Hi I really want a breast augmentation, i am 38 yrs old have breast feed , my children are now teenagers, no plans for any other children. I initially didnt want a breat lift but have realised i need one, but i am very scared of the scars. could i have a cresent style breast lift and implants??
Could I Have a Cresent Breast Lift and Augment?
Doctor Answers (21)
Crescent lift, vs. augmentation, vs. full matopexy
You pass the pencil test. This means you could have any procedure you want. This simple test requires you place a pencil in the fold under your breasts and see where the areola sits. If it's under you need a lift, if it's on it you may get away with a crescent and if it's over it you can possible do well with an augmentation alone. Another option if you want a modest increase in size is a natural lift where we transfer fat only to the upper pole to make it look lifted even though it isn't lifted at all. Consult a board certified plastic surgeon who's done a lot of breasts.
Silicone breast implants over the muscle will correct mild sagging.
A crescent breast lift really does not do much for most women. From your pictures, it looks like you may not need a lift at all. But if you do, we recommend a Benelli lift with a circular scar around the nipple.
Breat augmentation and "crescent lift"
A lot will depend on the volume of the implant. Yes you are low but not that low. If you were looking to be somewhere in the C cup range and the implant is placed appropriately it is highly likely that you will not need any form of lift. One way of approaching this is to do the augmentation alone and then reevaluated in six months or year, and allow things to settle, and see if you really need a lift.
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Crescent mastopexy is prone to elongated scars
There are many types of mastopexy, and they are not created equal. First of all, implants alone will give you some "lift", approximately 1cm per 100cc of implants. With this in mind, around a 250cc-350cc implant would be reasonable for you (just a shot in the dark here - obviously you need to try on the implants, show pics of what you want, etc), so you will still leave a small lift. Here's breaking it down:
- Crescent: scar over tope of areola only (9'oclock to 3'oclock). Very prone to scar stretching and creates vertical areolar shape
- Benelli: scar around the areola. Many surgeons do skin only (bad), which is prone to strectching out and makes the areola too big! If done correctly, with breast tissue getting moved around to tighter position(good), would be most appropriate for your breasts.
- Lollipop: scar has lollipop shape. I don't think you need this, but sometimes necessary for women who have stretched out skin that has stretch marks or no elasticity.
- Anchor or Wise pattern: Lollipop and also a scar under the breasts. You will not need this incision for your small lift, in fact in very few people is it ever warranted.
-Other: Some docs do an angular scar, like a lollipop but it curves to the lower outer quadrant of the breast. I have seen this work well, it is not my technique personally.
In summary, have your surgeon place the implant, then do the lift according to what you need to look good on the table. I strongly recommend a circumareolar scar, from a surgeon who is very comfortable with this technique. And remember, to achieve longevity in a breast lift, the plastic surgeon must understands that the lift is achieved my moving breast tissue - not just by removing skin.
Breast lifting type?
Thank you for the question and pictures.
Although your concerns regarding scars are very understandable I would suggest that your 1st 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 you select your surgeon based on the offer of a “limited scar” procedure you may be disappointed with the results. The crescent breast lift may leave you with an unsatisfactory “lift” and potentially an elongated areola.
It will be very important to communicate your overall goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible . By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this if helps.
Crescent Breast Lift vs Implants
A crescent lift is a very limited type of lift. If you want your areolas up higher you would need a traditional full lift. If you don't mind a little hang then you could do implants.
Augmentation and peri-areolar breast lift
If you are concerned about the vertical scar from a vertical breast lift a peri-areolar breast lift may be a suitable option in your case. You would likely look your best with the complete vertical breast lift requiring an incision around your areola and one down your breast but since your are close you could certainly just get the peri-areolar lift and decide down the road to add the vertical component of the breast lift. You would not be burining any bridges doing so.
All the best,
Dr Remus Repta
Breast lift with crescent technique
In order to determine if you will need a breast lift, it all depends on various factors including the location of your nipple, excess skin, and volume that need to be restored. It is hard to tell from your picture if you may or may not need anything more than a crescent breast lift. In my practice, I follow some general guidelines to accomplish great results. Number one, the patient needs to understand that the bigger is not the better. When the skin has been stretched to the point that it sags, it is always a bad idea to put a large implant to avoid a breast lift in the same setting. Why? Because your skin will not be able to handle the weight of the implant like a normal skin does. It will bottom out; in other words, the implant will be displaced inferiorly. Putting an implant will lift your breast to some extent; it is not going to be much. The only indication that I see for a crescent breast lift is if you need a minor correction of breast ptosis of about 1-2 cm. If it is 2-4 cm, I use a circumferential mastopexy. Now, both of these techniques are considered periareolar breast lifts. The difference is that with the crescent you excised just from 9:00 o’ clock to 3:00 o’ clock while with circumferential you excised all around the areola. The more breast lift with augmentation I do, the more I prefer the circumferential breast lift instead of the crescent. This is because with the crescent mastopexy (breast lift) you can distort the areola complex by stretching it in a superior direction into a more oval shape than its normal round shape.
Breast implants and lifts
In surveying the answers given I have to say I'm quite surprised by the number of plastic surgeons who would consider a so-called crescent lift. It seems that only Dr. Minniti understands the outmoded and misconceived nature of this attempt at lifting breasts. Crescent lifts do not lift breast. Even periareolar lifts don't really lift the breast but are better at rearranging the nipple-areola and having it look better balanced over the center of the implant bulge. There are also several suggestions that the size of the implant will lift a breast. This is an illusion. Implants are only pillow volume and do not lift breasts although they can simulate it by filling out the lower pole.
Breasts that are too low (ptotic) cannot be properly augmented with an implant alone. Any breast that needs a lift is best done with a true mastopexy and these days should be able to be done with a vertical or lollipop-type incisional scar. Your breasts are low on your chest and look ptotic but true droop has to do with where the nipple sits in relation to the inframammary crease behind it (at the base of the breast). This can't be judged in the photos but if the nipple is more than two centimeters below the level of the inframammary crease behind it then a real mastopexy with or without an implant is the only option. If the nipple position is not too low then a properly sized round implant (based on the width across the center) can be positioned behind the nipple-areola and fill out the lower pole of the breast. This will look as if the breast was lifted even though it wasn't but it can be done with just a 2 cm (saline) or 3 1/2 cm (silicone gel) incision in the inframammary crease. None of these procedures will change the tone of the skin and breast tissues. A saline-filled implant would be very easy to feel in the lower pole of the breast so many women would choose a gel-filled implant in this situation. I would avoid any periareolar incision unless a true lift (mastopexy) is required.
You can but...
You can probably do this but you will still be a bit on the droopy side. It depends upon whether you are more interested in lifted breasts or a decreased scar pattern. A more involved lift will lift better. I would need to measure you to be sure of course .
John Di Saia 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.