based on your photos, I suspect you would have a nice result with vertical mastopexy (lollipop lift). This should give you less scarring and a better shape than an anchor lift. Selectinga good plastic surgeon involves many choices. RealSelf is a good place to start
but I would do much more research. First you want to make sure you are
selecting a surgeon board certified by The American Board of Plastic
Surgery. Any doctor can call themselves a "cosmetic surgeon" and most
will be board certified in something, just not plastic surgery. I would look
for someone who is a member of the American Society for Aesthetic Plastic
Surgery (ASAPS). This goes a step beyond ASPS as member surgeons must
specialize in cosmetic plastic surgery and be recommended by their peers. You
should also only consider plastic surgeons who have local hospital privileges
and who operate in accredited facilities, not in their office. Also make sure
they only use board certified anesthesiologists. I would then look at reviews
on RealSelf and Google. Also look at their website to see if they have many
post op photos you like. Schedule several consultations and see which doctor
and staff seems to be a fit for you. Ask to talk with previous patients who
have had the surgery you are considering
The key to success 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.? However from your description it would appear that a lollipop type lift would be best for you rather than a periareolar lift like the Benelli procedure. 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.
The Lollipop incision for Grade 3 or 4 ptosis (areolar near or below your breast crease) works best in my hands and the use of a Lollipop technique can lift your breast to the perkiness you desire. However, other plastic surgeons are more comfortable with an inverted T or Anchor Pattern technique.The donut lift does tend to both flatten and have scars widened as you are removing skin around the areola which causes tension in that single area causing it to "spring' apart over time. With the Lollipop incision the tension is spread out over a greater distance of the lower vertical scar (where the areola once was) causing less tension on the areola and entire closure. The vertical lift tends to cone the breast making it more shapely (conical) and less flat. For a visual take a paper circle, cut out a small wedge on the bottom and bring the edges together to see this effect. In general I would pick the best Surgeon and explain fully what you want to achieve rather than the technique. Always choose a board certified Plastic Surgeon.
If you're wanting your nipples higher, then you do need a lift. A lollipop lift will work well and minimize your scarring so why take on the extra scars of an anchor lift? Some surgeons offer only one technique and its best you avoid those with limited tools in their toolbox. But if you just want more fullness of the upper pole, and if you have some fat somewhere that can be harvested, why not just fat graft the upper poles as your breasts look very appropriate for your age.
Plastic Surgery is really more of an art than a science which is why you are probably getting differing answers from differing Plastic Surgeons. My suggestion would be to look for a Plastic Surgeon who specializes in both primary as well as secondary breast surgery and discuss with him/her your goals and design a plan that will help you achieve that.On that note, my gut tells me that you may need the anchor approach to achieve optimal perkiness since this helps to reduce the distance from the nipple to the breast fold. But I can't be sure without actually seeing you in person.I hope that helps.
Do not get caught up on the technique. Both can work well. It depends on the amount of skin and tissue that needs to be removed. A surgeon may start with the lollipop incision and convert to an anchor incision if it is found necessary during the surgery. Good luck. Donald R. Nunn MD Atlanta Plastic Surgeon
As you can see by the varied responses, preferences will differ. In my practice, I would make the final decision whether or not a horizontal excision is necessary in the operating room after utilizing a "tailor tacking" technique. This technique allows for visualization of breast contour prior to making any skin incisions.
Ultimately, key will be careful selection of your plastic surgeon. Ask to see lots of examples of his/her work achieving outcomes you would be pleased with. Working together you will come up with the best plan to achieve an outcome you will be happy with. Best wishes.
HI Ponyrider, I think that a lollipop will be all that you will need. You could ask your surgeon why he/she believes that an anchor would be best. It is always best to be in agreement mentally with you surgeon before undertaking any surgical procedure. Best,Dr. Christine Rodgers
You have small breasts with limited skin excess. I cannot imagine doing anything other than a lollipop, or vertical mastopexy for you. I am quite frankly astonished that there are so many anchor procedures that continue to be done. All the best.
Hello,You will need the lift which best addresses both your vertical and horizontal skin excess. In the best of hands, this is usually an anchor scar pattern, even when 'vertical' lift techniques (internal tissue manipulation) are employed. There is way too much promotion of a lollypop scar-only lift that leaves many women with skin excess, or a long vertical scar with a dropped out, bottom heavy appearance.Best of luck!
Thank you for your question. The decision which type of breast lift to perform depends on careful examination and measurements in the office. It depends how much excess skin is located in the vertical and horizontal directions. You would not be a good candidate for a Benelli lift (donut), so you're left with the choice between a lollipop and an anchor incision. An anchor incision would be used if the distance between the nipple and the crease below the breast needs to be shortened. If you've seen board-certified plastic surgeons who have excellent pre-and postoperative photos, then it's reasonable trust their recommendations and proceed with the surgeon that you feel most comfortable with.