Dr. John Q. Cook is a respected Chicago breast lift surgeon with more than 20 years of experience.
Why Dr. John Q. Cook Is the Right Breast Surgeon for You
Breast Lift is one of Dr. Cook’s favorite procedures. Having developed the Structural Breast Lift Technique, which is based on the work of an Italian Plastic Surgeon, his patients can obtain lift as well as create a pleasing breast shape without implants.
Dr. Cook has lectured about the Structural Breast Lift Technique at national and international meetings and offers an extensive portfolio of breast lift techniques that he can apply on an individualized basis.
For every patient, Dr. Cook performs a detailed analysis based on your unique goals and what he finds during the physical exam. His overall goal for all patients is to improve the artistic balance of the body, but also improve body mechanics.
The three main advantages of the Structural Technique: Use of your own tissue to restore volume to the upper portion of the breast (no implants). Anchoring at several levels so that the stretched-out skin does not have to do all the work of lifting. Minimizing scars when compared to many conventional operations.
Education and Credentials
Awards and Recognition
REAL PATIENT RESULTS
See the difference experience makes. View the full before & after photo gallery of Dr. Cook and his team.
Restore Tone, Structure, and Position with Mastopexy in Chicago and WinnetkaAs a result of pregnancy, weight loss, or simply the passage of time, many women find that their breasts settle to a low position and lose their natural fullness. Often, the upper portion of the breast looks hollow or emptied out. Dr. John Q. Cook has in-depth experience with a wide range of techniques for breast lifts to address these specific problems at his Chicago practice. Dr. Cook even developed a breast lift technique: the structural breast lift, which limits scarring, provides a look of fullness from re-arranged natural breast tissue, and includes deep structural anchoring for a better lifting effect than skin-tightening procedures.
Why Do Women Choose Breast Lift Surgery?Known technically as mastopexy, the surgery balances the breasts and restores them to a higher position on the chest. In addition, there are a number of potential benefits that occur with breast lift surgery that go beyond the considerable artistic improvements a wellperformed mastopexy provides. Patients seek out a breast lift operation in Chicago for one or more common reasons. When breasts are significantly settled, the drooping impacts body mechanics. Certain types of exercise become uncomfortable, and the problem may even contribute to back pain. This is particularly true if the breasts are asymmetric. It is possible to compensate for this with aggressive support bras, but these undergarments can be very uncomfortable in their own right—especially as the day progresses. For some patients, the tight, restricting bras that are necessary to lift and properly support the breast are uncomfortable. Many of Dr. Cook’s breast lift patients tell him that their physical comfort and freedom of motion increase after the surgery. The correction of severely settled breasts can also remove a “roadblock” to maintaining excellent habits of nutrition and exercise. Patients can become frustrated when an area of the body does not respond well to a program of diet and exercise. Over time, this lack of response can cause people to slip away from their good habits.
Dr. Cook has seen patients who, after years of not taking care of themselves, restore their health and well-being through a positive program of nutrition, exercise, and stress reduction. Some of these patients tell him that by restoring a beautiful breast shape with a breast lift, they are celebrating their new body. If you feel good about how you look, you are more motivated to invest the time and energy to maintain your good appearance. The restoration of the breasts to a beautiful form and proper position can initiate a positive feedback cycle.
Some breast lift patients tell Dr. Cook that it is mainly a matter of returning their breasts to the beautiful shape they used to have. Others say the key issue is a lack of fullness in the upper portion of the breast, which restricts their choice of clothing and swimsuits. There are also women who find that as their breasts settle, they become increasingly asymmetric and unbalanced—or their breasts have been settled ever since they first developed. These patients may become self-conscious about their breasts, and their breast position can even have an effect on their posture and back comfort.
Breast lift surgery after pregnancy and breastfeeding deserves particular mention. Women make tremendous sacrifices in the process of bringing children into the world (not to mention what comes after). Sometimes, a woman who spent years keeping herself in optimum physical form and health will feel that pregnancy has played a bit of a cruel joke on her. Here she has done all of the right things and the result is a loss of what gave her great pleasure: the beautiful appearance of her breasts. For this woman, a breast lift can be a positive affirmation of her sensuality.
Each patient’s reason for choosing a breast lift is personal. Dr. Cook takes both motivations and goals into account when developing a customized plan.
But what causes breasts to lose their structure and tone in the first place, leading them to droop over time? The mechanical stretching of the breast structure that occurs with significant life events—such as pregnancy, breastfeeding, and weight loss—often loosens the breast’s internal support and stretches the skin as well. For some breast surgery patients, this is accompanied by a loss of breast volume.
What Causes Breasts to Lose their Structure?
The most common reason patients come Dr. Cook for breast lift surgery is to restore a pleasing breast shape after pregnancy and breastfeeding a baby. Dr. Cook recommends that his patients hold off on breast lift surgery until they are reasonably certain that they are not going to have any more children. If a patient becomes pregnant after she has had a breast lift, the breasts will typically go through the normal cycle of pregnancy, but the lift may have to be repeated in order to restore the desired breast shape.
Significant Weight Loss
Dr. Cook sees an increasing number of patients who seek him out to restore the tone of their breasts after major weight loss. These patients frequently have a very significant loss of breast volume, so that he may recommend the use of breast implants or fat grafting along with the lift to restore the internal breast structure. The structural breast lift technique allows him to rearrange the breast structure so that, in some patients, he is able to return enough volume to the upper portion of the breast with natural breast tissue that he can avoid the use of implants.
Gravity and Hormonal Changes
Even without pregnancy and weight loss, most breasts will settle over time because of the effect of gravity and changes in the hormonal environment. To a degree, supportive bras will help to delay this process. There is a wide variation from one person to another in the structure of collagen and other molecules that make up the support of our bodies. This variation is one of the reasons that some breast lift patients will come in after experiencing significant breast settling in their 20s, while others will still have a tight breast structure in their 50s and 60s.
Some patients experience severe drooping of the breasts from the time the breasts begin to develop. Plastic surgeons refer to this as congenital breast ptosis. There may be other changes with this type of breast, such as a restriction of the breast base or herniation of breast structure through the areola. Various names are attached to these changes, such as Poland’s Syndrome and constricted breast syndrome. In general, patients who experience this breast shape in their high school years tend to be very self-conscious. For these patients, corrective surgery can be a wonderfully liberating experience. Many will need a combination of implants, some type of breast lift, and other advanced techniques to get the best possible breast shape.
Large, Weighty Implants
If a large breast implant is placed beneath a breast that has already developed significant drooping, the device may provide a bit of a temporary breast lift, but the breast will eventually droop even more due to the weight of the implant pulling it downward. Dr. Cook sees a good number of these patients every year. His solution is to reduce the size of the implant and carry out a breast lift, sometimes in combination with other techniques.
What Are the Breast Lift Options?
Since patients come to the Whole Beauty® Institute for breast lifts 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 each patient to achieve a truly individualized solution to her unique problem.
With that in mind, there are several breast lift techniques to choose from, with different breasts and patient goals in mind.
Periareolar Breast Lift Surgery (Donut)
This operation 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.
This breast lift technique is well-suited to patients with smaller to midsize breasts that have developed a mild degree of settling after pregnancy or weight loss. The result is often enhanced by the placement of a saline or silicone gel breast implant in the plane that is appropriate for that patient’s needs (under the breast or under the breast and the pectoral muscle).
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.
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.
Structural Breast Lift (Structural Mastopexy)
The structural breast lift is Dr. Cook’s preferred breast lift technique. As breasts droop, they tend to spread out and lose their structure. A breast that was once firm and beautifully shaped becomes wide, hollow, and settled. Because of the lack of underlying structure, the skin of the ptotic breast also loses its tone.
The structural mastopexy addresses these issues head on. One of the most appealing aspects of the structural breast lift is that it recompacts the breast structure. It is also possible to narrow the base of the breast to a degree and raise the level of the fold under the breast, which is difficult to accomplish with other techniques.
The structural breast lift is close in technique to the vertical breast lift, but there are some important differences. Rather than going straight down to the fold, the scar curves in its lower portion toward the outer aspect of the breast. This eliminates the bunching seen at the lower end of a vertical mastopexy. More important, this breast lift pattern provides Dr. Cook with an unprecedented ability to sculpt and narrow the base of the breast.
The structural technique provides a multi-level anchoring of the breast in its new position. This is a significant feature, since breast lift techniques that merely tighten the skin tend to settle and stretch. The technique involves a structural rearrangement of the breast tissue to replenish upper pole volume. In many cases, this allows Dr. Cook to avoid using a breast implant to fill out the upper portions of the breast with a breast lift.
Patients are particularly pleased by the way this breast lift operation restores a degree of fullness to the upper portions of the breast in a way that still looks natural.
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. The resultant scar to some people resembles a lollipop, hence the term “lollipop breast lift.”
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.
In Dr. Cook’s practice, the vertical breast lift was a predecessor to the structural breast lift. Most variations of this operation do not provide as powerful an anchoring of the breast tissue as the structural operation accomplishes.
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.
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 a breast implant 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.
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.
If you are considering breast lift surgery, the first decision you need to make is whether a breast lift alone will satisfy your goals or whether you need to add volume with implants. Are you reasonably happy with the shape of your breasts when they are supported by an uplifting bra without padding? If so, a breast lift without implants may very well achieve your goals.
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.
How Do the Different Breast Lift Techniques Affect Breast Shape?
The periareolar breast lift provides a mild lifting of the breast structure and diminishes the projection of the central portion of the breast underneath the nipple and areola. The ideal patient for this operation is a woman who desires a mild naturalistic lift and who is not overly concerned with volume in the upper portions of the breast, particularly if she places a high priority on minimizing scars. This breast lift can be especially helpful to a woman with pointed breasts who wants to diminish their projection and round out breast shape.
The classical or anchor breast lift is helpful to patients with a great degree of loose hanging skin in the lower portions of the breast. This often occurs in patients who have lost very large amounts of weight, but Dr. Cook sometimes see this problem in patients who have undergone several pregnancies. There are limits in terms of restoring volume to the upper portions of the breast.
The structural mastopexy offers the greatest ability to control breast shape. It is particularly helpful for patients who want to restore fullness in the upper portions of the breasts, especially if they want to avoid breast implants. It also provides a good restoration of a firm breast structure. Some breasts tend to get spread out over time with a widening of the breast base and a tendency to spill over the side of the chest. The structural mastopexy technique can help to address these problems.
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.
What Are the Advantages of Structural Mastopexy?
Patients who come to Whole Beauty® Institute for breast rejuvenation or modification of breast size benefit from Dr. Cook’s development of the structural mastopexy technique. He has offered the breast lift variation to his patients for many years. The technique addresses in a powerful way the concerns his patients have about breast position, breast shape, and breast volume distribution.
What Changes Can a Structural Mastopexy Address?
Breasts change predictably as a woman ages. These changes may be amplified by pregnancy, breastfeeding, and significant weight loss.
- The lower portion of the breast settles and overhangs the skin that sits beneath the lower edge of the breast.
- The nipples descend, so that there is a long visual distance between the collar bone and the breast.
- As the breast structure descends, the upper part of the breast loses its natural fullness.
- The breast loses its internal support, so the breast loses its projection and tends to spread out.
- As the breast settles, the skin of the lower portion of the breast is stretched out.
What Are the Goals of Structural Breast Lift Surgery?
The goals of structural mastopexy are essentially the reversal of the changes that have occurred with the aging process.
- Restore the breast to where it used to be.
- What Dr. Cook calls a recompation of the breast structure. In other words, take a breast that has been spread out and make it firm again.
- Bring the nipples back to a higher position and reduce the size of the areolae if they have been stretched out.
- Restore a pleasing volume balance to the breasts so that there is a nice fullness in the upper portions of the breast.
- As much as possible, produce results that last a good long time.
For the beast lift surgery, Dr. Cook repositions a portion of the breast tissue to the upper part of the breast in order to replace the volume that has been lost in this important area. Because of this, he is much less likely to use breast implants with the lift. Of course, if a patient wants more volume, he can provide it as desired.
Dr. Cook provides the breast with deep structural anchoring at several levels, so that there is internal stabilization of the breast structure. In his opinion, this provides a much stronger lift that can be accomplished with a breast light that only tightens of the skin.
Scars are limited, especially in comparison the classical breast lift, which has a very long scar that runs along the fold under the breast. Most experienced breast surgeons will tell you that it is this lower scar that is most likely to heal in a less than ideal way. If this scar can be avoided, especially in the inner portion of the breast, it is highly desirable to do so.
Structural Mastopexy FAQs
Dr. Cook commonly hears certain questions during his consultations for structural mastopexy surgery:
Where is the breast lift surgery performed?
Dr. Cook performs the surgery at a high-quality private surgery center near his Gold Coast office. The surgery is performed with the breast lift patient under a light anesthetic that generally does not require full intubation (breathing tube through the vocal cords).
What is the recovery like after a structural breast lift?
Dr. Cook makes generous use of a long-acting local anesthetic, so most patients awaken with a reasonable degree of comfort. If structural mastopexy is combined with breast implants, your discomfort will be a little more for the first few days, but it is easily managed with common pain pills and a medication that relaxes the pectoral muscle. You will be protected by a supportive dressing for the first few days after surgery. Most patients return to see us three or four days after surgery, at which time we remove the dressing and provide a gentle support bra. Most patients are able to return to work four to five days after surgery.
What are the restrictions on my activity after breast lift surgery?
Patients can return to normal light activity as soon as they are comfortable. We encourage moderate amounts of light exercise during the recovery, but it is important for the patient to avoid heavy exercise for four to six weeks. Dr. Cook and his team will provide specific guidelines for athletes about when it is OK to return to specific activities of their sport.
Does the breast lift surgery affect breastfeeding?
All forms of breast lift and breast reduction carry the possibility of interfering with breastfeeding. Dr. Cook and his team will discuss this with you in specific detail at the time of your consultation.
What are the effects of structural breast lift on mammograms?
Dr. Cook recommends that your breasts be imaged at a high-quality mammographic center. Mammographic changes can occur after all forms of breast lift and breast reduction, but—in general—the changes are distinguishable from those that suggest breast cancer.
Is this breast lift surgery covered by insurance?
A breast lift (mastopexy) is almost never covered by insurance. Insurance companies are generally more restrictive about coverage of breast reduction than they were in the past, and the degree of restriction increases with each year. The Whole Beauty® Institute team has extensive experience with breast reduction surgery, and if we think there is a chance of coverage, we will work with you in the process known as predetermination. In this process, we submit information as to why this should be a medically indicated procedure.
What are the risks of this breast lift surgery?
Complications after this procedure are relatively uncommon and are similar to those encountered with other forms of breast reduction and breast lift. These include a collection of tissue fluid or blood (seroma or hematoma) that requires drainage, less than ideal scars, interruption of circulation to the nipple, disruption of sensation, and poor healing along the incisions. The risk of these complications diminishes significantly if you follow our pre- and postoperative instructions to the letter.
Is the structural mastopexy technique applicable to all breasts?
Dr. Cook has extensive experience with all major techniques of breast surgery, including breast lifts. The majority of patients who come to us in consultation are good candidates for the structural technique. Some patients with massively enlarged breasts or with extreme stretching of the skin will require different techniques. Dr. Cook will make this determination during your consultation.
What Are Other General Breast Lift Surgery Details?
If the breast lift is part of a reconstructive procedure, the surgery will be performed on an outpatient basis at either Rush University Medical Center or at a private surgicenter a few blocks from our North Michigan Avenue office. If the breast lift is for aesthetic or cosmetic reasons, the surgery is usually performed at the surgicenter. Depending on its complexity, the surgery will take from two to five hours.
Most patients are able to leave the surgical facility in less than an hour after the breast lift procedure is completed. Patients from the Chicago metropolitan area usually choose to recover at home. Patients from out-of-state will recover at a fine hotel near our office. We can arrange to have one of our highly-experienced caregivers stay with you for one or several nights.
What Happens After a Breast Lift?
Dr. Cook makes use of a long-acting local anesthetic, so pain is well controlled with standard prescription pain medications for most patients. In general, if a breast implant is part of the procedure, there will be a greater degree of discomfort in the first few days after breast lift surgery.
For some patients, the pain pump device, which provides a controlled infusion of a local anesthetic, can be helpful for the first 72 hours after surgery.
The breasts are protected by a fluffy dressing that is covered by a gentle stretch bra in the days following surgery.
Breast lift patients typically come for their first post-operative visit at either our Chicago or Winnetka facilities three or four days after their surgery. At that time, the dressing is removed, and the patient is fitted with a gentle support brassiere.
Most patients can return to normal light activity in less than a week after the procedure, but heavy lifting and vigorous exercise should be avoided for four to six weeks. Patients with young children should make arrangements for help with child care for the early weeks after surgery. We can provide each patient with specific recommendations that depend on the extent of her procedure.
What Other Breast Surgery and Related Options Are Available at Whole Beauty™ Institute?
For some patients who have lost significant breast volume, the breast lift procedure is combined with the placement of implants. This is known as a breast augmentation with lift.
Patients who have experienced a loss of tone in the abdomen along with the breasts often opt for a procedure in which the breast lift and an abdominoplasty (tummy tuck) are carried out in a single operation.
Many related procedures can be combined into a Mommy Makeover, ideal for mothers who are done having children and who want to regain their pre-baby proportions and contours.
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