Is it possible to create more upper pole firmness with only a lift? (photos)

I am a 41 year old 38d in good shape and have breast fed three children. I have a lot of volume and would like to get a lift. I Iam looking for a specific shape and I would like an option on the possibility of achieving this without an implant. Some lifts I have seen so achieve the look I am looking for and others are no where near . Thank you for your opinions and expertise.

Doctor Answers 7

Breast implants no longer required to provide upper pole fullness

Vertical scar breast lifts are without question flawed in their design. Placing an incision at the lower pole (place of maximum tension) weakens the skin envelope that is being counted on to maintain shape and position. With time, the incision widens or "gives" way to the weight of the breast  and soon sags again. This process is expedited if the weight of an implant is added. Initially, shape and position look great, but results are short lived and revision is required. With The Ultimate Breast Lift, the breast is secured to the underlying chest muscles to achieve long term results. So, the skin envelope is not the only structure providing stability. An internal cone is also used to provide long term shape and perkiness. The vertical incision has also been completely eliminated to ensure that the skin envelope is intact and not weakened.

Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

Upper pole fitness with only a lift

The key to success 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, what shape do you want to have, etc.? However from your description it would appear that a lollipop type lift would be best for you rather than a periareolar lift like the Benelli procedure. Here is a rule of thumb that works for most patients. If you nipple is above your lower breast crease then often a periareolar lift will be sufficient for most patients. If your nipple is at or below your crease then a vertical lift (lollipop lift), inverted T or anchor pattern may be required. The Lollipop incision for Grade 3 or 4 ptosis (areolar near or below your breast crease) works best in my hands and the use of a Lollipop technique can lift your breast to the perkiness you desire. However, other plastic surgeons are more comfortable with an inverted T or Anchor Pattern technique.The donut lift does tend to both flatten and have scars widened as you are removing skin around the areola which causes tension in that single area causing it to "spring' apart over time. With the Lollipop incision the tension is spread out over a greater distance of the lower vertical scar (where the areola once was) causing less tension on the areola and entire closure. The vertical lift tends to cone the breast making it more shapely (conical) and less flat. For a visual take a paper circle, cut out a small wedge on the bottom and bring the edges together to see this effect. In general I would pick the best Surgeon and explain fully what you want to achieve rather than the technique. Always choose a board certified Plastic Surgeon.

Breast lift

Hello and thank you for your question. Based on your photograph, you are a great candidate for a breast lift.  With good technique, you can achieve upper pole fullness without an implant.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

Breast lift and upper pole fullness

Some degree of upper breast fullness can be obtained with a breast lift alone, but adding a small implant would likely give you the shape you're seeking more reliably.

Andres Taleisnik, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 35 reviews

Dr Kayser

Thank you for your question. You are an excellent candidate for a breast lift which is the surgical correction of breast drooping. This also repositions the breast to a more youthful location and also allows redistribution of tissue into a higher position. This would improve the shape and contour of your breast and, through internal shaping, would also provide additional upper pole fullness. You would benefit from a short lollipop type approach which would reduce scarring and improve shape. I do not believe that the traditional wise pattern or anchor scar approach would be appropriate for you as this would leave you with excessive scarring and a boxy shape that would probably not be necessary in your situation. In any case, I would certainly recommend a consultation with a board-certified plastic surgeon who is experienced in all types of breast surgery. Please view the video on breast lift and reduction surgeries in the link provided below. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 reviews


Your upper pole fullness may be improved in a bra. Without one, it unlikely to improve without an implant. A small high profile implant would be useful

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 40 reviews

Breast lift

Your photo certainly demonstrates the need for a breast lift to elevate the nipples and tighten the lower pole. Generally you cannot expect upper pole fullness from a lift alone. But you CAN get the lift done and see if you are happy without implants since the implants cause most of the problems here. Please note that 2 of the 3 goal photos you posted do have implants.

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.