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Dr. Barry Eppley

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Posts Tagged ‘vertical breast lifts’

Case Study – Vertical Breast Lifts with Implants

Saturday, April 30th, 2016


Background: Sagging of the breasts is a common result from pregnancies and weight loss. The loss of breast volume withdraws the support of the overlying breast skin leading to collapse of the breast mound. The breast mound then falls over the fixed inframammary fold creating a sagging breast appearance.

Breast Sagging classification Dr Barry Eppley IndianapolisThe classification of breast sagging is well known and is based on the location of the nipple relative to the inframammary fold. The relevance of this classification is in how it directs how the sagging breast is best treated and what type of breast lift is used to get the nipple back up above the inframammary fold.

In Grade II breast ptosis where the nipple sits just below the fold, the best correction is that of a vertical breast lift. Known as the lollipop lift because of its scar pattern, It moves the nipple vertically upward leaving a vertical scar between the nipple’s new position and its former location. In some cases, surgeons may try and make the periareolar or donut lift      work to avoid the vertical scar but the lifting effect will not be the same.

Case Study: This 35 year-old female had two children and lost much of her original breast volume. She wanted her breasts lifted and large breast implants placed at the same time.

Vertical Breast Lift and Implants result front view Dr Barry Eppley IndianapolisUnder general anesthesia, a vertical breast lift was performed raising the nipples 7 cms in the process. Silicone breast implants of 650cc high profile were after the lift was completed. The push of the large breast implants had its own lifting effect as well.

Vertical Breast Lift and Implants result oblique view Dr Barry Eppley IndianapolisVertical Breast Lift and Implants result side view Dr Barry Eppley IndianapolisHer one year result shows a major change in breast shape and size. Her vertical breast lit scars were remarkably imperceptible. The areolas were wider and the nipples ‘flatter’ as often happens after breast lift with a large implant push behind it.

The vertical breast lift is a very effective tool in the management of the sagging breast. While many women fear the resultant scars, in the right patient even large implants placed at the same time do not cause excessive widening or prolonged redness of the scars.


1) Vertical breast lifts and implants is a common combination breast enhancement procedure when ptosis occurs after pregnancy.

2) Vertical breast lifts are useful when the degree of breast sagging is modest with the nipple at or just below the inframammary fold.

3) The size of the breast implant placed partially controls how much breast lifting effect can be achieved.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study: Breast Augmentation with Lollipop Lifts

Friday, February 3rd, 2012

Background:  Breast augmentation remains one of the most commonly performed body contouring operations because it can successfully increase the size of a breast mound in a very short period of time. While the underlying implant makes the breast bigger, the final appearance of the breast is influenced by more than just the size and shape of the implant. The breast tissue that sits on top of the implant will effect the symmetry of the two mounds almost as much as the effect of the implant itself.

One of the key elements of the influence of one’s breast tissue on a breast augmentation result is the position of the nipple. While the nipple should be ideally positioned in the center of the breast mound, it often is not. The effects of pregnancy, weight loss and gravity frequently have the breast tissue sagging and the nipple low or even pointing downward over the lower breast fold. This poses problems for both the patient and the plastic surgeon alike. The hope of an uncomplicated  solution by the placement of an implant alone is not going to work.

Known as ptosis, breast sagging has the greatest influence on breast augmentation results. An implant placed behind a sagging breast will only end up pushing the drooping breast tissue and nipple lower and giving the impression that the breast implant was placed too high. In the presence of breast sagging, implants must be done with some form of a breast lift. While there are four basic types of breast lifts, once the nipple is below the lower breast crease vertically directed types of breast lifts must be done. This results in scars that extend beyond the nipple, something that patients had hoped to avoid. Often this need completely surprises a patient as they had thought that an implant alone would solve the sagging breast problem.

Case Study: This 40 year-old female from Indianapolis Indiana wanted to reshape her sagging breasts. After three children her breasts had not only lost their size but had sagged as well. The droop in her breasts was significant as the nipples were well below the lower breast crease and were essentially pointing towards the floor. She had a moderate amount of breast tissue but too much loose skin. She had hoped that implants alone would help lift up her breasts.

Under general anesthesia, vertical breast lifts were initially performed. Known as the ‘lollipop’ breast lift, it is so called because of the final scar appearance. With a circular scar around the areola that then extends downward, it creates a scar pattern that resembles the shape of the candy. While this is the final closure pattern and shape of the scar, the pattern of the initial breast lift is a vertical skin cutout. With the shifting of the underlying breast mound and attached nipple to the top of the vertical cutout, the skin closure then creates this lollipop scar pattern.

During the breast lift, round silicone implants of 300cc size were placed under the muscle. Dissection under the muscle and the making of a submuscular pocket was done through the lower end of the vertical skin cutout of the lift. Once the implants were in place, the breast mound was lift up on top of them and the skin closed.  

Vertical or lollipop breast lifts with implants can very effectively reshape and lift the sagging breast. It does so, however, at the price of a resultant vertical breast scar. This scar can remain red for many months and can take up to a year to achieve maximal scar maturation. Depending upon how this scars heals and how the breast mound settles on top of the implants (size vs skin tightening), secondary revision may be needed. It is important to wait at least six months after surgery before judging the final results, particularly how the vertical breast scars look.

Case Highlights:

1)      Candidates for breast augmentation often present with sagging or breast ptosis. Implants alone will not create a significant lifting.

2)      If the nipple is below the level of the lower breast crease/fold, a breast lift will be needed that creates scars that extend downward from the nipple into the fold.

3)      Concurrently performed lifts with breast implant placement is a challenging operation that not infrequently may require a revision to optimize shape and symmetry between the two breasts.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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