Should I Get a Crescent Lift?

Question

I have had breast implants for three months. The left breast looks fine but the right one has not dropped. Before my surgery my breasts were asymmetrical and due to a rapid weight loss, both breasts seemed deflated and the right nipple seemed to sag downward. The breast implants unfortunately only seem to accentuate this problem. My PS suggests that I have a crescent lift to raise the right nipple and to push the implant down. Is there another procedure that would not cause bad scarring?

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	I think the best solution would be implant repositioning ( lowering).  If a breast lift is still necessary then a circumareolar  breast lift is your best option,  given that the &ldquo;crescent&rdquo; breast lift is fraught with complications such as scar spreading and distortion of the areola.

	Best wishes.

David Bray, Jr, MD · Answer

The breast implant on the right appears higher than the left. If this is the case, discuss this with your plastic surgeon. If you had asymmetry of the position of the nipple/areola preop, then a lift may improve symmetry. There are different breastlift techniques. Make sure you understand and discuss these options with your surgeon.

Vasdev Rai, MD · Answer

Crescent lift has limited but useful role in breast surgery. It can be used to make minor adjustments to nipple and areola. All incisions leave behind some scarring. You need to factor in scar with any surgery. However, I feel that crescent lift will benefit you and I agree with your plastic surgeon. You need crescent lift more than pocket revisions. Your breast augmentation was not the problem. Your preoperative asymmetry is the underlying cause of your post operative asymmetry. Have a crescent lift

Kamran Khoobehi, MD · Answer

You have breast asymmetry and lift will not resolve it since the issue is the implant position. You need revision to lower the right implant.

Michael Law, MD · Answer

Removing skin around the areola may enable a surgeon to elevate the position of the nipple/areola complex perhaps 1-2 cm on the breast mound, but it DOES NOT lift the breast itself.  In most cases, unfortunately, it serves to distort the shape of the breasts, making them appear flattened at the top.  If the breast needs to be lifted, it absolutely requires some internal rearrangement of breast tissue to create a projecting, aesthetically ideal and lasting result - which in turn requires that vertical incision and vertical surgical scar below the areola (and sometimes in the inframammary fold as well).

	Some surgeons perform what they call a "circumareolar" (or 'donut' or 'Benelli' ) mastopexy.  In my opinion there is absolutely no such thing as a "circumareolar mastopexy.

Lisa Lynn Sowder, MD (retired) - Account Suspended · Answer

From the photos, it looks like your right implant is too high.  If this is the case you would benefit from the surgical lowereing of the implant pocket.  This would help with your nipple position.  If your right nipple was lower preoperatively, you may benefit from having it raised a little with a periareolar lift.  I do not do crescent lifts because they distort the shape of the nipple and the scar is sometimes under quite a bit of tension and can end up quite wide.

	Lisa Lynn Sowder, M.D.

Richard P. Rand, MD, FACS (retired) · Answer

From your photo your right implant is sitting too high and needs to be lowered. That pluse a periareolar lift will give you better symmetry. I think the crescent lift scar is actually more visible that the periareolar because it only goes half way around and the bottom half looks different. The full circle scar is less eye catching and the areola are rounder too.

Robert M. Grenley, MD (retired) · Answer

From what i can see in your photos, your problem has a lot to do with your implant. Your right implant is higher than the left and therefore is not filling out the right lower pole as much as the left implant fills out the left lower pole. If your right implant has always been high and it looked like this right after surgery, then perhaps the right pocket was not dissected sufficiently inferiorly to allow proper implant positioning. If this developed afterwards, and the implant is firmer than on the left side, then perhaps this is a capsular contracture, since with contracture implants tend to get squeezed up into a higher position with more upper poel fullness and less lower pole fullness. In the process, the nipple looks low and may point downward. A crescent lift WILL NOT PUCH YOUR IMPLANT DOWN!!!! It also won't significantly lift the nipple up, but it will oftentimes give you a noticeable scar and a stretched out, oval shaped areola. If someone needs a minor lift or minor nipple positioning, a circular periareolar Benelli lift will work...for more major lifts, a vertical scar must be added. I would not even consider a lift until your implant is in the right position, unless it was VERY apparent preop that your right nipple was much, much lower than the left.

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