Crescent lift vs. periareolar lift with breast augmentation
I would agree with the periareolar / possible lollipop and breast augmentation opinion. Depending on factors such as implant size, tolerance for scars, need for projection, etc. a full lift might also be necessary.
We do not favor the crescent lift because it distorts the areola and is a weak lift, especially with your degree of asymmetry.
Crescent Lift with Breast Implants
We prefer to use the #short-scar #technique, “#lollipop scar” or “#donut lift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant #scarring.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. Also, often patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of #mastopexy.
Breast dilemma: to Lift or Not to Lift
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, how large (a "C" cup means different things to different people), what shape do you want to have, do you want more cleavage as your breasts are widely spaced apart, etc? The best way I have found is to bring in a medical photo from a plastic surgeon's website for discussion. I would anticipate that the look you desire may range from a periareolar lift to a lollipop type. If you want only a breast augmentation - make sure you discuss above the muscle (gives you a slight lift by itself) vs below the muscle implant position.
Best Breast Lifting Option?
Thank you for the question and pictures.
Your pictures demonstrate asymmetric breasts ptosis. I think you will be best off with a breast augmentation in combination with a circumareola and/or vertical mastopexy procedure. A crescent lift will not be effective.
You are doing the right thing by educating yourself about the pros and cons of each type of procedure. Keep in mind that most patients who undergo mastopexy surgery are pleased with the results. As long as they are happy with the improvements in size, shape (contour), and symmetry they are accepting of the scars.
I hope this helps.
Recommended procedure for you
Please be aware that recommendations made based on photos should always be taken with a large grain of salt, as it is not possible to understand the qualities of your tissues in two dimensions....
Having said that, I think that if your goal is for your breasts to be as beautiful as possible, you would be best served by a breast lift (lollipop or inverted-T) with implants.
The most important thing, however, is NOT the procedural details, but the SURGEON you choose to do this on you. Choose well, and you should be happy for many years.
How to best choose a surgeon you like and can trust? Please read this:
Breast lift with an implant. The smaller procedure is not the best for most patients.
Great question. From your photos it appears you have some asymmetry which you would benefit from correction with a breast lift. An implant alone will not be appropriate, and the peri-areolar or crescent lifts end up widening the areola and flattening the breast. I would recommend a vertical mastopexy with an implant on both sides because the scars should match. Discuss this plan with your board certified plastic surgeon.
I hope this helps.
Indications for breast lift
My answer is based on your photo so please note this may not be "my final answer". From the photo it appears you do not need a lift on the right side as the nipple is above your breast fold. On the left side, there appears to be loose skin in the bottom of your breast and the nipple is slightly lower.
The amount of ptosis on your left side seems minimal, so I recommend a donut lift to reduce the size of the areola (which is large relative your breast) and tighten the skin at the same time. In my experience, a crescent lift is always under tension and the scar widens with time. Although your right nipple is in good position, the areola is also large relative to your breast. Therefore, you may consider a donut lift as well, to reduce the size of the areola. Good Luck.
Knowing what lifts and implants do and don't do
Several things are quite clear with your photograph and consideration of options.
1. You are correct that you would be best with just an augmentation as long as you realize what a breast augmentation with implants will do. It will fill out your breasts and increase their size by a cup size (the minimal). It will give the appearance of a lift because of the filling out but will not actually lift them. It will make your areolas look smaller in proportion to a larger breast but will not actually change it. It can be done with as small a scar as 2 cm in the crease below the breast. But it will not bring your breasts closer together, correct the asymmetry, or change the position of the breast on the chest wall. If an implant is going to fit and look natural it has to fit and act like a pillow behind your breast.
2. Augmentation and lifts are two different procedures that do two different things and tend to work against each other which adds to the complexity, unpredictability of the result, and increases the chances of problems and revisional surgery. Your breasts are not low enough (ptotic) to benefit from a lift at this time. That could change but an augmentation now is simpler and will solve more of the issues you're concerned with. Aside from possibly scaling down the size of areola, a lift, regardless of the type, will result in a scar around the areola and will accomplish little else.
3. So-called Crescent Lifts do not work and have been abandoned by experienced breast surgeons. The nipple/areola cannot be truly or reliably moved without a full release of the nipple/areola and the breast from the overlying skin and reposition it. Even a circumareolar (periarolar, Benelli) lift will not accomplish what you would like to have in terms of nipple/areola position and no lift procedure (or implant procedure) will tighten anything. Tightness created by surgery is an illusion.
So a lift is not required and I would not recommend it at this time although it might be helpful in the future. An augmentation, probably using lowest profile silicone gel implants because of the lack of tissue coverage and lateral breast placement, would give you the most improvement for the least surgery and scars. Be sure the surgeon matches the width of the implant to the width of your breast.
Breast lift vs. augmentation with asymmetry present
Your questions are quite valid and its easy to see why you have received so many different opinions. We see many patients with your similar set of problems.Since your left breast is only about 1.5 cm lower than the right breast,I would reccommend doing a bilateral breast augmentation combined with a circumareolar lift on the left.The crescent lift is not very effective and the scar is anattractive. The lollipop lift is unnecessary and leaves and undesirable scar also.
I believe that an augmentation with a lift is necessary. Whether a periareolar or a vertical (lollipop) lift is used depends on how much movement is necessary in the surgeons opinion to achieve the best result. Typically if the nipple needs to be raised more than 3 cm then the vertical lift will be necessary. You must realize that in surgery the lift portion of the procedure is very artistic, Each lift may be temporarily performed once the implants to determine the which lift will achieve the desired shape.