Circumareolar Mastopexy WITHOUT Implants- Worth It?

Thank you for the question.

Congratulations on your significant weight loss;  most patients who have lost this amount of weight benefit from some degree of breast lifting. direct examination  or viewing pictures will be necessary to determine  which type of breast lift will best meet your goals.

Your concerns about the value of doing a circle regular mastopexy operation  are valid. In my opinion, this operation will produce minimal benefits ( minimal breast lifting)  and (like any operation)  is associated with certain down sides. For example, abnormal scarring may occur. Therefore, unless you are specifically concerned about the size of the areola,  you may want to  stay away from this operation...

Of course, in person examination and a full communication of your goals will be necessary for more precise advice.

Best wishes.

Without an exam and learning from you more information about your wishes it is hard to give you a definitive answer. The answer to your question lies in letting you surgeon know specifically what you would like to look like following the surgery. For example, how perky do you want to be, what shape do you want to have, etc.? . Here is a rule of thumb that works for most patients. If you nipple is above your lower breast crease then often a periareolar lift will be sufficient for most patients. If your nipple is at or below your crease then a vertical lift (lollipop lift), inverted T or anchor pattern may be required. Breast lift alone will not replace the upper pole fullness loss that is typical with significant weight loss. This is why an implant is usually required. If you do not want to explore that option then consider fat transfer to the upper breast. Make sure you pick a Board Certified Plastic Surgeon for this.Though this procedure is still considered investigational to a degree, more and more qualified plastic surgeons are using this technique successfully.   The advantage of this technique is its ability to create a natural augmentation without an implant. Fat grafting (also called lipoinjection or fat transfer) to the breasts is indicated for different reasons: as an alternative to implants for mild to moderate breast augmentations, to provide fullness to the upper part of the breast during a breast lift, after pregnancy, age, or weight loss, following breast reconstruction

Without photos, it is hard to comment.

Chances are with a 50 pound weight loss and enough sagging that you have noticed, a circumareolar lift will not be adequate. It permits one to two cm of lifting, and is seldom done without implants unless it is really just to reduce areolar size. A vertical lift at least will be the more appropriate choice in all probability. 

All the best.