Patients considering cosmetic breast surgery often want to know whether they can avoid breast lift surgery by getting implants. For most women, the question is rooted in a deeper concern about the potential scars created by the incisions used during breast lift surgery at my Columbia practice, but they are often pleasantly surprised by the results.
Breast lift candidates typically have skin that has lost its elasticity for various reasons. Often, women who have had children and nursed their babies will lose both the volume and shape of their pre-pregnancy breasts. Other patients who have lost significant weight can also benefit from a breast lift. Implants alone can create the appearance of a breast lift in a relatively small number of patients — but in many cases, augmentation without a lift can actually exacerbate the sagging, because you are essentially adding more volume to the breasts without creating any additional support.
After consulting with a patient, I create a surgical plan that includes one of 4 techniques used for a breast lift, either with or without breast implants. Those techniques correspond to the degree of sagging present in the breasts, and the incisions vary accordingly.
Breast Lift Techniques
- Anchor Lift: This versatile approach involves 3 separate incisions (which create the anchor shape that gives the technique its name). The first incision encircles the areola. I then make a vertical incision down the midline of the breast to the crease where the breast attaches to the chest wall. Finally, a horizontal or crescent-shaped incision is made at the base of the breast. This technique provides the most support and can help even severely stretched breasts.
- Crescent Nipple Lift: The least invasive approach, the crescent nipple lift involves only the removal of a crescent-shaped flap of skin from above the nipple. Women with naturally smaller breasts and only mild sagging can benefit from this technique.
- Doughnut Lift: This is sometimes called the circle lift because I make 2 incisions in concentric circlesaround the areola and remove the doughnut-shaped skin that remains. Suturing the incisions together creates the lifted, perkier appearance that patients want. The advantage of this technique is that scars blend well with the border of the areola.
- Lollipop Lift: This technique adds a vertical incision to the doughnut lift that runs from the areola to the inframammary crease (creating a lollipop shape). The lollipop lift is needed when sagging is more significant.
What to Expect From Scarring
No matter where incisions are made, the initial results can be a bit disconcerting. Most incisions look red and swollen during the recovery. But for most patients, that initial redness and swelling naturally fades considerably during the first year after the procedure. In addition, we can recommend some excellent creams to help diminish the appearance of scars even further. We also provide instructions about how to prevent scars from becoming more noticeable, such as avoiding direct exposure to the sun.
This 43-year-old patient underwent an augmentation-mastopexy with an incisions along the outer edge of the areolae. As you can see in the “after” photo, the patient’s scars are essentially invisible.