Do I Need a Lift? Peri Areolar or Traditional? Do Not Want the Vertical Scars (photo)

Do I need a lift (thinking about getting 325cc high profile silicone) Can I do a peri areolar lift or need a traditional lift? I can not find a doctor in the Cleveland area that does the peri areolar....does this mean it is not recommended?

Doctor Answers 9

If you need a lift you need it done right and a periareolar lift is ineffective.

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You cannot find a plastic surgeon in your area who uses the periareolar technique because it is a poor option.  Causes areolar distortion without providing any true lift.  The vertical technique is best.  I would advise this is the only lift to consider.  I know you don't want the vertical scars, but if you want a real lift, there is no substitute.  These scars do tend to heal well and I think they are less of a problem than a periareolar scar.  Yes, you want implants to fill your upper poles.  Your sagging is not terrible.  You might consider implants alone at this stage and then later have a vertical lift.  Do not have an inverted-T lift: the scars are excessive and the breast shape is suboptimal using this "traditional" technique.  I have attached the relevant section of my website if you want to read more about these issues or look at photos.

Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

Do I Need A Lift?

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The determination of whether you need a lift or not depends on the ultimate appearance that you want to achieve.  Droopiness or ptosis of breasts is classically determined by the position of the nipple in relation to the fold where the breast hits the chest wall.  It appears from your photograph that your nipple is correctly positioned, but your gland is hanging below the fold.  This situation is variously called "zero degree ptosis" or "pseudo-ptosis". 
You have chosen a moderate sized implant which won't give you much lift, therefore a circumareolar (Benelli mastopexy) would be my recommendation for you to keep your nipple in the right place and to pull up the extra droopy glandular portion of your breast. 
It has been my experience that Cleveland has some of the best plastic surgeons in the world.  They are very creative, innovative, and up with the latest techniques, and I am sure you will find many of whom do the Benelli mastopexy.  Even though Cleveland has the unique distinction of being the only city in the U.S. where a river caught on fire, it doesn't mean they don't have great plastic surgery.   

No woman wants vertical scars

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I agree completely, no woman wants the vertical scars on her breasts.  Vertical scars are impossible to hide and widen in time. Worst of all, they weaken the skin envelope causing 'bottoming out' of an implant (if added). The best approach for you would be the peri-areolar lift.  Through the peri-areolar approach the implant can be placed, the breast tissue elevated and anchored.  In your photographs, your nipples appear to be in normal position but you have a lot of breast tissue drooping.  This is psudo-ptosis and this can be corrected through a peri-areolar approach.  There is a new technique called the Mini Ultimate Breast Lift and you are a perfect candidate. 

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast Lifting Necessary?

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Thank you for the question and pictures.

The position of your nipple/areola complexes appears to be “normal”;  based on this criteria you do not need breast lifting. However, it does appear that you have some “sagging” skin  along the lower poles of the breasts;  It may be necessary to undergo breast lifting to improve the appearance/feel of this area.

I would suggest in person consultation with a few well experienced board-certified plastic surgeons.  Make sure you see lots of examples of their work.

Best wishes.

Periareolar lift is used for mild ptosis

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I'm sorry you've had difficulty finding a surgeon to discuss this procedure. Many plastic surgeons in Cleveland perform periareolar mastopexy (breast lift), including me. You can see photos of patients who have had this procedure on my website (see link below).

Periareolar mastopexy is generally used for mild ptosis (droop). It will not change the shape of the breast significantly, but can elevate the nipple and areola. Vertical mastopexy combines the periareolar (around the nipple/areola) incision with a vertical incision below the areola. This can achieve more aggressive lift. Breasts with more severe ptosis will usually benefit from an inverted-T lift (a.k.a., anchor or Wise pattern).

Implants may help restore fullness, especially to the upper pole of the breast. Some patients who feel that they need a lift will actually benefit from implants instead.

Your pictures suggest that you have minimal ptosis and significant breast tissue. A periareolar lift might tighten the breast somewhat, but at the expense of the periareolar scar (which generally does heal well). Based on your photographs, I do not think you need this procedure. A small implant (saline might be better for you) could give additional fullness to the breast, but will make the breast larger (which may or may not be desireable for you).

You need a thorough consultation with a board certified plastic surgeon familiar with these techniques. Good luck; perhaps we'll see you in Beachwood.

Steven Goldman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 168 reviews

Breast lift

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A lift is performed whent he nipple sits low o nthe chest or there is significant glandualr ptosis. Based solely on the photos you posted, it does not look like you hae either.  I personally perform many circumareola lifts in general.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast lift and implants

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A lift is needed when the location of the nipples are lower than the breast fold. That is certainly not the case with you. You do not need a breast lift. A high profile breast implant as you mentioned would be a great option for you placed partially under the muscle or fascia. Look at the link below for aesthetic board certified plastic surgeons in your area. Good luck. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 112 reviews

Peri areolar breast lift works very well with implants.

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1)  You certainly do not need a vertical scar.

2)  You may not need an external lift at all.  Implants and an internal lift should give you a great result, judging by your pictures.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

You don't need the lift

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Based on the photo the nipple is well up and centered and the overall shape of the breast is quite attractive. My vote is no lift at all.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 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.