I had a periareola lift with 525-550cc smooth saline moderate profile implants. During my consultation I voiced my concerns about not wanting vertical scars. My surgeon assured me that the crescent lift along with a large implant would give me a satisfactory lift. I had some sagging, but not sure exactly at what level. My nipple did not point downward. I am now 5 months post op. The results are a flat projection and odd shape. Can this be corrected? It is possible for me to get a vertical lift?
Correction After Periareola Lift? (photo)
Doctor Answers (18)
Unacceptable Appearance after Periareolar Lift
Yes, you can convert your current lift to a more formal mastopexy. Contrary to what you've been told here in this forum, a high profile implant will not solve your problems: a flattened mound, persistent sagging of the lower pole of the breast, and a low positioned nipple. Additionally, you do not need such a large implant either, if that was not your original intent. The mastopexy will give your breast an aesthetically pleasing shape regardless of the implant size.
You should visit a few surgeons with great reputations for all forms of cosmetic breast surgery, including lifts and reductions. These surgeons will be certified by the ABPS, and also be members of the ASAPS.
Best of luck.
Correction After Periareola Lift?
Your surgeon made a very poor choice in assuring you the donut klift would suffice. Your desire to have NO VERTICLE SCARS limited the options of having a more "natural result". Only a full lift will correct the issues.
Breast Augmentation with Periareolar Breast Lift
Periareolar breast lifts result in some flattening of the breasts that is especially apparent if used to lift a nipple areolar complex greater than 4cm. That being said, I think that you are going to require a vertical lift and a smaller implant to obtain a more ideal shape and improvement in your double bubble deformity.
Good luck with your recovery!
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A vertical lift will help with the double bubble shape of your breasts
Although it is difficult to answer your question from looking only at photographs, it appears that you have a double bubble shape to your breasts. This is typically characterized by a fullness in the upper pole of your breasts due to the implants and the breast tissue in the lower part of your breasts that creates a second fullness that appears to be falling off of your central breast.
A vertical lift will correct this issue. A periareolar lift will not correct your problem in a lasting manner. Any improvement from a periareolar lift in your particular case would most likely be temporary as the breast droop will occur again.
Concentric/crescent vs Vertical Lift
Thank you for your question. While a concetnric or crescent lift may help some women, it is common to notice some flattening of the breast on profile- especially as the amount of lift attempted gets larger. As you can see from the other experts who have responded to your question, there are several details that need to be sorted through, including the dimensions of your current implant and possibly switching up the implant.
Ultimately, however, I believe that you should consider a revision with a vertical mastopexy. This is increase the projection of the breast and give a better "coned" appearance.
An option might be a High Profile Implant , making the breast base width decreased and filling into the empty breast pocket. Hard to guarantee without a possible vertical component . Difficult not being there from the first consutation. It looks like a large implant with a concentric lift was done appropriately . But, to get to where you want to get to you will probably need more scar and possibly a different profile implant . Hard to tell from where you started from (ptosis/ breast droop) .
Periareolar breast lift can reduce breast projection
While the periareolar or crescent style breast lift can help improve nipple position over a breast implant, this form of breast lift will diminish projection and produce an overall flattening because of the geometry of this technique. In order to improve nipple projection of vertical lift is necessary as this will reduce the glandular ptosis and help push the nipple upward and forward. Though your result can be corrected it still is quite good so the patient with your decision.
Augmentation-Periareolar Mastopexy result
A vertical mastopexy incision would do the trick in achieving better nipple position on your breast mound. It is more dangerous to do this if the implant is under your breast tissue and above your muscle - healing problems might occur. If you decide to pursue the lift, be sure that you address any concerns you may have about breast size because that would be the time to address it. If you are happy with the size, then all you need is the lift. Good luck!
Correction of Breast Lift / Augmentation
Thanks for posting your question. I would be nice to see the before as well as the after pictures for a complete assessment. The crescent lift has limitations as the minimal incision does not allow for breast reshaping or very much actual lifting. This surgery relies primarily on the implant placed. This is the reason why in the vast majority of cases, it is better to do a traditional mastopexy / lift with augmentation. This gives the most freedom for customizing the size and shape of the breasts to best fit the patients anatomy and their expectations. The limited incision with the crescent lift unfortunately also limits the results. If you are looking for improvements, I would suggest converting to a traditional lift and a slightly smaller implant.
Correction after BA nd crescent lift
Thanks for your questions and photos. One of the questions I would have for you is what type of implant profile was used for the procedure. In addition as you did not want a vertical scar, this will cause you to have redundant tissue underneath the nipple, and cause a flattening from a side view. I do not think the implant needs repositioning, as it appears this is your actual breast tissue that is present below the NAC. If the goal is to never see a vertical scar, then not much more can be done besides a further tightening around the NAC, which in itself can expand the size of the NAC, or a switch to a larger implant with a higher profile to give more projection. I would seek another consultation with another board-certified plastic surgeon if you are not happy with your current one.
Best of luck
Robert Kratschmer, MD
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.