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Breast Lift Techniques

Dr. Cook explains the different techniques available for breast lift surgery.
Jean Metzinger, Nu debout, Cubisme, 1912





John Q. Cook, M.D.

Chicago 312-751-2112
Winnetka 847-446-7562

Breast Lift Techniques for Different Breasts and Different Patient Goals

Periareolar Breast Lift Surgery

Periareolar Mastopexy with Implants | John Q. Cook, M.D. | Whole Beauty Institute

Click image to view periareolar mastopexy with implants

The periareolar breast lift achieves its effect through the removal of an oval of skin around the border of the areola. This gap is then closed with stitches, which tightens the breast skin and provides a mild breast lift. I find this technique most useful when it is combined with the placement of a breast implant. There are some patients who just want a mild lift and don’t want any scars except those around the areola. For them the periareolar 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.

There is one other aspect of the periareolar 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 I take advantage of this aspect of the periareolar mastopexy is when I am 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.

Structural Breast Lift (Structural Mastopexy)

Structural breast lift | John Q. Cook, M.D. | Chicago and Winnetka

Structural breast lift. Click on image to view in gallery.

For the reasons that I have already mentioned, the structural breast lift is my 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 lift technique addresses these issues head on. One of the most appealing aspects of the structural lift is that it re-compacts 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.

Patients are particularly pleased by the way the operation restores a degree of fullness to the upper portions of the breast in a way that still looks natural.

Vertical Breast Lift

Breast Lift | Dr. John Q. Cook | Chicago and North Shore

Vertical lift with augmentation. Click on image to view in gallery.

In my 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 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 eliminates the scar that runs along the fold under the breast.

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 lift the tone of the lower aspect of the breast is better controlled.

Classical Breast Lift (Also Known As The Anchor Lift)

Classical Breast Lift | Dr. John Q. Cook | Whole Beauty Institute

Classical breast lift with reduction. Click on image to view in gallery.

The classical breast lift operation is a good alternative for some patients, although I use it much less frequently than I 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 a tailor, the surgeon takes 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 areolar are moved to a higher position on this tightened breast. Many very good plastic surgeons use this technique, although I have noticed a trend toward an increasing number of vertical lifts.

There are some patients for whom I recommend variations of the classical 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.

Patients Are Best Served When the Surgeon Can Offer a Variety of Breast Lift Techniques

As I mentioned in the introduction to the breast lift section of this website, patients come to the Whole Beauty® Breast Center for breast lifts with a variety of goals. It makes sense that I should be able to offer them a wide range of choices for their surgery, so that together we can achieve a solution to each patient’s problem that is truly individualized.

Collateral Benefits of Breast Lift Surgery

There are a number of potential benefits that occur with breast lift surgery that go beyond the considerable artistic improvements that a well-performed mastopexy provides. When breasts are significantly settled body mechanics are impacted. Certain types of exercise become uncomfortable and there may even be contributions 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 can be very uncomfortable in their own right, especially as the day progresses.

Many of my breast lift patients tell me that their physical comfort and freedom of motion are increased after the surgery. The correction of severely settled breasts can also remove a blockage 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 become a source of frustration and cause people to slip away from their good habits.

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. 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.

How Different Breast Lift Techniques Affect Breast Shape

The different methods of breast lift surgery have different effects on the shape and structure of the breasts.

  1. The periareolar breast lift

  2. 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 lift can be especially helpful to a woman with pointed breasts who wants to diminish their projection and round out breast shape.
  3. The classical or anchor breast lift

  4. 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 I 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.
  5. The structural mastopexy

  6. 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.

Schedule A Consultation Today

Dr. John Q. Cook is an experienced breast surgeon who has helped many women achieve beautiful, natural-looking results with breast lift surgery. If you are considering breast lift surgery, we encourage you to contact the Whole Beauty® Institute today to schedule a consultation. Call our practice in Chicago at 312-751-2112  or in Winnetka at 847-446-7562.