Breast Lift – Breast Lift Procedures

Augmentation alone

Depending on the size of the implant used, it can correct breast sag when the nipple is at least at the level of the IMF or above. If the nipple is lower than the IMF, then some form of lift will most likely be necessary. This is somewhat of a controversial topic, therefore, it is important that you are as educated as much as possible so that you can have done what is best for you. It is controversial because you must weigh the advantages of a properly positioned nipple versus a scar that goes completely around the areola. This is a decision that you and your plastic surgeon must make together. Hopefully, this has helped. (One caveat, if you are on the fence about whether or not you want to have a lift you can take some solace in knowing that it can be done later. If, after the augmentation, you are not happy with your nipple/areola location it can be done as a secondary procedure usually under local anesthesia).

If your nipples are at the level of the breast fold or above you are an excellent candidate for a breast augmentation. This will elevate the nipples, fill the upper breast, and increase cleavage without a visible scar.

Frontal view of a 38 year-old woman with minimal breast sag. After shows significant improvement with implant alone.

Lateral view of same patient. Notice the dramatic improvement of nipple positioning and breast fullness.

Peri-areolar breast lift

The peri-areolar breast lift is also know as a Donut Mastopexy or a Benneli Mastopexy. This type of breast lift is best when the nipples are no lower than 2 cm. below breast fold.This procedure involves excising the appropriate amount of breast tissue around the areola so that the nipple/areola are positioned on top of the breast mound. This procedure creates a small amount of rippling at the incision but this usually goes away within a year or less.

The ‘Donut’ breast lift is most useful for women whose nipples are no more than 2 cm. below the breast fold and in conjunction with an implant.

Example of incisions of
Peri-areolar (Donut) breast lift.

Of note, women with a significant amount of natural breast tissue usually require a more aggressive lift than women who have little breast tissue-even if the nipples are at the same level. This is part of the art that goes into breast lifting and this is why it is imperative to have an experienced board certified plastic surgeon performing the surgery.

Frontal view of a 38 year-old woman with minimal breast sag. After shows significant improvement with implant alone.

Lateral view of same patient. Notice the dramatic improvement of nipple positioning and breast fullness.

The ‘lollipop’ breast lift is best when the nipple is greater than 2 cm but less than 4cm below the IMF.

When the nipple descends greater than 2 cm below the IMF it is often necessary to incorporate a vertical incision in order to take up the additional skin that must be removed. This creates a much more attractive, round, full shape within the lower breast.

Frontal view of a 38 year-old woman with minimal breast sag. After shows significant improvement with implant alone.

Lateral view of same patient. Notice the dramatic improvement of nipple positioning and breast fullness.

Many variables determine when this horizontal incision becomes necessary.

When the skin excess is greater than the vertical incision can take up, it is necessary to remove the rest via a transverse incision. Sometimes even the plastic surgeon is not sure whether it is necessary until he begins to operate. The length of the horizontal incision is, once again, determined by the amount of redundant skin.

Here is an example of the classic breast lift incision. This incision is way too long and is not necessary when performed with an augmentation by a skilled plastic surgeon.

An “Anchor” breast lift is usually necessary when nipples have descended 4 cm or more.

This woman has a significant amount of natural breast tissue as well as significant sag with nipples pointing almost directly downward.

Lateral view shows repositioning of nipples back on top of breast cone. Also notice dramatic improvement of breast shape with a more rounded, youthful lower breast.