Am I a candidate for periareolar breast lift and implants?

Question

42 yo. After giving birth to my daughter 3 years ago, my breasts had gone from C to DDD overnight. I have no stretch marks, but over the past 2.5 years my breasts slowly "deflated " to what you see on the pictures. I would love to correct the sagginess and get a fuller look, but want minimal scarring (no vertical). Is it possible?

Gerald Minniti, MD, FACS · Answer

Your breasts have lost elasticity and are too ptotic. Your nipple areolar complex is too wide and it’s inferior edge is too close to the infra-mammary fold. What most women come to realize, usually too late, is that the shape of the breast mound is more important than inconspicuous scars, and that peri-areolar lifts do not look good when performed on the wrong breast (and can produce very prominent scarring as well). Go to a breast specialist and get the correct breast lift.

Yunus Dogan, MD, FEBOPRAS · Answer

hi thank you for your question and photos. Periareolar mastopexy is proper for breast which needs 1-2 cm breast lift. For more movement it is better to perform vertical or inverted T scar mastopexy. Otherwise you will have a depression around your nipple and areola.To decide this we need some measurements of your breast (nipple to notch,nipple to inframamarian fold etc). Good luck and get heal soon.

Gary M. Horndeski, MD · Answer

The no vertical scar technique you are looking for is called The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (95%) and the ability to breast feed.  Later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices.  8% fail within the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Ellen A. Janetzke, MD · Answer

Hello! Thank you for the question- I receive this question commonly in the office. Just from viewing photos alone, I would likely recommend a short scar lift (lollipop) with a vertical incision for you. The reason why is because of the diameter of your areolas and the level of ptosis (droopiness) of your breast. A lift with a vertical scar will be able to lift your breast more than a periareolar lift. Additionally, a lift only around the areola would most likely result in re-widening of the areola post-op. Finally, periareolar lifts tend to flatten the breast more than a vertical incision lift, even with implants in place. The vertical scar does tend to fade very well 6 months to 1 year post-operatively as well. It is best to make a consultation with a board certified plastic surgeon for a more thorough discussion and evaluation of your breasts.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. I would avoid  a peri-areolar llift in your case. I think you will have a better result with either a vertical lift, also known as 'lollipop' lift, and full Wise-pattern lift, know as 'anchor' lift. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Richard Greco, MD · Answer

One needs an in office consultations and evaluationYou can try it, but you won't like it,You have relatively saggy breasts and you arms are not even down at your sides.  You have large areolas and can get a significant elevation - but they will stretch out again and give you recurrent sag.  Also the more peri areolar lift - the flatter your breasts will become after surgery.   The vertical scar should be almost imperceptible and the shape difference is dramatic.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a vertical or wise pattern breast lift.  I rarely recommend a Bennelli or circumareaolar (donut) lift.  Over time, the areola tends to enlarge with a thickened scar.  The other even worse problem with a circumareaolar lift is that it flattens out the shape of the anterior breast over time.  A vertical or wise pattern lift with an implant can result in a very nice shape if good technique is used.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  
 
 Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Dear Trustworthy5238,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thatsbeing brought together to support the breast and hence improves longevity.
If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Chad Robbins, MD · Answer

Hello and thank you for your question and photo's.  You have grade III ptosis and would need a full mastopexy with an implant to get a good result.

Robert V. Mandraccia, MD · Answer

I think it is entirely possible to do a periareolar approach for this but be sure to pick a surgeon certified by the ABPS, American Board of Plastic Surgery for this work and DONT rely on a website which make make claims which are not true.

Am I a candidate for periareolar breast lift and implants?

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