The vertical breast lift and circumareolar breast lift are two types of mastopexy that both serve a similar purpose for patients. These procedures are designed to bring breasts up to a higher position on the chest and ensure attractive positioning of the nipples. The type of technique recommended depends on the size of a patient’s breasts and the degree of sagging.

Drooping is a Common Problem
Breasts of any size can experience ptosis (drooping). This typically happens with age as the connective tissues that support the breast become lax. The skin and subdermal tissue lose elasticity and firmness as well. Pregnancy and breastfeeding can have a dramatic impact on the appearance and position of breasts over a period of just a year or two. Breasts gain volume during pregnancy and then lose it afterward – and often become pendulous instead of regaining their former shape. That’s why a vertical or circumareolar breast lift is a common component of the “Mommy makeover” group of cosmetic surgery procedures.

Larger breasts are particularly likely to lose their perkiness from the weight of the breast tissue exerting constant downward pressure. Gravity can wreak havoc on breasts at any age. Even girls in their teens and women in their twenties can experience ptosis if they have large breasts. This can be particularly troubling for young women’s self esteem when the rest of their body is still youthful and their breasts appear much older due to drooping.

Can You Prevent Sagging?
There’s very little you can do to prevent ptosis from occurring in the first place. Some women believe that wearing a bra all the time – even at night – will delay or prevent sagging. Others think wearing a bra weakens the supportive structures (muscles and connective tissue) and actually hastens laxity. They propose that strengthening exercises that build up the chest muscles will prevent drooping. There have been no scientific studies carried out to prove or disprove either of these theories. Maintaining a steady body weight may help keep breasts from growing larger and sagging as a result. Other than that, the development of breast ptosis is pretty much out of your control. Fortunately, surgical options such as a circumareolar or vertical breast lift can correct drooping once it occurs.

Circumareolar Breast Lift
This type of breast lift is designed for women who have lost some firmness but who still have fairly small breasts without a lot of excess skin. It involves making an incision around the areola (either around the lower edge only or around the entire areola). Breast skin can be removed around the areola as needed to draw the skin tighter – like a purse string. The areola may also be reduced in size during this procedure if it is large or irregularly shaped.
A saline or silicone implant may be inserted through the periareolar incision and placed over or under the pectoral muscle. If you choose a silicone implant, it may require a larger incision than a saline implant for this type of insertion, so this is something to discuss with your plastic surgeon. The benefit of having an implant placed at the same time as the mastopexy for small breasts is that it helps fill out the skin to make the breast appear even perkier.

Vertical Breast Lift
This type of breast lift uses a periareolar incision coupled with a vertical incision down the underside of the breast. It is designed to provide greater lifting and reshaping for women with larger breasts who have moderately lax skin. This incision pattern is sometimes referred to as the “lollipop”. Since excess skin is removed vertically along the lower surface of the breast, the skin along the upper profile of the breast should look tighter and firmer after the procedure. If additional volume is needed, an implant can be inserted as well.

Traditional Breast Lift
Women who have very pronounced drooping and a lot of excess skin may need a full breast lift. This procedure involves making an incision along the bottom crease where the breast meets the ribcage in addition to the incisions around the areola and down the undersi