What Are The Different Types of Breast Lifts?

The droopy, saggy or “ptotic” breast has three main issues: (1) the breast tissue has lost its shape, it has deflated and hangs low on the chest with loss of upper pole volume, (2) the nipples and areolas droop on the breast, often pointing downward, and (3) there is an excess of empty breast skin.

Mastopexy therefore entails three separate but intimately related components: (1) reshaping the breast tissue and relocating it higher up on the chest wall, (2) repositioning the nipple to a more youthful position on the breast and reducing an enlarged areola diameter, and (3) removing and redraping extra breast skin.

Dr. Horton customizes each breast lift procedure to suit her patient’s anatomy, using a technique that includes an incision encircling the nipple and areola. This approach enables precise repositioning of the nipple and allows for reduction of the areolar diameter if needed. Throughout the procedure, key structures such as nerves, milk ducts, and blood vessels are carefully preserved. The nipple is not “taken off” or amputated from the breast and put back on, as is commonly believed—it remains attached to the rest of the breast on a stalk of tissue known as a “pedicle”, and lifted by internal rearrangement, similar to origami. Depending on factors like breast shape, skin laxity, and nipple position, additional incisions on the breast may be made to achieve optimal results.

Dr. Horton uses the “auto-augmentation” technique in every breast lift or breast reduction to enhance breast shape naturally without the use of a breast implant, for patients who desire a natural upper pole and teardrop shape to the breast. This method involves reshaping the breast by creating subtle fullness in the upper pole—the same area where an implant would typically be placed. During the procedure, the nipple and areola are repositioned to a higher, more balanced location, resulting in a tighter breast pocket and more youthful breast contour on the chest.

Inverted-T Technique

The most commonly used breast lift technique involves three incisions: one encircling the nipple and areola, a vertical line from the lower edge of the areola to the breast crease (inframammary fold) in the shape of a lollipop, and a short horizontal scar hidden within the fold itself. This scar pattern is more discreet than the traditional “anchor” scar—many patients describe the inframammary scar as resembling a “cat’s smile” because it usually stays tucked within the natural fold of the breast rather than extending outward.

The inverted T approach allows for the most dramatic reshaping, creating a perkier, more youthful breast shape with true three-dimensional lift and support. The nipple and areola remain attached to their original blood vessels, nerves, and milk ducts, which helps preserve erogenous sensation to the nipples and the potential for future breastfeeding.

The inframammary scar is not visible when viewed from the front or above and is well-hidden in bras and swimwear—even in minimal coverage tops. The vertical incision typically fades with time, and the areolar scar blends naturally at the border of the pigmented and surrounding breast skin.

“Lollipop” Scar Technique

The “lollipop technique” is an option for patients with mild nipple drooping and minimal excess skin. This approach uses only two incisions—one around the areola and a vertical line extending to the breast crease—omitting the horizontal scar along the inframammary fold. Similar to the inverted T method, the nipple remains connected to its natural blood vessels, nerves, and milk ducts to help preserve function. This technique is best suited for those with limited skin laxity and moderate reshaping needs, but it may not be appropriate for individuals with significant breast sagging or a large amount of redundant tissue.

Periareolar Technique

The periareolar approach involves making an incision along the border of the areola, where it meets the surrounding breast skin. This technique is typically reserved for cases that do not require significant reshaping or removal of excess skin. A limited periareolar lift may be added to a breast augmentation when the nipple needs only slight repositioning. It is also commonly used in procedures to correct tubular breast deformities, particularly when there is minimal drooping but the areola appears enlarged or puffy.

A variant of the periareolar technique is often called the “donut mastopexy” or “Benelli lift”. This technique is usually insufficient at lifting the breast, and often causes stretching of the areola to become wider than it originally was, due to excess tension around the areola. Adding a vertical incision below the areola takes tension off the circle and prevents areolar enlargement – this is why a lollipop incision is usually needed +/- an inframammary incision.

Mastopexy and Breast Augmentation

To restore breast volume after having children or after major weight loss, a breast implant can be placed at the same time as a breast lift. Occasionally, breast augmentation alone will help to lift the nipples very subtly. However, a combined mastopexy and augmentation procedure is indicated if there is significant ptosis of the breasts and the goal is to have the effect of a push-up and padded bra to enhance breast volume and projection.³ Please see our section on combined mastopexy-augmentation for more information about combined breast lifts with implants.

What to Expect During Breast Lift Surgery

During this cosmetic surgery procedure, an incision is made around the nipple and areola, and excess skin is removed. The breast “is opened up like petals of a flower,” and a space is created to move the breast tissue into, similar to creating a pocket for a breast implant. The breast tissue is rearranged three-dimensionally to reshape the breast and moved into this pocket. The nipple and areola are relocated to a higher position and more aesthetically pleasing location while maintaining their connections to the remainder of the breast. The remaining breast skin is then redraped to complete the procedure. This outpatient surgical procedure is performed under general anesthesia and generally takes 3 hours to complete.

For more details about what to expect in the operating room on the day of your procedure, please visit our Preparing for Surgery section.