Looking to educate self on reasons breast lift is needed? (Photos)

I have not yet met my surgeon and have been using this forum to educate myself! It has been suggested that I will need a lift and because I am naive, this came as a bit of a surprise! I am not trying to be argumentative, just trying to understand. I have done the fold test and it seems my nipple is either at or slightly above the fold. My nipples do not point towards the floor. Why is a lift a must for me? Thanks for your time, I greatly appreciate it. Such a wonderful resource!

Doctor Answers 15

Mastopexy: Information

Dear Ms. Kalena4905,

Thank you for your story, questions and photos.

Its refreshing to hear someone that wants to understand why a breast lift (mastopexy) is needed.
Nothing substitutes for a personal evaluation and a face to face discussion of your options.

Unfortunately without a examination I can advise you in general terms, however I hope you will find them helpful.

Based solely on your photos your most likely will need a mastopexy (lift) and enhancement with a breast implant.
The more "natural look" you want is less likely based on the style of the implant then on the surgical technique of implant placement and lift.

My response/recommendations:
1) the reason your breast sags is that the "skin covering" is proportional larger than the breast tissue.
2) the majority of your breast tissue is below where the breast mound should anatomically be located.
3)if you refill the volume only(breast implant)... the nipple areolar complex (NAC) will tend to rotate over the top of the implant like a waterfall resulting in a full breast mound but unfortunately a downward rotation and location of the NAC.
4)the only method known to create a aesthestically acceptable breast will require trading
incisions/scars on the breast for a pleasing contour and relocating the NAC.
5)depending on your desires (shape and size) the scar may vary from:
A) just around the nipple (doughnut)
B) to a added vertical incision (lollipop)
C) to include a horizontal incsion in the breast crease (anchor).
6)while breast incisions/scars are required....there are ways to modulate/improve the
appearance of the scarring process.
7) you could always start with a augmentation only and if you like the appearance= great
if you want a more sculpted breast with a higher NAC then you could undergo a lift (often just under local anesthesia).
8) select 3 nude model photos of breast you consider your goal breasts and bring with you to your consultation.

Please make a appt. with several experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and ideally a members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Positive Benefits of a Breast Lift

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). 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. There are also many things to consider with the various options of procedures and the results that can be accomplished.

The procedures include the Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, and 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. 

The Benelli lift as performed by most surgeons is just the donut lift, removing a donut shaped piece of areola and skin then using a #Pursestring or double purse-string suture to tighten the skin. 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

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Do you need a lift?? Or do you just have an opinionated jealous friend?

I love this question. Do you look like you need a lift? Sadly, the overplayed fake boob has made us look at a real boob with suspicion that it is too droopy, too hollowed on top, too "natural". Naw, it's just called real. If you like your breasts, don't even think about it. From my objective perspective, I think they look good. Fullness up top, nipple above the fold, maybe a little pencil test failure but that's every D sized breast. Who the heck is telling you that you need a breast lift? Girlfriend, look for ulterior motives.  

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Breast lift - necessary or not

Thank you for asking about your breast lift.
  • It isn't clear to me that you need a breast lift.
  • With your arms at your sides, your nipples and breasts appear to be well placed.
  • Some photos suggest you might be borderline (maybe a lift, maybe not)
  • But it doesn't look like a 'must' to me, given your photos.

Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

Breast lift

Thank you for your question and photos.  There are different degrees of sagging of the breasts (ptosis) and you need to look at where your nipples are relative to your inframammary folds.  You lack upper pole fullness and would significantly improve the appearance of your breasts by moving them to a more ideal position higher on your chest by undergoing the full breast lift.

Best of luck!

Breast lift and implants

Dear Kalena
Thank you for your question, I can see that you are a young women and you has had a thoracic surgery, it is important to consider if you want to do a surgery. I recommended you a breast lift, but it depend also if you want augmentation or if you want just the same breast size. Exist very kind of surgerys to do that, it depends what do you want with this.
I suggested you go with a Certificate Plastic Surgeon who will answer all your questions.
Yours faithfully.

Be cautious with breast surgery

because if you've had a open heart procedure, your blood supply is compromised from the medial half and could lead to catastrophic problems as I've been witness to one in my small town (thankfully not my patient).  But do you need a lift?  Only if you want one as you really don't need to do anything but if you have ideas of what your breasts should be like and its all perkier in appearances, a lift is the only way to achieve this.  Avoid the traditional anchor incision and only go with the lollipop lift if you do decide you need one to help achieve your goals.  If you're putting an implant in, caution again must be exercised as the patient I know of lost a significant portion including the nipple.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Breast lift

I would say the answer to this question is really based on what look you wish to achieve.  Are you just wanting more fullness to the breasts in the upper pole? Are you personally ok with your areola size and position of your breasts but you want them larger? If so then you can simply get implants.  However if you are really wanting your breasts to be perkier and more symmetrical then I would advise a mastopexy with or without implants.  Find a Board Certified Plastic Surgeon who performs a lot of breast lifts and show him/her pictures of the look that you wish to achieve.  Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.7 out of 5 stars 31 reviews

Need for Mastopexy (Lift)

A mastopexy, or, so called lift, repositions the breast tissue and creates a perky, aesthetically pleasing breast shape. All an implant does is add volume. If all you need to achieve proper breast shape is a little more volume, then all you need is an implant if it is properly placed. Your breast shape, however, will not be helped with just volume alone and needs tissue repositioning. If all you do is place an implant, your nipple will actually drop more, you will have significant upper fullness and a collection of tissue below the implant. When done by an experienced board certified plastic surgeon, the scars should almost disappear and be markedly better than the central midline scar you presently have. The correction in shape is usually well worth the added scar.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Looking to educate self on reasons breast lift is needed?

Thank you for your question.  Kudos to you for taking the time to learn more about your options!
Based on your photos, you are correct to say that your nipple is in fairly good position.  However, a good portion of your breast tissue is under this level - this is called pseudoptosis, unlike ptosis where the nipple is pointing south.  I generally don't like the term "breast lift" b/c it implies only lifting the nipple or breast.  I prefer to say mastopexy, b/c it is really a procedure which re-shapes your breasts by tightening your breasts creating a rounder perkier appearance, adjusting the size of the areola, improving symmetry and the option of raising the nipple position.  Breast implants would give you more upper pole fullness and improve cleavage; a limited mastopexy may be required to address the extent of your pseudoptosis.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 14 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.