Mastopexy and Augmentation - Best Procedure?

I am considering a mastopexy + tear drop implants 240cc. What procedure would you recomend? I´m 1.57m, 53kg Torax under the mammary fold is 81cm (31 inches), over the breast 90cm (28 inches) My left breast has a 21cm ptosis and 22cm for the right on.

Doctor Answers 15

Mastopexy and Augmentation - Best Procedure?

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Thank you for your question and photo.

If what you desire is to increase in volume, then an implant is necessary along with the Mini Ultimate Breast Lift technique which does not require a vertical scar nor an inframammary scar to properly reshape and reposition your natural breast tissue back where it belongs. But, if you are happy with your size, then the Mini UBL alone will suffice to give you an improved shape with a natural slope and minimal scarring. The Mini UBL is not a Benelli lift. The Mini UBL utilizes the same strapping technique as the full UBL, but without the infra-mammary scar. Vast improvements in the Ultimate Breast Lift series have made it possible to improve breasts naturally without the need of implants and almost invisible scars.

Remember, implants do not lift breasts. They simply add volume and weight to an already damaged skin envelope. The trick is to reshape and reposition your breast tissue to the highest part of your breast bone to achieve the maximum projection possible without implantation.

Hope this helps.

Kind regards,

Dr. H

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Augmentation mastopexy

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You are right on target. The breast augmentation will provide larger size and fullness, and the lift will center the nipple on the breast. Breast lift may be performed with a lollipop or anchor incision, possibly with an incision limited to the margin of the areola. It is important to meet with a Board certified plastic surgeon for an examination to determine which is the best approach. Tear drop implants are very tricky - while they are billed as "anatomic," if they tilt, then they become completely non-anatomic. More patients are having round implants, and anatomic implants tend to be limited to reconstructive procedures.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 57 reviews

Breast augmentation and mastopexy

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Thank you for the question and picture. Much of what I would recommend for you would be based on what your goals are. I think the communication with your surgeon is critical. In my practice, I like to communicate patient goals with pictures.

Having said that, it is likely the would benefit from breast augmentation with limited mastopexy (circumareolar  or vertical). Because you do have some component of constricted (tuberous)  breast anatomy, release and rounding of the lower poles  of the breasts will be important.  

I hope this helps.


PHOTO: Options for breast ptosis (sag or droop)

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In my opinion, I prefer round to teardrop implants and would consider a circumvertical lift which would allow reduciton in the size of the areolae. Round will give you better upper pole fullness.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Implants and lifts

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From your photos and without an exam it is difficult to say exactly what would be best for  you, but you may be a good candidate for a circumareola lift and implant or possibly a vertical lift.

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

Implant and Lift

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i would recommend a augmentation with a perioareolar mastopexy.  I would place beneath the muscle.  You can guide the choice of saline or silicone implants.  Visit with several plastic surgeons to get a complete exam and recommendations.

Dr. ES

Limitations of periareolar (donut) mastopexy

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You have challenging anatomy with your mild tubular deformity, high breast fold and large areolas.  I would recommend resizing your areola with a small vertical lift (some call it the lollipop lift).  Using just an incision around your areola combined with an implant is going to put a lot of tension on the areola.   This could lead to a funny, chopped off shape (think Aztec pyramid vs Egyptian pyramid), spreading of the areola or a really wide scar or even all three!  Even though a vertical lift would leave a vertical scar on the lower part of your breast, I think it would give you the best shape. 

I do not use anatomic implants.  I learned to fear and loath them many years ago.

Again, the above was learned the hard way!

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Mastopexy and tear-drop breast implants

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I disagree with the answers given although I can not be certain where the inframammary crease lies in relation to the nipple even with pictures. This requires an exam or in a picture, a line drawn on the face of the breast at the level of the crease behind it. 

If the nipple level is no more than 2 cm lower than the level of the inframammary crease, then the simpler procedure is to augment the breast with an implant and fill out the lower part of the breast which will make it look as if the breast was lifted. The minimum size increase is one cup size and this will not change the asymmetry that the right nipple is 1 cm lower than the left. The dimension of the supposed ptosis (21 or 22 cm) is not relevant and has to do with where the breast sits on the chest, not the degree of ptosis. The other possibility is that the degree of ptosis can be accommodated by an implant now but in the future the breast will sag further and a mastopexy will be desirable later on. In my opinion, the implant does not cause the breast to sag in the future but breasts do sag over time and various stresses. 

The tear-drop shaped implant is of no benefit as your breast is wide enough for a round implant to fill the upper pole and positioning the oval shape is at risk for malposition either short term or long term. A round implant that is properly sized and positioned will do just fine and is simpler with less chance of malposition. 

A mastopexy should be considered if the nipple position is lower than 2 cm from the inframammary crease level or if the minimum of one cup size increase with an implant is not acceptable. I would recommend one or the other and not both at the same time as it is quite difficult to balance all the changes in the breast size and shape and predict the outcome. The two procedures work against each other in terms of risks and are much better done separately when needed or appropriate. The only advantage to the mastopexy is to raise the right nipple/areola higher than the left in order to try to get them at a more even level. Periareolar (donut) mastopexies do not truly lift and reposition the breast and in my opinion are only good for breasts that need nipple/areola size or position adjustment but aren't worth it on breasts that are truly too ptotic. A lollipop or circumvertical incision is best for true lifting of the breast with its attached nipple-areola. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Augmentation with lift (mastopexy)

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Based on your photos, I would recommend a periareolar subpectoral breast augmentation with a circumareolar mastopexy.  The breast lift would involve a circular incision around your areola which typically heals very nicely with minimal scarring. This would elevate your nipple/areola position and add to a nicer overall shape.  I usually use a Gore-Tex suture for this type of lift to prevent widening of the areolar diameter.

Be sure to consult with a board certified plastic surgeon to be examined carefully before scheduling an augmentation with mastopexy (lift).

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 412 reviews

Benelli breast lift with implants will work.

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Sounds like you have a good plan.  You get a circular scar around the nipples.  The right areola needs to be made smaller. The implants should go over the muscle.

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

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.