give more fullness to the upper portion of your breast. Keep in mind however that this doesn't always give the fullness that a breast implant can provide. Your areolar size can also be reduced significantly to give a more aesthetically pleasing breast.
Please consult with one or more board certified plastic surgeons for a comprehensive examination and review of your surgical options.
Best breast surgery option for you = lift + implant
Given the photo you provided, from what I can see, if you wish to have a "high & full appearance" (aka clevage) you will need a prothesis - otherwise, you will have to relie on a push up bra. Full cleavage requires a reasonable amount of breast tissue in the upper portion of the breast. With the size of your nipple areola and loss of superior fill, you would get the best result with a submuscular implant and a vertical “Lollipop” mastopexy.You can adjust the size of the prosthesis to your ultimate desired size and with the vertical mastopexy your nipple areola will be made significantly smaller. This can be accomplished without giving you that fake Barbie look, though at first things will sit a bit higher. I certainly would never recommend any sort of fat transfer in your situation.
Regarding longevity, I have found that a *properly* and *appropriately* performed mastopexy with implant performs better over the long term than a lift alone if you do not have enough breast tissue in the superior pole.
Breast lift type for you
You will need a lollipop-type lift (vertical mastopexy) at the very least. As noted on other posts, there are slightly different types, and some surgeons may consider an inverted T as well. An implant will of course make you larger, but an implant can also restore some "perkiness" that a lift often does not do. Even a small implant can make a difference, so you may want to consider that, if you're willing to accept slightly larger breasts. By doing the lift only, you haven't burned any bridges - you can always get implants later if you decide you want more firmness or perkiness.
Breast lift options
Thanks for the photo--I think this is really helpful, and based on this photo, I think that at the very least you would need a full mastopexy, with an incision around the areola, down the breast, and probably some type of small transverse incision in your crease. This can be done with or without an implant, and the whole purpose of the implant would be to increase your breast fullness in particularly in the upper pole (top of the breast). If this is what you want, I think it can be done in one procedure most likely. If not, or if you are not sure if you want the implant, then I would recommend having the breast lift first and see if you like the way things look after you heal-- if you want more fullness, then an implant can always be inserted as a second procedure.