Periareolar lift with implants over muscle through breast crease? (Photo)

I Went to see my PS and he suggested periareolar lift and implants as I want upper pole filled out. With tear drop implants through breast crease over muscle. Does that seem right?

Doctor Answers 12

Periareolar lift with implants

I have been doing periareolar lifts with and without implants  since 1985. You are not a candidate for this lift. Based on your photos a traditional anchor type mastopexy would give you the best result. You have enough tissue where I don't believe that you need additional fullness  with breast implants 


Sacramento Plastic Surgeon
4.9 out of 5 stars 107 reviews

Periareolar lift with breast implants over muscle through breast crease?

Thank you for your question.   Based on your photographs, a periareolar lift will be in adequate to properly lift your breasts and you will require a vertical component to your breast lift such as a lollipop for anchor lift. In my opinion it is safer to place the implant beneath the chest muscle when doing a breast lift in addition to implants. For more information combination breast lift with implants please read the link below:

Mastopexia without implants

Dear Jenny. Thanks for the photo. Based on it you have a very good breast tissue and therefore you will not need implants. Also a periareolar mastopexy is not possible for you. The best in my opinion will be a mastopexy surgery with lolipop scar but without implants. Please consult with a plastic surgeon....


Ozge Ergun, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 12 reviews

Periareolar Breast Lift

A periareolar breast lift can be a great choice for a woman who has a relatively small amount of droopiness (ptosis).  When the nipples are near the level of the crease and there is just a little bottom-heaviness of the breasts, a periareolar lift with implants may provide a terrific result.  Unfortunately, this type of lift is used too often, in my opinion.  Many surgeons use this lift even when the nipples are far below the crease level.  In cases like that a lot of tension is placed on the closure, and this may result in wide, very noticeable scars around the areolas and possibly severe distortion of the areolas.  

Judging by the photograph you supplied, I suspect I would suggest a different type of lift for you.  Sometimes some of the lower breast tissue can be removed and an implant can be placed at the same operation, but this requires either a vertical ("lollipop") or an inverted-T ("anchor") pattern breast lift.  I have also taken care of many women who have moderately full-volume breasts who were happy with just a breast lift without implants, and from your photograph it is something you might consider.  However, a breast lift alone will not provide upper breast fullness.  Upper breast fullness requires either an implant or fat grafting or both.  

I encourage patients to obtain a second opinion.  Another surgeon may have the same thoughts or very different thoughts about what may work best for a woman.  Information is powerful, though, and when you are going to spend the type of money you are talking about and you are going to have the anxiety and possibly discomfort of surgery, you should arm yourself with as much knowledge as possible before heading to the operating room.  Make sure you visit with an experienced, reputable plastic surgeon who does a lot of breast surgery. Clearly you have doubts about what your initial plastic surgeon said.  Consider obtaining another in-person consultation with a different plastic surgeon.  

Kelly R. Kunkel, MD
Fort Worth Plastic Surgeon
4.8 out of 5 stars 24 reviews

Wrong choice

Thank you for your question.  A periareolar lift with implants is not the correct surgery for you.  You would require a full (anchor-type) mastopexy with or without implants.  Your breasts are already large and so you may be very happy with a mastopexy alone.  I suggest you seek a second or third opinion.  Be sure to look at before and after photos of the surgeons with whom you consult, and as always make certain that your surgeon is board certified by the American Board of Plastic Surgery.

Lift and implants

It looks like you would be better off with a more formal breast lift using weight a lollipop incision or a "T".

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Choice of Lift Procedure and Best Implants

A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is used for #breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an #implant is used at the time of mastopexy.  This is called an #Augmentation/Mastopexy.  The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. 

#FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast. A hybrid operation may use both an implant and fat to provide the best contours of the lifted breast.

I prefer to  use 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. There are plenty of implant choices available to help ensure the best shape and position of your breast and nipples. Good luck.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Periareolar lift with implants over muscle through breast crease?

I like the periareolar lift procedure but it is not one I would choose for you, your nipples are too low and the breast tissue is quite heavy. The PA lift is not really a lift, it has no strength, it just moves the areola and reduces its diameter. You need a full lift for an aesthetic result. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Periareolar Lift Not Strong Enough

Based on your pictures alone, a periareolar lift is not going to be strong enough to support your breast tissue over time.  That lift can only elevate the nipple a small amount and tighten a limited amount of tissue.  You appear to need at least a circumvertical ( lollipop) lift, if not a full anchor pattern to really get the breast tissue up in the higher position you want.  Even with an implant, if the tissues are not tight enough, the implant will simply fall into the looser tissues and give you a larger, lower breast.  I would go for a few more consultations with board-certified plastic surgeons and see what is really recommended.  I hope this helps.

Peri lift or full

Thanks for your question. Implants above the muscle fill out the skin more directly, so some surgeons use this approach to avoid larger lifts. From your photo you appear to have a lot of laxity and a good amount of natural volume. It is the natural breast tissue that will continue to go south over time. Given your laxity you may wish to consider a full lift and even some reduction. By removing some natural tissue there is less of it to respond to gravity over time,  followed by a staged implant to give more fullness to the upper pole of the breast.With a tall subglandular implant you could have more upper fullness, but I would be concerned  even with periareolar lift you would still feel too droopy.

Hope this helps and makes sense. Best wishes

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

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.