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 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. A true Benelli actually will expose much of the breast through this incision and then the breast itself is shaped and lifted with sutures. This is a more complex procedure and is often not done as describe by Dr. Benelli. 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 In the end it will be best to discuss all options based on your desired final results with your plastic surgeon in consultation. Then, the decision as to the procedure that will be best for you is up to you in the end. Good luck.