Dallas Breast Lift Surgery by Dr. John Burns

Sagging of the breast occurs naturally as the skin loses its elasticity, and can be accelerated by pregnancy and breast feeding. 

Women who are dissatisfied with the shape and position of their breasts can elect to have breast lift surgery to both raise and reposition their breast tissue in better proportion on their body.

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What Is Breast Lifting Surgery?

A breast lift is a surgical procedure designed to lift saggy breast tissue while creating a more harmonious breast shape.

The nipple-areolar complex is repositioned by raising it to the same level of the breast crease for a more youthful appearance. The ideal position would be an equilateral triangle between the center of the collar bone to each nipple and between the nipples.

A pattern is then used to remove excess skin which wraps around the breast to hold it in its new lifted position.

How To Tell If You Need A Breast Lift

Breast lift patients typically fall into three general categories:

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women who have had a pregnancy and breastfed.

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women who have experienced significant weight fluctuations & weight loss.

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Less typical are women who have skin that stretches easily or who develop breast tissue rapidly. 

How Is Breast Sagging Classified?

Breast sagging is classified on a scale of 1 to 3: 

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  • Pseudoptosis: the breast tissue is inferior to the breast crease but the nipple is above the breast crease.
  • Grade I Ptosis: the nipple is at 1 cm below the breast crease
  • Grade II Ptosis: the nipple is at a level 1-3cm below the crease
  • Grade III Ptosis: the nipple is more than 3.0cm below the crease

The Pencil Test

The pencil test has become a popular method for women to determine whether or not they need a breast lift. The pencil is placed at the breast crease and the breast tissue falls over the crease and pencil. If the pencil stays in place in the sitting or standing position then a breast lift is needed. While this does correlate with some good candidates it should not be used definitively.

Best Candidates For Breast Lift Surgery

The best candidates are those women who desire perky breasts. Many women will hold their breasts in a lifted position or use a support bra to simulate the result they desire. Breast lift patients typically fit into one of the three following categories:

  • Post-pregnancy: pregnancy and breastfeeding cause breast enlargement which stretches the skin envelope. Once breastfeeding is complete the breast loses volume but the skin does not fully retract, resulting in a droopy ptosis.
  • Weight loss: weight gain typically results in larger breasts which can sag. Similar to pregnancy, weight loss causes the breasts to shrink but the stretched-out skin does not retract resulting in droopy breasts.
  • Genetics:  During puberty, some women's breasts develop rapidly, causing the skin to stretch too fast and produce droopy or ptotic breasts. Some women have poor skin elasticity and are more prone to stretch marks. These women also typically have drooping breasts.

Regardless of the cause, breast lift patients need to be in good overall health. They will have needed to stop breastfeeding for at least 3 months and return to their pre-pregnancy breast size. They should have a stable weight with a BMI (body mass index) less than 35. For women over 40 or women who are at high risk for breast cancer; a mammogram is recommended. Candidates should not smoke or use nicotine products and avoid contraindicated medications such as diet pills before surgery.

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The Different Types of Breast Lifts

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Crescent Lift

A crescent lift is limited and usually only useful for patients requiring minimal lift: < 2 cm. In this approach, a crescent piece of skin is removed from the superior part of the areola.

Crescent lifts often result in irregularities of the areola and can have wide scars due to tension. They have a high degree of recurrence of the ptosis/drooping.

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Donut Lift

A donut lift is also called a Benelli lift, or peri-areolar breast lift. This lift removes excess skin circumferentially around the areola. Similar to the crescent lift, it is useful only for minimal lifts: < 2 cm. While this technique can be useful for removing excess skin, it is a poor way to lift the breast.

The disadvantage of a donut lift is its limited ability to actually lift the breast. It is very short-lived as any lift gained is very temporary. Because the areola is typically placed under tension, the scars tend to widen and become disfiguring and can make the areola irregular or misshapen. Tension around the areola also causes the areola to widen sometimes making it larger than it was prior to having surgery. This is why the lifting effect is so limited.A donut lift is mainly useful only as a means to remove some excess skin thus tightening the skin envelope.

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Vertical Breast Lift

A vertical breast lift is also called a “lollipop lift” or Lejour mastopexy. This technique attempts to eliminate the transverse scar which lies in the inframammary breast crease. This technique offers a more powerful lift compared to the crescent or donut techniques but is still limited: < 4 cm.

The primary drawback of a vertical or lollipop lift is the long vertical incision required when excess skin is not removed at the base of the breast through a horizontal incision. In most cases, the vertical scar elongates more over time and often requires a revision. The increased nipple-to-breast fold distance causes the nipple-areola complex to be placed too high on the breast and the breast to appear too low or bottomed out. This generally requires a revision with a transverse incision to shorten the vertical scar and remove excess skin.

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Full Anchor Breast Lift

The anchor or full scar mastopexy is the tried and true method that delivers consistent, reliable, and reproducible results. This also gives the most powerful lift with the most longevity. The anchor incision repositions the areola in a lifted position which also allows for an areolar reduction if necessary. The is a vertical incision from the areola to the breast crease and an incision in the breast fold of variable length. This technique is highly versatile and provides the best long-term shape.

In my practice, I generally use the anchor lift because it gives the best results. The drawback is that it incorporates the most incisions but breast scars generally heal beautifully and the improved shape is well worth it.

Breast Lift Before and After by Dr. John Burns

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Breast Lift with Breast Augmentation

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When both lift and volume are necessary, it is possible to combine a breast augmentation with a breast lift. This procedure can be tricky because with a breast lift skin is removed but the tighter skin envelope makes placing an implant more difficult. In essence, there are opposing forces with the lift and augmentation but if done correctly the results can be amazing.

In my opinion, the lift is the most important component of the procedure and I generally do this part first. Once the lift is done a temporary implant called a sizer is placed. The sizer is filled with saline to achieve the optimal volume. Once this volume is known, the sizer is replaced with a permanent implant. This technique allows for optimal precision.

Alternatively, a fat transfer can be used with a breast lift if the patient does not want an implant. Fat generally can increase breast volume by about one cup size so there is a limit on how much size increase can be achieved. Fat also won’t give as much upper pole fill or cleavage as it is more gravity-dependent.

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How Do I Prepare For Breast Lift Surgery? 

Like any plastic surgery procedure, patients should be in good health and have a stable weight with a BMI < 35 (preferably <30). Patients should not smoke, use nicotine products, take diet pills, or blood thinning medications. Patients with a recent pregnancy should let their breasts return to pre-pregnancy size and stop breastfeeding for about 6 months. A recent mammogram is suggested for patients over 40 or with a positive family history of breast cancer.

What A Breast Lift Can't Do-

Breast lifts start out almost cone-shaped and then relax as the skin envelope stretches. It is difficult to maintain upper pole fullness or extensive cleavage.

If upper pole fill is important, patients will want to consider placing an implant under the chest muscle can provide more roundness, upper pole fullness, and cleavage.It is important that while no breast tissue is removed with a breast lift, the breast is placed in a tighter skin envelope. This generally results in a breast that is round, perky, and a bit smaller. Most patients feel about a cup size smaller after a breast lift. For this reason, an implant or fat transfer is often desired to fill out breast volume.

Patients need to look at options like an implant or fat transfer breast augmentation for feminine fill and shape.

Breast Lift Recovery

This is typically not a painful procedure. These will be a tight feeling and some incision discomfort. Long-lasting numbing medication is used in surgery to alleviate this discomfort. The incisions are taped with steri-strips and a surgical bra is worn for support. In most cases, a drain tube is not necessary. Medication is prescribed to prevent pain, nausea, and muscle spasms, and an antibiotic is given to prevent infection.

The Recovery Period

Patients are cleared to shower on day 3 but may not totally submerge in water for at least 6 weeks. Light exercise, no lifting or bouncing exercises, is permitted at about 2 weeks and gradually advanced as tolerated. Most patients can return to work in several days for most desk jobs. Underwire bras are discouraged until the incisions are fully healed at about 8 weeks.

Scar Care Recovery

Scars are permanent but do fade considerably. Initially, the scars will be red and raised. In the first 2-3 weeks only antibiotic ointment will be used. At 3 weeks a scar gel will be prescribed and silicone sheeting instituted. Dr. Burns recommends Biocorneum or Skin Medica Scar Recovery Gel. Once the scar maturation reaches 4 weeks women can elect to begin laser therapy at our onsite laser center, EpiCentre. In most cases, 4 laser treatments are recommended.

Scars take time to mature. By 6 months the scars have faded significantly, but will continue to fade for up to 24 months following surgery. In general, breast scars also heal much better than other locations on the body.

How Much Is A Breast Lift In Dallas?

Cost includes the plastic surgeon’s fee, surgery center or facility fee, anesthesiologist, and post-surgery bra. For a breast lift only the cost is around $8,750.

For a breast lift with breast implants the cost is approximately $12,000, based on the type of implant selected

Will I Be Able To Breastfeed After Breast Lift Surgery?

In almost all cases, breastfeeding is possible after a breast lift. Breastfeeding is more affected by procedures like a breast reduction where breast tissue is removed. If patients become pregnant and breastfeed after a breast lift there can be breast changes that may necessitate another breast lift.

Are The Results Permanent?

Age and gravity will have an effect on any plastic surgery procedure and breast lifts are no different. After a lift, there is inevitable stretching of the breast skin and a gradual descent of breast tissue. While the degree of sag won't reach the pre-surgery degree of ptosis, recurrence can happen. In some cases, another breast lift will be necessary to tighten up the skin envelope and raise the tissue.

Maintenance is important in achieving a longer-lasting result. Breast skin should be cared for by keeping the skin well moisturized and taking care to avoid smoking and sun damage. Wearing supportive bras keeps the breasts lifted and supported and prevents skin stretching. This is especially important during exercise where the breast skin is more susceptible to stretching due to repetitive motion.

Breast lift surgery doesn't stop the long-term effects of aging on breasts but it can significantly improve the appearance and quality of life for women struggling with saggy breast tissue. As women continue to mature, they can experience age-related and hormonal changes to breast tissue, but for women who have had a breast lift, these changes will be significantly lower than if they hadn't had surgery at all.

That said, nothing lasts a lifetime.

How Long Will My Breast Lift Results Last?

There is no hard and fast number as everyone ages differently. Longevity depends on factors such as compliance with wearing a supportive bra, skin quality and age of the skin, smoking and environmental factors that can age tissue, and the effect of gravity on larger breasts. In general, your chest will always appear lifted but will settle and may require tightening of the skin or a revision later in life. Like facelifts, you should expect a well-done breast lift to last at least 10 years.


What happens to my results if I become pregnant?

Pregnancy will affect the breasts as the enlargement and contraction of the tissue will leave extra skin droop. In many cases both an augmentation with lift is needed. Generally, it is advisable to wait until after pregnancy for a breast lift. A breast augmentation can be done anytime: either before or after pregnancy.

Will insurance cover my breast lift?

A breast lift procedure is considered cosmetic surgery and is not covered by insurance.

Can my nipples be shortened in a breast lift?

Yes. Nipples can elongate during pregnancy and can be shortened if desired.

How does the surgeon resize my areolae?

The diameter of the areola should span about ⅓ the distance across the base diameter of the breast. The areola is the focal point of the breast and should have perfect shape and dimensions. During a breast lift the areolar is commonly made smaller and more perfectly circular. We use a device in surgery that cuts a perfect circle as part of our breast lift design.

How long before my scars fade?

Scarring is highly variable between different patients with different skin types. However, breast scars are typically favorable and tend to heal very well.

The healing process is very predictable and takes about 6 months to progress through the different healing phases. Initially, the scars are red and raised. They gradually fade over the next several months before eventually turning white. Scar continues to improve for up to 24 months after surgery.

How long before my scars fade?

We offer the latest scar therapy through EpiCentre Skin Care and Laser Center. Most patients will have scar gel, silicone sheeting, and laser treatment to optimize their scars.

Schedule Your Breast Lift Consult with Board-certified Plastic Surgeon Dr. John Burns

Dallas breast surgeon specialist, Dr. John Burns is one of the leading plastic surgeons in the United States. Having performed thousands of breast lift, breast augmentation, and breast revision cases, Dr. Burns was selected as one of America's Top Plastic Surgeons by Newsweek Magazine and Statista.

Dr. Burns offers both virtual and in-office plastic surgery consultations for men and women seeking plastic surgery in Dallas, throughout the United States, and the world.

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