How would a crescent lift with saline implants look? (Photos)

Question

thoughts on how a crescent lift with saline implants would look? My ideal look is an upper pole fullness and a full chest. I am look at more like 475-525 cc. Nervous about scarring but I feel as though on my consult I absolutely agreed that I would like a small lift and minimal scarring as I tend to scar significantly. 5'2" 138 pounds 34c, breast fed 2 children my breast tissue is extremely squishy and just deflated. I have a extreme flat upper chest and really want the appearance of cleavage.

Jed H. Horowitz, MD, FACS · Answer

The procedure is done on an outpatient basis
under intravenous sedation and local or general anesthesia. As mentioned above
there are a variety of techniques for these operations.  Lollipop lift (vertical lift), donut
(periareola) lift, Benelli lift, crescent lift, anchor lift (inverted T). Most
commonly, we prefer the lollipop or donut lift because of the shape, small
scars and easier healing. Although the “anchor-shape” or inverted “T” incision
is still more popular in the United States, it represents an older technique
with extensive scarring and a less optimal result in many cases. These newer
techniques are utilized in the vast majority of cases, the rare exception being
extremely large breasts. The nipple-areola complex is repositioned higher, the
excess skin is removed, and the breast is reshaped in a pleasing contour and in
a more normal position.

The crescent lift removes a small amount of
skin at the top of the areola. We find that there is very little lift and the
areola becomes oval in shape and distorted with this method.

The
insertion of an implant as well, may be advisable to restore superior fullness,
which is lost with aging and after pregnancy despite the rest of the breast
being overly large.  Fat grafting can be
used instead of implants to improve the contours of the breast. This is the
#NaturalBreastLIft or #CaliforniaBreastLift

#AugmentationMastopexy: This involves placing a small implant at the time
of the #mastopexy to add volume or contour the upper breast.   Another option is the #NaturalBreastLift or
#CaliforniaBreastLift which places fat in the upper breast instead of an
implant to help the shape of the breast.

Leland Deane, MD, FACS · Answer

Thank you for your questions and photos. I would advise caution because:1. implants do not create cleavage. They only give you more volume. Attempts to create more 'cleavage' can lead to malpositions, like symmastia, as well as visible rippling.2. mastopexy (lift) is impossible without some scarring. To make matters worse, the results can be unpredictable, depending on swelling, implant placement, technique, and tissue characteristics. The most conservative plan is to stage the surgeries, that is, to do either the augmentation or the mastopexy first and then the other operation later if needed. I tend to do the augmentation first.Remember that the general satisfaction rate with implants combined with mastopexy is significantly lower than either operation done alone.Hope this helps.Leland Deane MD FACSNYC, Garden City, Babylon

Prashant Soni, MD · Answer

Based on the description of the results you wish to achieve, I think you should have a discussion with your plastic surgeon about implants with a full mastopexy. This would involve an incision that goes around the areola and a vertical scar that meets with an incision along the entire breast fold. In my experience, that is the only way to hold a breast implant in more elevated position on your chest wall. I suspect that placing even a large implant without the necessary incisions, will only create a full low riding breast with no upper pole fullness. If you feel that this is an acceptable alternative, I would still perform a lift of the areola alone, to center it on the implant.

Also speak to your surgeon about scar treatments after surgery, such as silicone creams and laser therapy.

Best regards, Prashant Soni M.D.

Also speak to your surgeon about scar treatments after surgery, such as silicone creams and laser therapy.

Best regards, Prashant Soni M.D.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for enquire.After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 550ml will be excelent on you, to fill the breasts properly.Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".Respectfully,Dr. Emmanuel Mallol Cotes.-

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With that
being said, based on your photographs, the best shape and contour could be
achieved with an implant and a wise pattern breast lift.  I do not ever
recommend a crescent lift.  Over time, the areola tends to enlarge with a
thickened scar.  The other even worse problem is that it flattens out the
shape of the anterior breast over time.  A wise pattern lift with an
implant can result in a very nice shape if good technique is
used.    The size of the implant is based on your desired
breast size/shape, your chest wall measurements, and soft tissue
quality.  This decision should be based on a detailed discussion
with equal input from both you and your surgeon.   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

Adam Tattelbaum, MD · Answer

Thanks for your question and the photos. Implants will restore fullness to the upper portion of the breast and make you larger, but they may not elevate enough skin for a crescent lift to be effective. It is certainly ok to start this way as long as you have realistic expectations. If you feel too droopy afterwards larger lifts can always be added later.Best wishes.

Richard Zienowicz, MD · Answer

A crescent mastopexy will not give you significant lift.  It is an unacceptable choice for your situation.  Your degree of sag is serious and needs a more aggressive answer than a little skin from above the areolas.

Jeffrey D. Wagner, MD · Answer

Based on these pictures, you have too much ptosis for a crescent lift.  I think you are going to require a lollipop or even a 3 incision lift, along with an implant.  The crescent lift is really best thought of as a minor nipple repositioning procedure, not a major breast reshaping procedure--I think you need something more than a simple nipple repositioning to rejuvenate your breasts.

Steven Wallach, MD · Answer

I do not think a crescent lift will be enough. You will have to be seen in person to get an appropriate evaluation. Best of luck.

Robert L. Kraft, MD, FACS · Answer

I do not think that the crescent lift will produce a good result for you.  It would be helpful to know why you believe that you scar poorly.  Contour is the key consideration in the augment pexy.  Scarring can be controlled afterwards but shape is irrevocable.  Implant profile will also be an important consideration.

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