Do I need a Crescent Lift along with Implants or will Implants alone suffice? (photo)

   A breast augmentation can be performed initially with the understanding that a breast lift may be necessary later.Kenneth Hughes, MDLos Angeles, CA

A
crescent lift is inadequate and I recommend a new technique called Breast
Augmentation with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be
placed. Aligning the areola, breast
tissue and implant over the bony prominence of the chest wall maximizes
anterior projection with a minimal size implant. Small round textured silicone gel implants
placed retro-pectoral look and feel more natural, are more stable, less likely
to ripple or have complications needing revision. Implant profile is irrelevant in the
retro-pectoral position since the muscle compresses it. I would never lower a patient’s inframammary
crease. High perky breasts are
attractive, lowering the inframammary crease does just the opposite. Best Wishes,Gary Horndeski, M.D.

It appears as if your nipple to IMF distance is relatively short. This would indicated that you might be able to avoid a breast lift and still have a nice result. I would suggest augmentation alone, allow the implants to settle for 3 months, and then decide if you really need a breast lift. You probably will do fine without one. 

  Dear littlewing327, Thank you for your photos. I would agree with most of the other surgeons...I would perform a augmentation alone with a lowering of your infra-mammary crease and a bi-planar release. I'm confident this will give you the results you are seeking and you can avoid the extra incisions on your breast. Good luck. #Dr. Gervais

I agree no lift to start.  You have a short nipple to fold distance and  with a dual plane technique  with a small amount of fold lowering you should be fine. Lowering the fold does not correct true ptosis or droop but in your case it is should work well. Good Luck!

Hi. I do not think that you will need a lift - lowering the inframammary fold at the time of surgery is probably all you need. If in doubt my advice is to just have the breast augmentation, rather than committing to a scar around the areola - a small lift can always be performed later under local anaesthetic in the office if you are not happy with the nipple position. Regards Dr Charles Cope

Thanks for your question. The photos offer a little help but this would best be done with the exam. You can certainly have the augmentation first and the lift done later. You do appear borderline. I would highly discourage the crescent lift. If your surgeon feels that the implant will sit too high and the nipple position will be too low, then you should to a formal augmentation/mastopexy at the beginning. Best of Luck

You do have ptosis, but your surgeon has identified that you are "borderline." So your approach makes the most sense, rather than adding a potentially visible scar that really does not "lift" much at all. If the surgeon tried to make a crescent lift really lift a quarter or half an inch, there will be scalloping or pleating of the incision, since the upper crescent incision is longer than the lower crescent. The more he tries to lift, the more tension and creation of an oval-shaped areola, as Dr. Pousti has correctly pointed out. So, what you really get is a (sometimes) crappy scar that distorts the areola shape, and doesn't lift more than a few millimeters. And what is your surgeon charging for this? Even if it was FREE, I'd still question the value, as you may end up with no improvement and a scar that is permanent and unsatisfactory. Then you need more surgery anyway. Why not try your suggested plan, which makes great sense, since you understand that secondary surgery MAY be necessary.Augment only, do your best to be patient and let the implants drop into "final" position, and then add the appropriate lift later if needed. (Even then, avoid the crescent lift--it really IS worthless unless lifting a few mm is enough to warrant a scar and cost.)BTW, larger implants will help your result, if larger is what you seek. Large(r) implants do NOT lift, but they do "fill" the somewhat saggy skin brassiere better, and will drop slightly more, giving a better areola/mound relationship.Unfortunately, while some surgeons may actually feel that crescent "lifts" really are an appropriate choice, I believe that for some it is simply a way to use a periareolar incision (on top of the areola instead of on the lower edge) to perform breast augmentation, and then charge "extra" for the (non)lift. Sure, the result may actually look OK, but it would have anyway without the crescent "lift." One way to identify a potential abuser of this technique is to determine if the surgeon is using the crescent lift incision in addition to the normal augmentation incision, say inframammary (crease) incision, or axillary (armpit) incision. If he ONLY is planning a superior periareolar incision and is "adding" the crescent lift, this is simply the augmentation incision that would be sutured anyway. In these cases, the "crescent lift" should be free, since it takes about 10 seconds longer to make a second crescent incision above the augment periareolar incision which would be sutured "lift" or not. Can you spell SCAM? I hope your surgeon doesn't fall into this category.I agree with your plan for augmentation only and add a lift if needed later. Scars are permanent, so avoid them (and the cost) if at all possible. For more information click on the web reference link below (my Comprehensive Guide to Breast Augmentation). Best wishes! Dr. Tholen

Thank you very much for your
photo, in my opinion I do not think a crescent lift would be sufficient to lift
your nipples to the required degree. This unfortunately is the case because
your right nipple is slightly lower than your left and your nipples need to be
elevated a number of centimetres on both sides.



Crescent lifts are normally used
for small elevations of the nipple and I think if this is used in your case it
will not give you the result you wish for.




For more information about other
types of breast uplift procedures, please look at our website: aurora-clinics.co.uk. Here you will see videos of the
procedure being performed and give you an understanding of what’s involved in
the various uplift procedures.



With best wishes,



Adrian Richards

Photos can be a little deceiving but the point you make is exceptionally likely to be correct. If a person asks for an augmentation but also would benefit from a lift, my practice is to give them the options you describe.  One option is to do the augmentation first and see how you like the position of things. Your case is not so obviously in need of a lift and an appropriately sized augmentation may look beautiful.  If you decide, down the line, that it is not, the option remains to do a lift.  Doing the two surgeries separately provides the most predictability for the surgeon and is the easiest on us.Doing them together, when necessary, saves the recovery time and expense of a second surgery for you.  Combining the two has the highest rate of revision surgery for breast operations, however, and requires great skill to get right the first time.  One could argue that a reasonably high revision rate leaves the possibility for a second operation when a staged approach guarantees it.  So to most, the preferred option is to combine the two.The most important part of your question, however, is that you are asking it. Plastic surgery requires an exceptional amount of trust and a good, open relationship between surgeon and patient. If you are not 100% comfortable with your surgeons opinion, it is time to look elsewhere. He or she may be the right surgeon for you but it is likely worth looking around to find out.Best,Dr. Pyle