Vertical or Anchor breast lift? (No implants) (Photo)

You are actually a great candidate for a vertical mastopexy with a pectoral sling superior pole auto-augmetnation.  A vertical pattern- lollipop scar should work wonderfully for you and instead of excising and discarding the inferior pole tissue as in the conventional vertical lift/reduction, a technique called the pectoral sling should be used.  This technique was originally described by Dr. Ruth Graf a Brazilian leader in breast surgery.  essentially the inferior pole of the breast that is conventionally discarded is used to create superior pole fullness by supporting it with a sling of the most inferior part of the pectorals muscle and fascia.  The results are beautiful and lasting.  A Wise pattern (anchor scar) type approach will leave your breast flattened and scarred and likely lead to you seeking an augmentation to replace the removed and atrophied volume.  I hope this helps!All the best,Rian A. Maercks M.D.

A vertical breast lift may be a reasonable option
just based upon your pictures, but an exam will be necessary to make a
determination. Find an expert in breast surgery in your
area who has great reviews and great before and after photos.Kenneth Hughes, MDLos Angeles, CA

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. Given your description and photo, it appears as if a vertical/lollipop incision will likely be needed to give optimal shape given the amount of droop that you have. 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!

Good question!  The vertical scar reduction techniqe differs from the inverted T scar -anchor scar lift/Reduction in many ways.  The most obvious difference is the lack of the big scar that runs transversely across the chest below the breast!  The shape of the resulting breast is also different in that the anchor scar removes skin from the lower part of the breast resulting in a flattened, boxier shape long term. "Bottoming out" is very common. The real difference between the two is what takes place under the skin. The vertical scar lift/reduction creates internal pillars that create better projection and shape in the long term. The internal breast tissue is rearranged. Lack of scar on the breast is an added bonus! Conversely,  The anchor scar relies on the skin to hold the breast up....skin that has already stretched and given under the weight.  Many would question that logic. Having performed both procedures extensively, first the Anchor then the vertical, I can say I rarely if ever resort to an Anchor scar anymore. It has been probably 7-8 years! I certainly would not recommend an Anchor scar for you. In a case such as yours, extra skin " pleating" should not be a problem. I would say however, that it is important that your surgeon has experience with the newer techniques for reduction and breast lifts. Best Wishes,Joel A. Williams, M.D., FACS

Depending on whether or not an implant is to be placed the amount of skin removed determines the length of the incision. If the vertical limb of a Lollipop incision is inadequate for removal the excess skin a revisional procedure would be necessary.

Hi.  Given your moderate degree of ptosis, I would think that a vertical design mastopexy should work nicely for you.  Another physician mentioned the "auto-augmentation" approach - and this could certainly be done at the same time.  It doesn't appear from your photos that you need the full "anchor" incision lift.All the best!

Based on your photos, you would likely do well with a vertical (lollipop) breast lift.  This technique uses internal sutures in the breast tissue to help support the breast and can have a better long-lasting result than a technique (like the anchor) that primarily uses the skin to support the breast.  How long your lift will last really varies from patient to patient and can be affected by the elasticity of your skin, size of the breasts, weight changes, and pregnancy.  Bear in mind, in all patients there is some natural settling of the breasts as part of the healing process, so the results you see the day after surgery will be different than those 3 months later.  A lift in and of itself does not change the size of your breast, so if you want to go to a B cup, some breast tissue would need to be removed to do so, which is possible with either breast lift option.

Thank you for your question and photographs. A new technique called the Ultimate Breast Lift has been developed that uses your own tissue to design internal straps (much like a bra) that permanently anchor and secure your breasts on to your chest muscles. These internal straps are also used to reshape, reposition and create upper pole fullness without implants and without a vertical scar. In general, vertical scars mechanically weaken the strength of the lift. This is where the vertical lifts usually fail resulting in the 'bottoming out' effect. By adding implants the 'load' is increased resulting in the need for revision sooner. The UBL technique is a stronger more reliable method resulting in natural results with minimal scars.Hope this helps. Best wishes,Gary Horndeski M.D.

After reviewing your photos, it is my opinion that to achieve your best result-- you would need the anchor lift--or the inverted T -shaped incision site. This will allow the most precise and optimal position of the nipple and shape of the areola. We utilize precise measurements pre-operatively to plan and outline the surgical procedure. We follow this plan carefully during the operation. 

The long term problem you'll have is upper pole fullness. You have a long torso and without an implant you'll tend to be deficient in the upper portion of your chest once your breast tissue settles. That should occupy more of your thoughts than the incision...