Breast Lift

Breast Lift

Enhance the Shape, Contour, and Position of the Breasts with Mastopexy in Chicago and Winnetka

Aging, pregnancy, and other factors can cause the breasts to descend over time to a lower position on the chest wall. Happily, there’s an effective way to address this sagging while restoring a more youthful shape and position of the breasts. A breast lift at the Chicago-based practice of Dr. John Q. Cook can restore a perkier, more aesthetically pleasing shape to the breasts and restore volume to the upper portion of the breasts.

Breast Lifts Options for Patients

Patients come to the Whole Beauty^® Institute for breast lift surgery with a variety of goals, Dr. Cook believes it is important to offer a wide range of choices for the surgery. That way, he can work with individual patients to achieve a truly individualized solution to each unique problem.

With that in mind, there are several advanced breast lift techniques to choose from, each focusing on different breasts and patient goals. Dr. Cook will choose the most appropriate technique for you based on your breast size and shape, the level of sagging you are experiencing, your skin elasticity and quality, and the size and position of the areolas, as well as other factors.

Consider all of this, you may be wondering, “What are the different techniques for a breast lift?” or “What are the different types of breast lifts?”

Structural Breast Lift (Structural Mastopexy)

This is Dr. Cook’s prefered technique for breast lift surgery given the many advantages it offers patients. The structural mastopexy technique allows for a rearrangement of breast structure so that the upper part of the breast is filled with natural breast tissue. With this breast lift operation, the scar runs around the areola, down toward the fold, then curves off to the side along the undersurface of the breast. 

Before and after of Structural Breast Lift with no implants.

Classical Breast Lift (Anchor)

For patients who have severely settled breasts, the classical operation may offer significant benefit. As with the other types of breast lifts, this surgery may be combined with breast implants to provide better upper pole structure and increased volume.

For many years, this was the dominant breast lift technique in the United States—and still is probably the most commonly performed technique for breast lift. Essentially, the skin is used as a brassiere to lift the breast by removing excess skin from along the fold under the breast, as well as around the areola and along a line that runs from the fold under the breast to the bottom edge of the areola. This produces a scar that somewhat looks like an anchor.

The classical breast lift operation is a good alternative for some patients, although Dr. Cook now uses it much less frequently than he did in the past. It has two main disadvantages: relatively long scars along the fold under the breast and its reliance on tightening the skin as the main mechanism for lifting the breast. With this operation, the skin is tightened in vertical and horizontal directions.

Like tailoring an outfit, this breast lift surgery involves taking a vertical “dart” by removing a segment of skin in the midline of the breast and a horizontal “dart” by removing skin along the fold under the breast. The nipple and areola are moved to a higher position on this tightened breast. Many very good plastic surgeons use this breast lift technique, although Dr. Cook has noticed a trend toward an increasing number of vertical lifts.

Before and after of Classical Breast Lift combined with High Lateral Tummy Tuck.

There are some patients for whom Dr. Cook recommends variations of the classical breast lift. In patients with an extreme degree of looseness of the skin, such as might occur with massive weight loss, the combined horizontal and vertical tightening can be of benefit—even though it means accepting the scar along the fold in the inner portion of the breast.

Another possible variation is adding volume at the same time as achieving a breast lift. For many years, breast lift surgery in the United States consisted of a tightening of the skin. Over the short term, this will lift the breast structure, but skin-lifting techniques have three disadvantages: People who need breast lifts often have stretchy skin, so the breast tends to stretch again; the only lift is at the skin level, so there is no deeper support of the breast structure; and, very often, the area of the breast that is most in need of volume is the upper portion of the breast. This is the first area to hollow out after a skin lift, since the breast structure descends as the lower curve of the breast stretches out again.

Because of these issues, many surgeons routinely use breast implants with their breast lifts so the device will partially compensate for the limitations of breast lift surgery by keeping some fullness in the upper pole.

Here is a simple visual test that will help you determine the best option for your situation: Stand in front of a mirror and look at your unsupported breasts from several angles. Next, gently push your breast upward with one hand so that it no longer hangs over the fold. Look at the supported breast from several angles. If you think that the breast seems to be reasonably full, then a breast lift without implants may work well for you.

Vertical Breast Lift (Lollipop)

This breast lift procedure was developed largely in France and Brazil. American surgeons were reluctant to accept it, but the technique has become much more popular in recent years.

Skin is tightened along a vertical line that runs from below the areola to the lower portion of the breast. A circle of skin is removed from around the areola and skin is also removed from the midline of the lower breast. The resultant scar to some people resembles a lollipop, hence the term “lollipop breast lift.”

Before and after of Vertical Breast Lift with submuscular breast implants.

This technique tends to create a bunching up at the bottom end of the scar. This is either allowed to “settle in,” or a circle of skin is removed and tightened down with a purse string suture. What confuses many patients is that the scar is only part of the procedure. Sometimes the breast lift just consists of skin removal, in which the procedure is conceptually similar to the classical mastopexy—using skin to lift the breast. Sometimes internal work is done on the breast to provide reinforcement of the lift. If you are considering this type of lift, make sure you understand what is being done beneath the surface.

Vertical breast lifts also do not typically allow for an effective restoration of volume in the upper portion of the breast. The appeal of the vertical lift is that it largely avoids the scar that runs along the fold under the breast.

In one variant of this breast lift operation, Dr. Cook can utilize a portion of the breast structure to restore volume in the upper pole of the breast. In select patients, this can allow for the restoration of a pleasing breast form without the use of implants. With more significant loss of upper pole structure or with patients who desire an increase in breast volume, a saline or silicone gel implant can be used as part of the breast lift procedure.

With greater degrees of lifting, there may be the disadvantage of a puckering of tissue at the lower end of the vertical scar. With the structural breast lift, the tone of the lower aspect of the breast is better controlled.

Periareolar Breast Lift Surgery (Donut)

This technique for breast lifts is appealing in concept because it limits the scar to a line that runs around the border of the areola. The idea is to remove an oval shaped area of skin from around the areola so that when the skin at the edge of the oval is sewed to the smaller circle formed by the areola, a tightening and lifting will occur. The big problem with this breast lift technique was that the scars tended to spread because of tension.

Dr. Louis Benelli of Paris made a wonderful breast lift contribution when he suggested weaving a purse-string suture under the skin at the border of the oval. When this is tightened and a knot is placed, it brings the big oval down to the size of the smaller circle, so that healing can occur without excessive tension.

There are some patients who just want a mild breast lift result and don’t want any scars except those around the areola. For them, the periareolar breast lift can be a reasonable option. It is possible to extend the power of this operation with a wider undermining of the skin and a tightening of the breast structure in the lower portion of the breast, but even then the operation is not as powerful as other types of breast lift. For some patients, the power of this approach can be enhanced with the BodyTite^® procedure.

Before and after of Periareolar Breast Lift with breast implants.

It is important to realize that this technique does not provide a powerful lift.

There is one other aspect of the periareolar breast lift that deserves mention: In breasts that have an overly pointed shape, the operation naturally diminishes the projection of the central part of the breast and rounds out the breast shape. For some patients, this is a significant benefit. One situation where Dr. Cook takes advantage of this aspect of the periareolar mastopexy is when he is trying to match the shape of a reconstructed breast by sculpting the opposite natural breast, since a reconstructed breast does not project as much as a natural breast.

In Dr. Cook’s experience, this breast lift technique provides a reasonable degree of long-term satisfaction when the breast is not too large and where an extremely powerful lift is not desired.

Frequently Asked Questions about Breast Lift Surgery

Why Choose Dr. John Q. Cook for Breast Lift?

As an experienced breast surgeon who has helped many women achieve beautiful, natural-looking results with breast lift surgery, I have a wide range of mastopexy techniques at my disposal. During your breast lift consultation at my Chicago or Winnetka center, I will carry out an in-depth evaluation in order to advise you as to which technique is most appropriate for your needs. I will obtain a sense of your preference for breast shape and volume and also pay careful attention to your habits of exercise and weight fluctuation, all of which may affect the surgical outcome.

I refined my techniques of mastopexy in the demanding field of breast reconstruction, where the surgeon must often sculpt, lift, or modify the shape of the natural breast in order to obtain a pleasing harmony with the reconstructed breast.

Early in my career, I recognized the potential for innovative techniques that were developed by colleagues in Europe and South America, which allowed for shorter scars than the traditional breast lift procedure that was practiced in the United States. From a conceptual standpoint, these procedures also had an advantage of relying on more than the skin to lift the breast. In general, these techniques rely upon an internal tightening of the breast structure to provide and maintain the power of the lift.

The breast lift surgeries that I perform for patients at my Chicago and Winnetka centers have a variety of components that can be customized to each individual’s needs. From the patient’s perspective, they can be viewed according to the location of the external scar.

In the periareolar mastopexy, the scar is confined to the border of the areola. This technique is often combined with the placement of an implant and with modification of the breast structure to enhance internal support.

The vertical mastopexy involves a scar around the areola, as well as a vertical extension from the lower border of the areola to the fold under the breast.

The structural mastopexy technique—my preferred choice—allows for a rearrangement of breast structure so that the upper part of the breast is filled with natural breast tissue. With this breast lift operation, the scar runs around the areola, down toward the fold, then curves off to the side along the undersurface of the breast.

The classical mastopexy involves a scar along the fold under the breast as well as a vertical and periareolar component.

Alternative or Combination Procedures to Enhance the Breasts

Dr. John Q. Cook  and the Whole Beauty^® Institute offer a complete range of breast-related cosmetic surgeries. A breast lift on its own will not significantly increse the size of the breasts. Breast augmentation with breast implants and fat transfer adds volume and fullness to increase the size of the breasts. A breast reduction reduces volume from the breasts to improve their appearance, balance, and body mechanics.

A breast augmentation with lift is an option for some patients who wish restore lift and increase the breast size. The procedure can address sagging or stretched skin while also adding volume.

If you are concerned about sagging or loss of volume in the breasts but also want to correct sagging skin, resistant fat, or weakened muscles on the abdomen, a breast lift can be performed at the same time as a tummy tuck.

A Mommy Makeover is a combination procedure of a breast lift and a tummy tuck. This procedure addresses sagging or loss of volume in the breasts and corrects sagging skin, resistant fat, or weakened muscles on the abdomen. For some patients it may also include liposuction to reduce stubborn fat.