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Structural Mastopexy

A technique developed by Dr. Cook which restores tone, postion, and fullness to the breast.





John Q. Cook, M.D.

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

The Structural Mastopexy Technique

Limited Scars, Stronger Lift, and A Natural Creation of Upper Breast Volume


Structural mastopexy with limited scar and enhanced upper pole volume without implants.

Patients who come to us for breast rejuvenation or modification of breast size benefit from the structural technique of breast surgery. Dr. Cook developed the structural mastopexy technique and has offered it to his patients for the past 5 years. This technique addresses in a powerful way the concerns our patients have about breast position, breast shape and breast volume distribution.

Changes That Occur In The Breasts Over Time

Breasts change predictably over time. These changes may be amplified by pregnancy, breast feeding, and significant weight loss.

  1. The lower portion of the breast settles and overhangs the skin that sits beneath the lower edge of the breast.
  2. The nipples descend, so that there is a long visual distance between the collar bone and the breast.
  3. As the breast structure descends, the upper part of the breast loses its natural fullness.
  4. The breast loses its internal support, so the breast loses its projection and tends to spread out.
  5. As the breast settles, the skin of the lower portion of the breast is stretched out.

The Goals Of Breast Lift Surgery

The goals of breast lift surgery are essentially the reversal of the changes that have occurred with the aging process:

  1. Restore the Breast to where it used to be.
  2. What I call a recompation of the breast structure. In other words, take a breast that has been spread out and make it firm again.
  3. Bring the nipples back to a higher position and reduce the size of the areolae it they have been stretched out.
  4. Restore a pleasing volume balance to the breasts so that there is a nice fullness in the upper portions of the breast.
  5. As much as possible produce results that last a good long time.

Structural Mastopexy – Restoration of breast structure without implants

The Types of Breast Lifts Currently Performed In The United States and The Role of Structural Mastopexy

Classical Breast Lift – Sometimes Referred To As The Anchor Lift Due To The Scar

For many years this was the dominant 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 when the surgeon removes 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.

Periareolar Breast Lift – Sometimes Called “Donut” Or Benelli Lift

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 technique was that the scars tended to spread because of tension. Dr. Louis Benelli of Paris made a wonderful 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. You can only do a limited lift with this technique. I find it most useful for the patient who desires a small lift in combination with breast implants.

Vertical Mastopexy – Sometimes Called The “Lollipop” Procedure

This 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.” There tends to be a bunching up at the bottom end of the scar. Either this is 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 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.

Structural Mastopexy and Other Forms of Structural Breast Surgery


Structural Mastopexy with Augmentation (Silicone Gel Implant). Click image to enlarge.

Of the types of breast surgery already discussed the structural breast lift is closest to the vertical breast lift, but there are 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 pattern provides the surgeon with an unprecedented ability to sculpt and narrow the base of the breast.


Structural Mastopexy with Augmentation (Silicone Gel Implant). Click image to enlarge.

The structural technique provides a multi-level anchoring of the breast in its new position. This is a significant feature, since lifting techniques that merely tighten the skin tend to settle and stretch. The technique allows for a structural rearrangement of the breast tissue with a replenishment of upper pole volume with breast tissue. This allows the surgeon in many cases to avoid using a breast implant to fill out the upper portions of the breast with a lift.

Contact John Q. Cook, M.D. at Whole Beauty® Institute

For more information or to schedule a consultation with our plastic surgeon, please contact Whole Beauty® Institute.