Looking to lift & firm the breast, uplift/project the nipple, always been large 36/E/F but now 48yrs old. Any suggestion?(photo)

I would love minimal scar's, with still quite a full envelope I would like the option to remove the skin around the nipple, donut - to then firm up the skin and raise the nipple. I did see a surgeon 5/6 years ago who said I had a full envelope and only significant reduction would be an option to have skin to lift and advised against this. I have read many surgeon's views/advise. Are my bust too large to use this technique?

Doctor Answers 12

Any suggestion?

Hello Dear, thank you so much for your questions and pictures,

According with your pictures you would be an excellent candidate for a Breast reduction or reduction mammoplasty, is a surgical procedure to reduce the size of breasts, by the removal of fat, breast tissue and skin, making them more small,light and firm. You can also reduce the size of the areola.Breast reduction aims to provide women with breasts smaller and with a more proportionally to the rest of your body.

Hope hear from you soon,best wishes!!


Dominican Republic Plastic Surgeon

Breast Lift Procedure Preference

Candidates for Breast Lift (#Mastopexy) surgery are women who have #saggingbreasts due to past pregnancies, genetics, or aging. Often times the sagging is too great to be treated by implants alone. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume.  One side can be tightened more or less than another.

A mastopexy or breast lift operation is designed to improve the shape and position of the breast 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. 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. 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.

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

Find the right surgeon to decide if you're a good candidate for a Breast Lift

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. 
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a mastopexy

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Limits to all Techniques

In my own practice, I have been known to push the limits for the indications for each of the varied breast lifts/reductions that I perform. Here are the types of techniques and the limitations;

  1. Goes Technique - a circumareolar lift/reduction - a modest lift for those patients with sternal notch to nipple distance of less than 25 cm's. Reduction is also modest as well.
  2. Lejour Technique - a lollipop technique for those with a SN to Nipple distance of less than 35cm's. The shape is great and the volume to be reduced can vary widely.
  3. Hall-Findlay Technique- a lollipop technique for those with a SN to nipple distance of less than 30 cm's. The shape is good but not as perky as the Lejour. I use this technique when the anatomy does not allow for the Lejour.
  4. Anchor scar/ Wise Pattern/ Mckissock Technique - for those with SN to nipple of greater than 35CM's. This technique tends to bottom out and appear boxy, but is for those exclusively in this group. 

You appear to be in the last group. If you would like more information, please read my book "Cosmetic Breast Surgery - A Complete Guide From A to Double D".

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 30 reviews

Breast Reduction

Thanks for your question and pictures. With a breast reduction, the breasts are reshaped by removing excess breast tissue and skin while also repositioning the nipple and remaining breast tissue. The incisions for breast reduction are determine by the nipple position and loose skin. In my experience, I think you would be best served by a breast reduction with an inverted T scar (Wise Pattern). I think a donut incision would give you a result that you would not be happy with.

Reduction

You can achieve the look you desire but only with a full Wise pattern lift/reduction.  The nipple needs to be transposed at least 10 cm superiorly and excess lower pole skin needs to be removed.  You are not too large for this technique.  Best wishes, Dr. T. 

Suggestions?

Thank you for your question and photos. Unfortunately, the donut mastopexy will not be a sufficient technique to achieve what you would like to achieve. A moderate reduction through an in verted "T" incision will be best able to do this. This technique will be able to remove enough skin and reposition the nipple appropriately to give you a firm uplifted and youthful appearance. 

Consult with a Board Certified Plastic Surgeon in your area to discuss your options.

Best wishes,


Breast reduction

You are best suited for a small reduction if you want to keep a reasonable amount of volume. This would likely be best accomplished with a "T" closure.

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

Breast reduction

Hello and thank you for the question and the photo. Based on the photo, your breasts are very large and ptotic ( sagging ) . the best option for this is a breast reduction. It will remove the excess skin, remove the excess mass and size of the breast and reshape the breast into a more youthful shape. A doughnut lift will NOT work in this case. There is just too much breast and skin. 

You should factor about 1-2 weeks off of work and month out of exercise. 

You should seek several consultations with board certified plastic surgeons in your area before making a final decision.
As always it is best to be healthy, no smoking, and make sure any health care concerns you have are managed by your primary care doctor.
Best to you


Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 16 reviews

Breast lift with a reduction

Hello and thank you for your question. Based on your photograph, you are a great candidate for a breast lift with a reduction.  A wise pattern lift would be best for you.  The donut life will not provide enough lift for you.  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 77 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.