Lollipop or Anchor lift required with breast implants? (photo)

I'm getting a breast augmentation in 20 days. My doctor is recommending a lollipop or even an anchor lift with my implants. I am thinking about going with round silicone implant between 400cc's and 475cc. I was hoping to do this with minimal scars. I am wondering if either lift is necessary to get great results? I am 5'5" and 135lbs.

Doctor Answers 18

Lift with implants

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The key to getting good results with this combination procedure is a technical one.  There is a structure within the breast tissue as well as on the muscle itself called the fascia.  This structure exists in every organ of our body.  It serves as a supporting network.  It has more tensile strength than the skin or  muscle.  We have all seen it on a cut of steak.  It is that strong whitish lining that we cut away.  Using this layer to support the position of the implant as well as the lift provides long term support.  Additionally, by using this structure, less incisions on the skin is required.  When otherwise a horizontal incision would be required in a skin lift operation, this technique allows for a lollipop only pattern.  Also, since no or very little tension is placed on the skin incisions, these scars usually heal quite imperceptibly.
Ary Krau MD FACS

Miami Plastic Surgeon
4.7 out of 5 stars 357 reviews

Type of Breast Lift with Implants Needed to Address Sag

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Your photos show that you will definitely need a mastopexy (breast lift) in order to elevate your nipples to a higher position, and reshape your breasts to keep the breast tissue from falling downward off of the implants. Another benefit of mastopexy will be the ability to address any geometric asymmetries.  While silicone is a bit softer than saline, situations where there is already a significant amount of breast tissue to cover the implants often allows very good results with saline implants.  It looks like your existing breast tissues are going to probably limit how much you feel the implants, unless they are placed over the muscle.  In situations like yours, I usually use a vertical mastopexy approach (lollipop lift) to limit scarring, as the crease scars are the ones that usually have a tendency to thicken.  I have written a lot of information about various types of breast lifts with implants on my website, along with several galleries of mastopexy and implants to address sag and tubular malformation.  I hope that this helps.

Best wishes,   

Tom DeWire, MD, FACS   
Richmond, VA

Thomas M. DeWire Sr., MD (retired)
Richmond Plastic Surgeon

Lollipop or Anchor lift required with breast implants?

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You will find that there's no consensus opinion about this. In the US, most surgeons do the anchor scar technique, especially surgeons who had their training 15-20 years ago. Younger surgeons tend to use the lollipop technique. There's a learning curve with this technique, and as you can see, one of the surgeon's posted a badly done lollipop result. Whoever did that surgery, obviously missed a couple of principles of the technique. Augmentations combined with lifts are especially difficult surgeries no matter what technique one uses. In the plastic surgery literature, there's a 28% re-operation rate reported, but if it is done in two stages, of course the re-operation rate is 100%. I personally favor the lollipop technique, not only for the shorter scar, but also for a better shape to the breasts that lasts. In my opinion, you will need a lift with the augmentation. Ask you surgeon to show you before and after photos of patients with similar anatomy as yours or seek another in person consultation if you don't like what you see. Good luck.

Lollipop, anchor, or no lift plus implants?

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Nipple position with relation to your infra-mammary creases is the prime determinant of "needing" a lift or not. Try placing a pencil beneath your breasts at your infra-mammary creases and then look at yourself in  mirror. If your nipples are at or above the crease level, Implants alone may adequately "fill" your breasts. As they drop behind and within your breast tissue and skin brassiere, you will get more breast volume (from the implants) in the lower poles of your breasts, giving the appearance of nipple elevation (with respect to the new breast mounds).

This is why some surgeons and patients feel that implants will "lift" sagging breasts--what they really mean is that better "filling" of the loose skin and gravity dropping more volume behind and in the lower poles of the breasts gives the appearance of a "lift."

If, however, your nipples are below your creases, then you will need a breast lift. That means more incisions, scars, and cost.

Of course, everyone wants less of all of those! (But, that's also the start of problems sometimes!)

Paradoxically, the full Wise-pattern (anchor) lift requires the most incisions and scars, but also has a huge advantage in shaping the breast skin brassiere in both vertical AND horizontal dimensions, and having most accurate skin-skin approximation, leading to better scars than some of the other breast lift designs (periareolar and lollipop) allow. These latter designs try to scrunch tissues up with fewer incisions, but this means the scars are often mismatched in length and tension, and therefore heal more poorly.

Thus, if you really need a lift, I would carefully assess your skin laxity and determine what lift works the best with the best-healing scars, not necessarily the shortest or fewest scars (that heal poorly with pleating, bunching or widening). For an example of one of my patients who underwent a total of 3 operations by 2 surgeons (elsewhere) before I corrected her badly scarred and mismatched breasts with her 4th operation (first by me), click on the web reference link below.  I corrected her vertical (lollipop) lift on her right breast and her periareolar (Benelli or donut) lift on her left  breast with what should have been done in the first place--a full Wise (anchor) breast lift plus the proper size implants. Click on the link below to see this patient's photos.

Hopefully, wise choices on your part will help you to avoid her fate--4 operations by 3 surgeons and over $30000 spent before she "got it right"! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Breast Lift Options

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Your pictures indicate that you would definitely benefit from the combination of breast augmentation and breast lift surgery. The specific type of breast lift chosen would depend upon your physical examination. Your pictures suggest that a vertical lift would be adequate to correct your associated breast sag. However, without a physical examination, this can't be determined with a 100% certainty and for this reason, an anchor mastopexy might still be needed.

If you're considering this type of procedure, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon can perform an exam and formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Breast Lift Recommended with Implants

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Getting #Implants without a #BreastLift is said to be a "mistake" to many patients. Most breasts will look larger and more droopy without the lift. They tend sag more, and, sooner due to the excess weight. The shape will usually not be satisfactory without combining a lift with augmentation. Also, at times, a “Snoopy” breast or double bubble can result.
As far as incisions, I prefer touse a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Lift or not

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I think you will be best served with a lift to at least recenter the nipple position over the implant.  If you do not mind the shape of your breast and the position of you nipple on the breast, you might be able to get a larger version of your current breasts with a sub glandular implant and no lift at this time.  Eventually, you are probably going to want/need a lift.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 30 reviews

Lollipop Breast Lift - Great Shape, Less Scarring than Anchor Pattern for most

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Always best to choose the best plastic surgeon with the most experience rather than the procedure. It is there job to guide you on this choice to match your desired goals. See below link for advice.

Personally, from your photos I would select a lollipop lift for both shape and to minimize scarring. 

Lollipop or Anchor lift required with breast implants?

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I would probably offer you breast augmentation and a vertical lift.

Kenneth Hughes, MD

Los Angeles, CA

Lollipop or Anchor lift required with breast implants? (photo)

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Thank you for your question.

Based on your photos I believe you are a great candidate for a Breast Lift with Augmentation this will give you the look you desire.

Many surgeons offer online virtual consultations where you send your photos and medical history information so that you can receive accurate cost at no cost to you.

Choose a board certified plastic surgeon who has done a ton of Breast Lifts and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.