Hello!~ I am a 32 year old female, no children, just periods of weight gain and weight loss which have led to tubular breasts. I just had 2 consults: -Full breast lift with the lollipop incision, and add silicone implants under the muscle. -crescent lift and shape my breasts so that the nipples matched and put in silicone as well, on top of muscle Any alternatives to lollipop incision? Would like to avoid scarring if possible. Under muscle? On top of muscle? Any suggestions? I am torn~
Crescent Lift with Silicone on Top of Muscle OR Lollipop Lift with Silicone Under Muscle? (photo)
Doctor Answers 17
Crescent lift is ineffective and distorts the areolae. Vertical lift is better.
Your dilemma is easy to solve. First of all, a crescent "lift" simply distorts your areolae. It does not provide an effective lift, so I would recommend against that option. The vertical lift with a lollipop scar is much better. Yes, you have to accept a vertical scar, but better that than an ineffective procedure that makes your areolar shape look odd. Both saline and silicone implants are fine and really there is no difference in terms of appearance. I usually place them submuscularly. Not that it matters, but you don't really have tuberous breasts. If you would like to see some examples of vertical lifts with implants you can visit this part of my website, attached.
Crescent or lollipop?
In my experience, I feel the lollipop is a better operation overall and will give you a better shape. The crescent lift has two problems. First of all, you never get the amount of lift you think you will. Secondly, It often stretches the areola out too much. If this occurs, you will need a lollipop lift to fix the problem. The Benelli lift, in my opinion, has the same problems as the crescent lift.
Your posted photos show a slightly larger and more drooping right breast, the right nipple further from the midline and lower than the left and a lot of stretchmarks on both breasts. It is clear that just putting in breast implants will not correct the asymmetry and may make it more visible and that there is more excess skin than can be appreciated in these 2 dimensional photos. With this amount of stretchmarks the skin is lax and does not wrap around the implant the way skin without stretchmarks does. You will need some breast skin procedure to take out some of the laxity and make the nipples more symmetric at the time of implant placement. How much skin is removed and the pattern of its removal is dependent on the size of implant placed to fill the skin envelope. A larger implant means you can remove less skin but as some point the largeness becomes counterproductive.
All of these issues need to be discussed with your surgeon and accounted for in the planning of surgery. That cannot be done in the limited format of this forum. Either surgeon you have seen may have an appropriate plan depending on the size and type of implant which are not stated in your post.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
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Choices in lifts/augmentation
In my opinion and experience, the first thing to condemn is the idea of a crescent "lift" which is a misconceived attempt to accomplish a lift of the breast and does no such thing. The second is to go with the experience of properly done subpectoral implant placement. Above the muscle implants is not misconceived like a crescent "lift" but it doesn't pad and protect the implant as well and doesn't do as well over the long term.
If your right breast was not larger and lower than the left, the simplest solution would be an augmentation with an implant and no lift at all. Implants do not lift the breast but they give the illusion of one as they fill out the upper scallop and the lower pole of the breast. Although it is low, the nipple-areola on the right side doesn't look too low to be filled out with an implant alone (best determined by exam though).
If you are trying to actually lift the breasts and even them out, a periareolar lift might be adequate since it doesn't lift the breast much but you don't need any lift on the left and only a small one on the right. I usually recommend the lift (and possibly a small removal of tissue for balance on the right) first and then see if an implant is still needed/wanted. It's possible to do both at the same time but harder to balance all the factors and get everything to settle perfectly. In other words, the need for a revision is higher in an augmentation-mastopexy than in either operation alone.
#CrescentLift with Silicone on Top of Muscle OR #LollipopLift with #Silicone Under Muscle? ANS:
I also am not a big fan of the crescent lift...It has been my experience that there really isn't much lift achieved and that it seems to just stretch out the areola...I feel that the crescent and about muscle will still be a bit droopy...
Crescent lift, benelli lift , periareola lift , augmentation/mastopexy, lollipop lift
crescent lift, benelli lift , periareola lift , augmentation/mastopexy, lollipop lift
crescent lifts do not work and just distort the areola,, i know , i tried these years ago
- these are not all the same
- lollipop lift will give the best lift overall with very good shape
- periareola or benelli type with give a nice lift
- either submuscular or submammary can give you a good result
- call to discuss the benefits of each
You do not have tuberous breasts. You DO have asymmetry with some ptosis (droop) on the left side of photo. You also have an unusual prominence of the upper chest wall on profile. I think you will be unhappy if you have a crescent lift. For best chance at best symmetry you will need lift scars on the left. You might consider submuscular augmentation ONLY at first. Then re-assess after 4 months and see how satisfied you are. You haven't burned any bridges and could always have some form of lift later (if needed).
Crescent lift v standard lift and implants
I am not a big fan of the crescent lift. I would recommend a concentric lift and submuscular augmentation. Your nipple areolar complex is sagging some but it is above the infra mammary fold.
Crescent Lift with Silicone on Top of Muscle OR Lollipop Lift with Silicone Under Muscle?
Based upon my review of the posted photos and your info but never have seen you in person my choice would be unders with L-shaped or full mastopexy.
LIft or implants or both
An exam in person is essential but in many cased with very mild ptosis, I perform an augmentation and a circumareolar lift.