Would you recommend a crescent lift, or would I have a better outcome redoing both. Or is there a better third option? (Photos)

Question

8 years ago I had a breast lift with implants. At the time, they only lifted my right breast because my breast were drastically uneven. Because they only lifted one side my nipples are now facing different directions. I’ve gone to a plastic surgeon who advised me to either lift the other breast or get a crescent lift on the left. My biggest concern was the placement of my nipple, hence his suggestions. However, I have been told by friends, that it might be worth redoing both breasts. I feel like I have breast blindness and need the reality check of a professional. Would you recommend a crescent lift, or would I have a better outcome redoing both. Or is there a better third option? Thanks! (I’m a very active 26 year old with lupus and rheumatoid arthritis (which I’ve been told shouldn’t be an issue for either procedure). 25% body fat and I weigh 150lbs).

Daniel Barrett, MD · Answer

Dear Daisy3453,

my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gianfranco Frojo, MD · Answer

I would recommend a bilateral breast lift revision. This is a complex breast problem that requires a highly experienced breast surgeon. I would ensure that your future surgeon has
1) certification by the American Board of Plastic Surgery (ideally also a member of The Aesthetic Society or completed an accredited The Aesthetic Society fellowship)
2) performs these procedures frequently and has extensive experience
3) performs the procedures at an accredited facility with proper hospital admission priviliges
4) has good photos and reviews available in person or online

Leila Kasrai, MD, FRCSC · Answer

It looks like both nipples are located below your breast fold, which would make a vertical breast lift suitable. A more aggressive lift can be performed on the lower breast to improve symmetry.

Gary M. Horndeski, MD · Answer

I recommend explantation and lift using the Bellesoma. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

George Marosan, MD · Answer

Thank you for your question and photos. Currently you do have sagging in both breasts, asymmetry in shape and nipple/areolar complexes at different levels. This is a more complicated issue that a crescent lift cannot correct. A crescent lift is not a true lift, it can reposition the areola by about 2cm only, but will not affect breast shape. For a better outcome, you would do better with a bilateral breast lift, with or without implants. Because of your active life style and history with lupus/arthritis, we would need to carefully weigh the risks of implants. Often a "lift only" approach can give a beautiful sustainable results with fewer long term complications for patients with your profile. I have treated many patients with similar degree of asymmetry and medical history.  See a board certified plastic surgeon with experience in all aspects of breast surgery for an in person consultation/evaluation. Good luck.

Gerald Minniti, MD, FACS · Answer

They only elongate the areola and you need a major repositioning of your left nipple areolar complex. You need to do what you did for your right breast. If what you said is accurate, that a crescent lift could be an option, then you should stay far away from that plastic surgeon. Finally, looking at both breasts tells me that you have asymmetric implants (or no implant in the right side?), and so both need attention, not just lefty.

Kadir Berat Oyur, MD · Answer

Based on your history and photos, the main issue appears to be asymmetry in nipple position and breast shape following a one-sided lift. In such cases, we generally believe that addressing both breasts provides the most balanced and predictable result, rather than performing a limited crescent lift on one side, which may not fully correct the asymmetry. A revision breast lift on both sides allows better control of nipple position, symmetry, and overall contour. The exact technique depends on your current tissue, implant position, and skin quality, but a comprehensive approach typically gives a more harmonious outcome. Of course, your medical conditions (lupus and rheumatoid arthritis) should be stable and cleared before surgery, but they are not absolute contraindications if well managed.

Donovan Rosas, MD · Answer

Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts.

This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. A small degree of necessary lift can be addressed via a circumareolar/crescentis lift without a vertical/transverse component (lollipop/anchor). More significant droop will mandate greater scarring to better reshape the breast envelope.

Based upon your photos, the degree of asymmetry would likely be too great for a crescentic lift. Symmetry is always easier to achieve when both breasts are addressed at the same time.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Camille Cash, MD · Answer

Based on the submitted photos a bilateral lift (both sides) is recommended.  This will give your surgeon the best opportunity to optimize your results.  You can discuss your goal look as you may want to exchange implants as well.  Having the crescent lift alone will likely still leave you asymmetry.

Darryl J. Blinski, MD · Answer

Based on the post photo, I would recommend virtual consultation with the understanding you may need two surgical procedures. Approximately 3 to 6 months apart initial stage would be a lifting of the normal breast with decreasing the size of the nipple complex on the previous lifted breast to gain some symmetry, then allowing 3 to 6 months healing and a secondary procedure for finalization. Expect fees to arrange from $8000-$12,000 for the first stage and fee fees will depend on what that needs to be done if there’s a second stage. Best of a virtual consultant with regards.

Would you recommend a crescent lift, or would I have a better outcome redoing both. Or is there a better third option? (Photos)

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