The inverted-T or wise pattern reduction provides the most lift. It will also move the nipple/areola higher and give the breast a better shape and size that is proportionate to the body. The dog ears toward the armpit area of the lower incision may be related to excess tissue that goes all the way to the back and cannot be reached in the original surgery. I would recommend getting a consultation with an experienced, board certified plastic surgeon to discuss your surgery and concerns.
What type of breast reduction surgery provides the greatest lift? Is areola reduction typically done also?
Thank you for the question; based on your question, it is clear that you are giving a lot of thought to the details associated with breast reduction surgery. Generally, breast reduction surgery is one of the most patient pleasing operations we perform. The outcome achieved with breast reduction surgery depends greatly on who performs the procedure. In my opinion, plastic surgeon selection, as opposed to specific procedure performed makes the greatest difference when it comes to aesthetic outcomes. Areola reduction surgery is done at the same time as the procedure and "dog ears" can be avoided with careful planning and execution of the procedure. If dog ears do result, correction is usually a relatively minor procedure done under local anesthesia in most cases.
In other words, careful selection of plastic surgeon will be key. I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons. Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. ***Ask to SEE lots of examples of their work AND preferably speak/see patients who have had similar procedures done. Then, it will be important to communicate goals carefully as well. The use of goal photographs are very helpful during the communication process, both in terms of communicating patient's goals as well as helping patients achieve realistic expectations prior to proceeding.
I hope this, and the attached link/video dedicated breast reduction surgery concerns helps. Best wishes.