I have 36 C/d sized breast, 5'1" 135 lbs 38 yrs old with 2 kids. I need a lift but don't want the scar. I like the perky look of my younger breasts and would like to remain the same size. what options do i have?
What are My Breast Lift Options? (Photo)
Doctor Answers 15
Breast lifts without scars
A true breast lift requires an incision (and thus scar) around the areola and from the bottom of the areola to the inframammary crease. Periareolar (and particularly the "crescent" lift) are not true breast lifts and even the old apporach of seeming to lift the breast using skin tucks (wise pattern) is not a true lift and will stretch back out again. In your situation, the difference in volume could be addressed with liposuction of the right breast with an insignificant scar. This will not lift it or raise the nipple-areola to the level of the left. The simplest true solution would be a small reduction and lift of the right breast through a "vertical" or lollipop type incision to try to match the left side. Most would recommend a lift of both sides with more lift on the right and a small reduction of breast tissue on the right.
Breast lift options
Breast lift options with limited scars
There are a variety of techniques for these operations. Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, anchor lift (inverted T ). Most commonly, we prefer the lollipop or donut lift because of the shape, small scars and easier healing. Although the “anchor-shape” or inverted “T” incision is still more popular in the United States, it represents an older technique with extensive scarring and a less optimal result in many cases. These newer techniques are utilized in the vast majority of cases, the rare exception being extremely large breasts. The nipple-areola complex is repositioned higher, the excess skin is removed, and the breast is reshaped in a pleasing contour and in a more normal position.
The crescent lift removes a small amount of skin at the top of the areola. We find that there is very little lift and the areola becomes oval in shape and distorted with this method.
The Benelli lift as performed by most surgeons is just the donut lift, removing a donut shaped piece of areola and skin then using a #Pursestring or double purse-string suture to tighten the skin. A true Benelli actually will expose much of the breast through this incision and then the breast itself is shaped and lifted with sutures. This is a more complex procedure and is often not done as describe by Dr. Benellil.
The insertion of an implant as well, may be advisable to restore superior fullness, which is lost with aging and after pregnancy despite the rest of the breast being overly large. Fat grafting can be used instead of implants to improve the contours of the breast.
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Breast incision options
1) Around the areola - partial or whole
2) Vertically from the lower part of the areola towards the fold
3) Horizontally from the inner to outer portion of the breast along the fold - partial of whole
Your surgeon will choose one or more of these based on the desired result as well as the physical exam. Some factors on the physical exam include nipple position, skin laxity and distribution of breast tissue. The lower the nipple, the greater the skin laxity and the more deflated the upper portion of the breast, the more likely you will need all three elements of the breast incision outlined above.
I would visit with a board certified plastic surgeon who can help you discuss different options in more detail.
Surgical Options Associated with Scarring
Under these circumstances, it may be appropriate to leave well enough alone.On the other hand, a variety of surgical options do exist to treat breast sag.Unfortunately, all of these options are associated with scarring.
For these reasons, it’s appropriate to consult a board certified plastic surgeon with experience in this area.This surgeon should be able to discuss all your options including relevant trade-off’s.In the final analysis, you’re the only one who can determine whether the scarring is worth it.
Breast Lift Candidate?
Thank you for the question and picture.
Only YOU can answer the question whether breast lifting is "worth it" or not in your specific case. It will come down to how much the the "deformity" (position of the nipples) bothers you versus the costs ( time, money, scarring) associated with fixing the “deformity”.
Based on the pictures it is clear that a breast lift will help you by raising the nipple/areola complexes and tighten up the breast skin envelope.
The operation will likely involve incisions around the areola as well as vertically oriented ('vertical mastopexy"). The trade-off typically seen with breast lifting is improvement in breast position versus the presence of scars. Whether to proceed with the surgery becomes a very personal decision that should be made after weighing the pros and cons carefully.
I hope this helps.
Scars in a breast lift
Martin Jugenburg, MD
There are techniques to minimize noticeable scars
The concept behind a breast lift is to remove excess skin from the "envelope"that holds the breast tissue. This will compress the breasts so you may have a little less volume but you will have more tissue in the upper portion of your breast. From looking at your photos it would be difficult to do the procedure exclusively with incision around the areola. You will need to add either a vertical incision from the areola down to the inframmary crease or a horizontal incision in the inframmary crease. The whole idea of a breast lift is to have the nipple at the peak of the breast mound and keep the distance between the areola and the inframmary crease around 4-5 inches. In addition, most plastic surgeons use a "cookie-cutter" metal template to make the new areola approximately 4 cm in diameter. Your areola appear to be larger than that and if you don't want to make them smaller you should let the plastic surgeon know
Breast Lift Without Reduction
You can keep your original breast size but have the nipple elevated, more fullness at the top, and the breast fold shorter using a breast lift. My choice is to use a short scar (Lejour technique) to accomplish this.
Breast Lift Options to Minimize Scar
There are three ways to do a lift, basically. They are peri-areolar, vertical (lollipop), and anchor or inverted-T.
The peri-areolar technique tends to flatten the breast, not make it perky, unless an implant is used. For someone who already has sufficient volume and does not want more, not a good choice.
That leaves the other techniques. For a patient who does not need much nipple elevation, the vertical lift might be fine. However, there is a scar on the front of the breast. This scar usually heals well as a fine line over time.
Sometimes the vertical lift requires the addition of a small horizontal incision in the inframammary fold to remove excess skin in the vertical direction.
Unfortunately, when excess skin must be removed to get elevation, there will have to be a scar on the front of the breast. These trade-offs should be frankly discussed with your plastic surgeon and should be acceptable to you if you want a breast lift that has the potential to give a nice lifted shape.
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.