Breast Lift

Breast Lift Surgery – How I like to do it


Photos – Crescent Lift + Saline Implants – 350cc Left & 375cc Right changing cup size A to full C

Breast Lift surgery should really be thought of as breast contouring. This procedure will tighten loose skin, raise and reduce the size of the nipple and areola and add projection outward to the breast. When you are evaluated, I will discuss whether you would benefit from a Breast Lift, if a Breast Implant would improve your shape and if any other breast procedure might enhance your result?

Listed below is my overview for determining a lifting technique.

To determine if a Breast Lift is needed, I will ask you the following questions:

  • Do you wish to be larger or stay near your current cup size?
  • Do you desire more projection outward and more fullness up top?
  • Are you willing to accept visible scars as a trade off for a better shape?

Did you know that a breast lift will not move your breast from a low, hanging position to a very high position?

Next, I’ll examine your breasts for the following

  • Is your distance from the base of neck to the nipple appropriate for an implant alone? Normally this is 17-21 centimeters.
  • Is your nipple positioned in the center and fullest part of the mound? Normally this is 7.5 to 8 centimeters from the breast fold.
  • Is your nipple pointing downward or below the line of the breast fold?
  • Is one nipple positioned lower than the other side?
  • Are your breasts symmetrical in size?

Measure Your Breasts and Match Them to the Following Lifts

Take a ruler and measure in centimeters the distance from the lowest point of the groove (sternal notch) at the base of your neck to the middle of your nipple on each side.


If you don’t have a centimeter ruler 1 inch = 2.5 centimeters.

Submuscular Breast Augmentation Only

If your sternal notch to nipple distance is between 17 – 21 centimeters:

  • You do not need a Breast Lift, unless all of your breast tissue has sagged to the bottom

Subglandular Breast Augmentation Only

If your sternal notch to nipple distance is 22 – 23 centimeters:

  • And you are not too thin
  • Your nipple is centered properly and you have very little loose skin

Then a Subglandular (on top the muscle) will shape you the best

Crescent Lift with Breast Implants

If your sternal notch to nipple distance is around 22 – 23 centimeters:

  • But your nipple position is pointing downward
  • And you have very little loose skin

Then you should have a Crescent Lift with a Breast Augmentation

Vertical Mastopexy or Anchor Incision “No” Implants

If your sternal notch to nipple distance is 24 centimeters or lower:

  • Your breast mound flat
  • And you don’t want bigger breasts

Then you will need either a Standard or V-Shaped Mastopexy to create some projection outward and shape each breast

Vertical Mastopexy or Anchor with Implants

If your sternal notch to nipple distance is 24 centimeters or lower:

  • Your breast mound flat
  • And you want bigger breasts

Then you will need either an Anchor or V-Shaped Mastopexy with a Breast Implant. This will create some projection outward while helping shape each breast

2 Staged Operation – Breast Lift followed by implants months later

Sometimes it may be necessary for you to have 2 operations to get the best result. If you have any of the following, here are some reasons to think of a Lift before getting Implants:

  • Heavy breasts with very little loose skin
  • Severe bottoming out or sagging of the breast tissue
  • A desire for large breasts, but your natural breasts are small and sag
  • 2 different size and shaped breasts with sagging
  • If you want less visible scars then I suggest you do a Breast Lift first. This will avoid stretching of the incisions caused by insertion of the implant at the same time.

Don’t be afraid of a 2-staged operation- You only get 1 set of breasts, so pick what’s right for you, for a better shape for life

Don’t be Afraid of Lift Scars to Get the Shape You Desire – 7 months after


FAQ / My Opinion and My Recommendations

I heard of a Laser Lift, is this important?

No, using a Laser during a Breast Lift adds no advantage to the procedure. The Laser is a cutting or vaporizing tool which acts as a surgical knife. Therefore, the Laser cannot shape your breasts to make them look better, make the Breast Lift last longer or make your breasts heal better or faster.

The Laser Lift is used as a marketing tool to entice women interested in a Breast Lift. Because most persons think that using Lasers for Cosmetic Surgery means they are getting the most advanced technologies, Cosmetic Surgeons advertise Lasers for use in hopes you will select them over another surgeon.

I do not use Lasers for Breast Lifts because this increases the cost, increases the time of the operation and adds absolutely no benefit to the women having breast shaping.

I head you can get a Breast Lift with only a circular scar around the areola?

That’s true, however, this type of Breast Lift is not a shaping lift and is only used with a breast implant. My preference is the Crescent Breast Lift which will raise your nipple position. This is important if your nipple position is slightly low or pointing downward. This allows me to position the implant higher so you get more fullness at the top of your breasts.

The Benelli or Doughnut Lift is a poorly designed Breast Lift operation and because of this I no longer use this lift, but instead use the Crescent Lift. The problems I’ve seen with the Benelli Lift or Doughnut Lift are:

  • Very noticable scars
  • A flat look to the nipple
  • Widening of the areola / nipple area

Should I get a Breast Implant with my Breast Lift?

For some woman a breast implant will be beneficial. If you breasts are sagging, gotten smaller after pregnancy and lost support, the a breast implant will give you back fuller breasts and a better shape. However, if you have reasonably good support, no significant loss in size, but your breasts have begun to sag, then a Breast Lift without an implant would be a good choice.

Why would I need an anchor incision Breast Lift?

Sometimes the breast is very flat and loose and by adding an incision along the fold at the bottom of the breast maybe necessary to give you a better shape.

Types of Mastopexy / Breast Lift

  • Crescent Shaped or Nipple Lift – is used to reposition the nipple upward in order to place the implant slightly higher. This procedure will also correct small discrepancies in the nipple level between the two breasts or tip the nipple upward if it is pointing down.

    A crescent of skin (1/2 moon shape) is removed from just above the nipple/areola area. I like to place the implant through the periareolar incision on the bottom half of the areola, thereby creating a full circular incision around the whole areola. The drawbacks to any lifting procedure done around the areola is that the areola itself may enlarge in size. Also, nipple elevation can only be moved upward a small distance. The Crescent Lift is normally done with a breast implant.

  • Doughnut, Circumareolar or Benelli – Doughnut or Benelli Lift takes a rim of tissue around the whole nipple- areola area, helping to tighten the skin and lift the nipple. I don’t like this procedure because of the problems with poor scars, widening of the areola and flattening of the nipples.

  • Anchor Incision Mastopexy – raises the nipple and tightens the skin of the breast. I use this most of the time in conjuction with a breast implant.

  • Vertical or V-shaped – V-Shaped Mastopexy ( lollipop incision) gives some of the best overall contouring, because it keeps the nipple position centered on the mound, while giving the greatest amount of shaping and tightening to your breasts.

  • Breast Reduction followed by the placement of a breast implant is a better choice than a Breast Lift with a breast implant if you fall into the following categories:

    • You have heavy, low hanging breasts; These large breasts tend to be wide and will look better with a larger diameter implant. By removing some of your non-supportive tissue and replacing it with a larger volume implant, your breast will be higher and more projecting.

    • If you want to remain about the same size; I would first reduce and shape your breasts. Then add the volume back with a breast implant. This will allow you to stay around the same size. Whereas a Breast Lift combined with a breast implant placement at the same time will make your breasts larger.

For More Information on a Breast Lift, Mastopexy or Crescent Lift with Implants, Call Dr. Costanzo at (805) 373-9919

Breast Galleries