My main priorities are having symmetrical, natural-looking breasts. Breast Lift, Fat Transfer, or Areola Reduction? (Photos)

girlpop1234,
Thanks for your questions. Let me jump in with my thoughts. 1- Do my breasts look mildly tubular or constricted, especially in the inner lower area? not in the "classic" sense of herniation of tissue through your areola and high breast fold. Your breasts appear asymmetrical. 2- If I had a breast lift, would part of the areola end up within the lollipop portion of the scar? That’s something I’d like to avoid if possible. Yes, a "lollipop" or vertical mastopexy will reduce the size of your areola and lift the nipple areola complex (NAC) higher. all breast lift incisions incorporate a cut around the NAC.3- If that’s unavoidable, I’d rather embrace the natural sag but at least improve symmetry and shape through: • Fat transfer to the smaller breast and the constricted lower areas, and possibly • Areola reduction to make them smaller and more even? You may consider a peri-areolar incision to reduce the areola, which will lift and tighten your breast 1-2 cm from the original position. Fat grafting is not advisable, as not all (and possibly none) of the breast fat transferred may survive. Consider different small-sized implants or "reduce" the bigger breast to the size of the smaller.
Hope that helps.

Thank you for your question. You do not seem to have true tuberous breasts. The issue appears to be ptosis and areolar size, so the usual solution is a breast lift with areolar reduction to center the nipple–areola and improve symmetry. Schedule an in-person examination with a board-certified surgeon to measure nipple-to-fold distance, assess skin quality, and determine if a vertical lift alone will achieve your symmetry and shape goals.

Your photos suggest that you could achieve a good aesthetic outcome from a bilateral breast lift. This would include areolar reductions. Fat transfers may add some improvement but depending on your goals, they may not be necessary.

Your breasts do not appear to be tubular, as you have a defined breast fold and no constriction of tissue around the nipples. The scar around the areola during a breast lift is typically placed along the border. A breast lift with areola reduction would be more suitable to improve shape symmetry, rather than fat transfer.

You have tuberous breasts. Breast lift without reduction will be good for you. And yes areoles will be reduced.

Dear girlpop1234,

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 thats being brought together to support the breast and hence improves longevity.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

This is Dr Özge Ergün
First of all, thank you for sharing your photos. You have moderate breast sagging and your areola appears wide. With a vertical scar mastopexy, you can maximize your own tissue and achieve a symmetrical breast with ideal areola size.