Which Breast Lifting Technique Would Be Most Suitable? (photo)

I have consulted a board certified PS & am in process of scheduling the surgery. Dr. has said for perkiest look go for a full lift w/ augmentation, and for a more natural look go with a donut lift w/ augmentation. Below are photos of the look I'm after & my own breasts. I know "perky" and "natural" have different definitions depending on each person. Which lifting would bring mine to the same position and shape? I know all breasts are different, I am simply going for that "style" in the pics

Doctor Answers 22

Which breast lifting technique would be most suitable?

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Thank you for your question! It is normal for the breast to lose its firmness and perkiness over time, which is accentuated with age, pregnancy/breast feeding, weight gain/loss, and gravity. This ultimately results in ptosis, or sagging, of the breast with a “deflated” appearance. Women often seek the mastopexy, or breast lift, procedure to regain the previous youthful appearance of her breasts and desire that uplifted and perky appearance of her breasts. Women report increased confidence, self-esteem, and femininity once she achieves this desired shape and fullness. Breast lifts may or may not be performed with implants – the implant would add increased size but also greater fullness in the upper pole of the breasts which creates more cleavage. It is also common for the areola to enlarge and stretch during these changes. The lift will also serve to raise the nipple areolar complex to its appropriate position above the breast crease and at the most projecting portion. In addition the areola size will be decreased, which is often desired by the woman. A circumareolar, a lollipop incision, or a full inverted 'T'/anchor incision may be needed to give optimal shape. I wouldn't compromise shape and overall result to minimize scarring.  Given your photos, a lollipop/circumvertical lift would likely give the best result for you. The implant would give increase upper pole fullness.

The decision for a breast lift will be up to you...depending on how much you are bothered about the shape as well as your concerns. Consult with a board certified plastic surgeon well-versed in breast surgery and s/he will assist you in deciding if a mastopexy will be the right decision for you. Thank you for your question! Hope that this helps. Best wishes for a wonderful result!

To look like Megan Fox, a vertical (lollipop) mastopexy + small breast implant is needed

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Based on the photos you shared of yourself and your desired look, I'd recommend a small implant for superior fullness and a vertical ("lollipop") mastopexy as the best approach. Your plastic surgeon described things quite well actually, in that a vertical mastopexy will give you a firmer and higher positioned breast mound that's “perkier” in apparence. 

As for whether or not a periareolar mastopexy ("donut lift") would produce an attractive result in your case.... I suspect that it would/could (assuming, of course, that it's performed by a surgeon who is comfortable with the periareolar technique). It's just that a vertical lift will leave you with breasts that look much more like those in your goal photos than a donut lift will.

So while a periareolar (re: "donut lift") approach is certainly an option for women with breasts similar to your own, I wouldn't recommend it in your case for the following two reasons:

  • First, you have a bit of excess tissue on the lower pole of your breast... so a periareolar mastopexy will result in breasts that are still slightly ptotic after surgery (especially in comparison to the breasts in your goal photos).
  • Second, you didn't voice any concerns or objections to the scars associated with either approach... if you had, then the efficacy of the periareolar approach would certainly deserve greater scrutiny. That said, I get the feeling that you'd want whichever incision will get you closest to the look in your goal photos.

The link below is to a patient with breasts similar to your own and who decided to combine small implants with a vertical "lollipop" lift. The result is similar to your desired outcome in shape and projection, though larger in size/volume.


Best of luck, 

William DeLuca, MD


Breast lift without vertical incisions

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If you want to look like the model in the photographs, you will need an augmentation.  I recommend silicone gel implants, retro-pectoral.  You will also need a lift since your nipples are too low and the nipples reduced since they are too large.  The circumareola lift can be done, with implants placed and your breast tissue elevated along with internal plication.  It is important to align the nipple, the breast tissue and the implant in the same horizontal plane to give maximum projection.  ALWAYS avoid vertical incisions, they are impossible to hide and the scars can widen in time.  You certainly do not need a boat anchor shaped incision.

Best of Luck,

Gary Horndeski, M.D.

Vertical lift

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Thanks for your question.  I believe you need a vertical "lollipop" type lift to both elevate the nipple-areolar complex and tightening the lower pole of your breast. 

Which breast lifting technique would be most suitable?

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You are looking for a very natural look with less breast overhang and a somewhat higher nipple position and smaller and less stretched areola.  Judging by the photo example of what you are looking for, you are not concerned about having more upper pole fullness or even a "natural" implanted look.  There are two reasons to use implants...if patients are looking for larger breasts, or if they are looking for more upper pole fullness. I would therefore suggest a breast lift, perhaps a "lollipop" or vertical technique, versus a circumvertical or anchor lift depending on physical exam in terms of how much overhang you have and how low your nipple position is.  Periareolar or Benelli lifts, in my opinion, only work well with implants, as otherwise they result in a persistent flat breast, and if this mild lift is overused (used in a patient who needs a stronger and better shaping variation of a vertical scar lift), then the resulting breast shape and scar quality suffers. If you have a lift to obtain a better breast shape, and later decide that you want more upper fullness from a small and natural-looking implant, this can be easily done.

What type of breast lift for me (photos)?

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A circumvertical pattern will produce the projection you desire with a nice breast shape, and implants added for volume.  In skilled hands, you should have the result you desire, or better.

Breast lift and augmentation

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Without and sam it is difficult to say.  Many times I do perform a circumareola lift with an augmentation but it has to be the right person.

Breast Augmentation and Lift

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Hello Simona,

Although I've not performed an true examination on you, your photos suggest that your skin envelope lacks elasticity. Further, it appears that your inframammary fold is quiet a bit above you nipple, which means you have a significant amount of redundant skin that will need to be addressed.  This is never a good situation for the circumareolar mastopexy.  May I remind you that the circumareolar mastopexy is the number one procedure listed in malpractice lawsuits for plastic surgeons.  This is because it is all too frequently misapplied to people that aren't good candidates for the procedure. We as surgeons are all too willing to give what the patient desires, even if it is not what is right for them. 

If you look at my website, you will see many with the circumareolar lift, but NONE of them look like you prior to their surgery.  That is because that procedure is excellent for people with minimal sag of their breasts with good skin elasticity.  This is NOT about a minimal, 'natural' appearance versus a perky one.  This is about obtaining a shape that is natural with the finest scars possible.  Ironically, many people choose the circumareolar lift because of fear of scarring.  However, the circumareolar lift when misapplied yields conspicuous and potentially thickened scars in the wrong candidate.  In addition, the other problems associated with this lift in the wrong person includes: recurrent widening of the areola, non-circular areola, pleating around the areola, flattening of the breast mound, and persistent sagging of the breast mound below the inframammary fold.

I wanted to touch on two comments made by other surgeons. There is no evidence whatsoever that a 'Lejour' lift is any better than a standard form of a anchor lift.  In fact, there may be evidence to the contrary in the December issue of Plastic and Reconstructive Surgery.  In that article, photometric analysis of breast lifts gave objective results (not opinion) suggesting that a anchor lift gave the most lift to the bottow of the breast.  Finally, regarding placement of your implant, there is no evidence that a 'cold sub-fascial' placement of the implant is any different than subglandular placement, which is not a good option in a thin person like yourself.

I hope you make the right choice, and not one that makes you 'feel good'.  What I mean by that is if you are really adverse to the concept of scars on your breasts, maybe you should not do anything at all, rather than do the wrong thing. 

Best of luck!


Breast lift options

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From your photos, I think a vertical lift would get you close to the look that you like.  I do not think an augmentation with a periareolar lift would.  First of all, your volume is similar to the model's.  She does not have alot of upper pole fullness that an augmented breast would have. 

I think the aug and periareolar lift results in a particular look that does not look natural, at least in patients with your degree of sagging.

I must compliment you good taste.  You wouldn't believe the photos some patients think look good and natural!

Which breast lift for you

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The photo shows a breast not too much unlilke yours with greater projection and better nipple size. The vertical lift or lollipop patern will lift the nipple and reduce the size. Importantly it will reduce the lower laxity and give more projection just like the photo and should be the best lift for you.

Best of luck, peterejohnsonmd.com

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