Anchor or Periareolar lift? (Photo)

Question

Hi there. For as long as I could remember my breasts have had an unusual shape. And have decided to go through with lift+augmentation. I’ve had some different opinions on the technique of the breast lift and it would be incredibly helpful to get your input. From what I’ve been told I have tubular breasts and doctors have suggested a periareolar lift or an anchor lift. I’ve had different suggestions and am unsure which one to pick. What lift would you recommend?

Gerald Minniti, MD, FACS · Answer

Any surgeon recommending a periareolar lift has little understanding of the issues at hand: 1. Nipple areolar complex (NAC) facing the floor and below the fold. 2. A very high and tight inframammary fold. 3. Breast volume asymmetry. The only chance you have of having an attractive result is with a full anchor scar breast lift. This is the only way to reliably reposition the fold, lift the NAC, and get symmetry to the breast shape and size.

Allyson Deziel, MD · Answer

Hello! It's great that you're taking the time to research your options for breast lift and augmentation. I would recommend an anchor lift in order to get the best results, but ultimately the choice between these techniques should be made after a thorough consultation and in-person exam with a plastic surgeon.

Daniel Barrett, MD · Answer

Dear Optimistic353439,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ira H. Rex III, MD · Answer

In general, a periareolar lift can be very unsatisfactory as far as being able to move the nipple far enough up, and also can be commonly associated with widening of the areolae. The anchor pattern lift will usually give you a much more stable result and allows the plastic surgeon to reshape the breast.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Richard Baxter, MD · Answer

Your pictures do show tubular breasts, and I have had the most success in cases like yours with the vertical (lollipop) lift rather than either a Benelli or full anchor. Implant sizing is important because of the narrow base diameter with tubular breasts.

Gary M. Horndeski, MD · Answer

You do not have tuberous breasts. They are widely separated and ptotic. The technique I recommend is a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ramin Behmand, MD, FACS · Answer

Typically, tuberous breast deformity responds well to a periareolar lift and augmentation. This is because the breast base is already tight, and excess tissue needs to be removed from the central portion of the breast. However, in cases of significant asymmetry like yours, two factors become crucial.  
Firstly, it's important to allow the surgeon some flexibility to potentially convert the periareolar mastopexy to a lollipop or anchor lift if the intraoperative result calls for a change in technique. Starting with a periareolar lift and converting allows for adaptation without burning any bridges, though it may prolong the operating time.

Secondly, the skill of the surgeon plays a significant role. Not all periareolar lifts are the same; some surgeons specialize in them and excel at achieving optimal results. Try to review various before and after photos to ensure that your expectations align with the surgeon's work.

The link below is to a periareolar lift.  Patient 4 is also a periareolar lift.

Dr. B.

Connie Hiers, MD, FACS · Answer

Just from your two photos, your breasts do not appear to be tubular, but do sag. I would suggest the vertical lift for best results. The peri-areola incision will not be a sufficient lift.

Camille Cash, MD · Answer

From the submitted photos you will have the best result from an anchor lift with implants.  This will allow your surgeon to remove excess skin, downsize the areola and better shape the breast.  A periareolar lift may not provide enough lift and the tension on the incisions may stretch the areola again.

Anchor or Periareolar lift? (Photo)

Answers (13)

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