What Type of Breast Lift Would I Need?

It is most important to have a thorough discussion of your specific goals and examination to determine what, if  any procedure might be best suited for you.

Based on your photograph, considerations include:

• do nothing, if the scars would be unacceptable
• breast implants to gain upper pole fullness and limit visible scars
  • the significant added volume may be undesirable
• breast lift to improve
  • shape
  • upper pole fullness
  • elevate the droopy part of the breast
  • tighten the skin

The techniques that might work best for you would require a "lollipop" or "anchor" scar.

I think that attempts to otherwise limit the scar would probably produce unsatisfactory results.

• Because it appears that your nipple position is good, I would recommend against "crescent" incision.
• I would advise you against periareolar Mastopexy because I think it would produce poor shaping and risks areolar distortion or widened scar.

You may want to consider an implant to fill out the upper portion of the breast which will give you more fullness and make the nipple appear to be lifted.  In your case, you are borderline in needing a lift at this time and may be very happy with just implants, then after 6 months or so,  you could decide to have the nipples lifted, then it would be more accurate and a smaller lift procedure. The problem with just lifting is the lack of fullness at the cleavage and if you would like to have a rounded fuller look then you may be disappointed with a lift.  A smaller implant under the muscle along with the breast tissue you have now, would be pretty and you may love it.  So, much depends on what look you want.  When you see a plastic surgeon, he or she will measure how many centimeters your nipples are down from the clavical and if you are over 20cm you will definitely want to condider a lift at some point.  You could get an idea of how much you are down by looking in the mirror without clothing, now determine  what point is halfway between your shoulder at the boney part and the elbow with a bent arm so that you see the tip of the elbow.  If your nipples are lower than halfway then you will need a lift eventually.

Breasts continue to age, which will change the way they look a little at a time.  They will continue to lose volume and so in conclusion I would suggest you strongly consider implants, gel being my favorite, and live with it for a year before you decide on a lift.  Because they are pushed out by implants, you may only need a donut mastopexy (the scar around the aerola).  Be sure to choose a board certified plastic surgeon who is a member of ASAPS or ASPS.  Your chances are so much greater to get a great result with few or no problems.

A picure can not take the place of a physical exam.  Plastic surgeons look at the degree of "droopiness" or ptosis.  How much of your breast has fallen beneath the breast crease, and is the nipple facing forward or down?  From the picture, I think you would at least need a vertical mastopexy type lift (lollipop incision) but some patients still require the anchor type lift.  It might be difficult to get a good result just making an incision around your areola (doughnut type).

The choice of lift depends on several factors including your desire to remain the same size or larger which would require implants and place you at greater risk for sagging in the future. A lollipop (vertical) lift would allow you to reduce the excess lower fullness as well as the size of the areola whereas a minimal scar technique will not..

A breast lift or Mastopexy is designed to reposition the nipple and reshape the breast. This procedure can be combined with a breast implant which can add volume to the breast and can be utilized to shape the breast around the implant. In order to figure out exactly what you need you have to have an idea of what you want. A frontal photograph only can tell a small amount of information about your breasts, likewise measurements only give an piece of the Mastopexy puzzle. A four dimensional evaluation involves looking at breast skin quality and stretch, nipple position, existing volume and the desire for a breast implant. I would recommend that you meet with a board certified plastic surgeon, or two, and listen to what recommendations are made. There is a textbook algorithm which can provide some direction, but you already have a significant volume and good shape to your breasts, so you may be looking at a Mastopexy augmentation which would involve the placement of a conservative sized breast implant with a vertical type breast lift, or just a breast implant alone. Be careful with a periareolar lift which may lead to wide areola and scars.

I hope this helps.

Dr. Trussler

From your photos it looks like you have pseudoptosis.The simplest thing to do would;d be to put a silicone implant on top of your muscle.To do a mastopexy would entail more scars such as a donut mastopexy with a scar around the nipple.You could do a lollipop incision as well but once the scar is made you buy it.i would just consider an augmentation. 

IT is important to determine the position of the nipple in relation to the infra mammary fold underneath the breast to evaluate the amount of breast sagging or ptosis.  A full evaluation will help determine the quality of the tissues, i.e., skin elasticity and breast tissue volume. 

Equally as important is the patient`s expectations.  If repositioning of the nipple  with moderate improvement in upper breast fullness is desired, some type of breast lift or mastopexy may suffice.  If more fullness and cleavage is desired,  then a breast augmentation may be more appropriate with or without a lift to reposition the nipple.    

Hi Orlando321,

From the picture I would say you have some true ptosis because the nipple looks a little low.  As you said, can be hard to tell from pictures.  You also have ptosis of the gland itself.  Assuming in person this is correct, I would recommend a superior pedicle mastopexy with lollipop scar to reposition the nipple areolar complex.  I would also do work on the gland itself.  Usually a combination of repositioning it higher and/or plicating some of the lower pole tissue.  This is very effective for ptosis of the gland.  The most important thing is that the plastic surgeon addresses the ptosis of the gland itself (this can be done in a number of ways) and not just reposition the nipple and resect skin.  Hope this helps.

Tracy M. Pfeifer, MD, MS

If you want a  higher nipple (and maybe smaller areola) with a shorter breast fold, I would perform a LeJour lift using a lollipop scar. You could have this with or without an implant.

What Type of Breast Lift Would I Need?

I know that it is hard to tell from a picture. However, I'd like an idea on what would be done. So I am able to do more research prior to my consultations. Based on doing some of my own measurements. I think I have pseudoptosis Thanks

It is very difficult to tell exactly where your breasts sit in relation to the crease.  This is what really will determine if you need a lift and how much a lift you will need.  I would recommend a implant to gain the upper pole fullness with a minimal lift if needed, perhaps a circumareolar or circumvertical.  You may be able to get away with a projecting implant and no lift.  I would recommend seeking a board certified plastic surgeon to go over your options.