If I’m not looking for volume, can I get just a lift to correct nipple look/placement? (Photo)

Question

I am small framed and have birthed 7 children, including 2 sets of twins. All my children were nursed for a year. I have no breast tissue left. A surgeon recommended implants, which I really don’t want, and said a lift won’t fix my creased nipples. Looking for a second opinion.

Semih Yildiz, MD, FEPOBRAS · Answer

A breast lift can improve nipple and areola position, reduce excess skin, and make the breasts sit higher, so it may be a reasonable option if you are not seeking more size. In your photo, photo review is limited, but there appears to be significant deflation with low, outward nipple-areola position and very little upper-pole tissue. A lift alone would likely make the breasts smaller, tighter, and better positioned, but it will not restore fullness the way an implant does.
The creased nipple appearance may improve if it is mainly caused by the nipple-areola complex folding at the bottom of a loose breast envelope. However, if the crease is related to very thin tissue, loss of central volume, or nipple shape itself, a lift may not completely correct it. For someone who does not want implants, options to discuss include a vertical or anchor-pattern mastopexy, internal reshaping/auto-augmentation using your own breast tissue if there is enough to work with, areola adjustment, and possibly modest fat grafting. The key is to be clear that your goal is position and shape rather than added volume, because that changes the surgical plan.

Daniel Barrett, MD · Answer

Dear Imaginative655584,

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

Kadir Berat Oyur, MD · Answer

hank you for your question.
While a lift can improve nipple position and breast shape, it may not completely correct creased nipples on its own. If you wish to avoid implants, a lift combined with fat grafting may be a good alternative.
A consultation would help identify the best approach to meet your goals.

Mehmet Ozdemir, MD · Answer

Thank you for your question.
A lift can improve nipple position and breast shape, but without volume, it may not fully fix creased nipples. If you prefer no implants, fat grafting combined with a lift might be an option.
A consultation will help determine the best approach for your goals.

Gary M. Horndeski, MD · Answer

The technique I recommend is a breast lift using 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 (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Emre Guvercin, MD, FEBOPRAS · Answer

Hi there &mdash; your story is incredibly common after multiple pregnancies and years of breastfeeding, especially with a small frame. What you’re describing is not true “sagging.” It’s actually volume loss with very thin breast tissue.
Important point:
If the breast has no remaining tissue, a lift cannot reshape what isn’t there &mdash; and it will not fix creased or deflated nipples. A lift only tightens skin and repositions existing volume.In your case, the issue isn’t position &mdash; it’s absence of volume.
So what are your real options?
1️⃣ Implants (most reliable option)An implant is the simplest and most predictable way to restore: • Nipple projection • Breast shape • Upper-pole fullness • Lost volume from breastfeeding
Even a very small implant can recreate a natural-looking breast without looking “augmented.”
2️⃣ Fat transfer (if you strongly prefer no implant)Fat grafting is another option, especially if you want a gentle, subtle, natural increase.However: • It may require more than one session • Volume retention varies • It cannot achieve as much projection as an implant
But it can help restore a soft, natural breast if your expectations are modest.
3️⃣ A lift is NOT needed
Because you do not have true ptosis, a lift would: • Not improve your shape • Not correct nipple creasing • Potentially add unnecessary scars • Not address the real issue: volume deficiency
So your surgeon is right about one thing &mdash; a lift alone would not help. But that doesn’t mean you must get a large implant. You simply need volume restoration, not skin tightening.
You have very fixable anatomy &mdash; you just need the kind of solution that replaces missing volume rather than lifting tissue that isn’t there.

Tyler Frew, MD · Answer

Hi there,
I would agree with your first assessment, a small implant would easily fix the problem. If you aren’t looking for that, it’s ok, you could also get fat grafting. Fat grafting is not as strong as an implant but can provide you more bulk and help the skin look fuller. There is also a product called alloclae that can be used if you don’t have enough fat on your frame 
All the best

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. 
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos alone, you have some skin laxity. This can be addressed either by tightening the envelope via a lift or filling the envelope via augmentation.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Jeffrey M. Darrow, MD · Answer

Thank you for your photo. Without the benefit of a direct physical exam, it appears that your nipple/areolar complex sits above the fold underneath your breast, which is its proper position. There appears to be only a very small amount of the breast tissue, which hangs below the fold underneath your breast. Therefore, a standard breast lift would not be in order, as your nipple/areolar complex does not need to be moved upward.  It may be possible to perform a lift where your nipple/areolar complex is not moved upward, but the skin of your breast is tightened slightly in order to fill out your breast skin envelope as much as possible.  Speak with your plastic surgeon about the different options. Best wishes.

If I’m not looking for volume, can I get just a lift to correct nipple look/placement? (Photo)

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