Breast
What are the Different Kinds of Breast Lift?
The breast lift patterns discussed in this episode are the donut, lollipop and anchor lift. Their names describe the incisions. Choosing a pattern depends on the breast's anatomy and the amount of lifting and reshaping being considered, rather than simply selecting the smallest scar.
In this episode.
Episode summary
The breast lift patterns discussed in this episode are the donut, lollipop and anchor lift. Their names describe the incisions. Choosing a pattern depends on the breast's anatomy and the amount of lifting and reshaping being considered, rather than simply selecting the smallest scar.
In this July 3, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD explains breast lift surgery, also called mastopexy. He introduces breast ptosis, or drooping, and the tradeoff between reshaping the breast and accepting permanent scars.
Key takeaways
🔎 A donut lift uses an incision around the areola.
The episode calls this a periareolar or circumareolar mastopexy and discusses it for limited lifting.
🔎 A lollipop lift adds a vertical incision.
This circumvertical pattern extends from the areola down toward the breast fold.
🔎 An anchor lift adds a fold incision.
The inverted-T or Wise pattern includes a horizontal component along the fold beneath the breast.
🔎 Nipple position helps describe drooping.
Dr. Smith explains the relationship between the nipple and the inframammary fold.
🩹 Pregnancy plans and scars belong in the discussion.
Future pregnancy can change the breast again, and a lift leaves scars even when they fade.
Questions this episode answers
Is a mastopexy different from a breast lift?
No. Mastopexy is the medical term for breast lift surgery.
Can I choose a donut lift just to avoid a longer scar?
The episode describes a donut lift as a more limited approach. The incision pattern needs to match the amount of correction being considered; a smaller incision is not automatically the right operation.
Will the scars disappear?
No. Dr. Smith explains that scars can become less noticeable over time, but they are permanent. Their likely position and the shape change you hope to achieve are part of the decision.
🔗 Related information
Explore breast lift surgery, breast procedure information, or request a consultation with Dr. Smith in New York City.
Originally released July 3, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.
Original show notes
A breast lift (mastopexy) is a powerful operation that does exactly what its name implies: lift the breasts. However, there are several different ways a breast can "droop" or become "ptotic," and there are different kinds of breast lift to match. Dr. Darren Smith, a board certified plastic surgeon in New York City, explains.
Read the conversation.
[00:08] I'm board certified New York City plastic surgeon, Dr. Darren Smith, and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. What are the different kinds of breast lift? So first a little bit of vocabulary, and that's just to say that a breast lift is the same thing as a mastopexy. And the goal of a breast lift is exactly what it sounds like. It's to make the breasts higher or more perky. And this is a procedure that is often performed after a woman is finished having children. And that's the ideal time for this procedure because pregnancy and breastfeeding can cause the breasts to droop or sag. That's not to say that it's the only time to have this procedure. There are plenty of women who have droopy or saggy breasts just due to genetics or after they've lost a significant amount of weight and they would like to improve the appearance of their breasts prior to childbearing but it's just a good idea to remember that if childbearing is in the near future It's probably not the best time to go ahead with one of these procedures because the process of being pregnant and breastfeeding will likely undo most of the work that was done. So there are essentially three types of breast lift or mastopexy and the kind of breast lift that is performed depends primarily how droopy or tautic the breast is. And breast ptosis or droopiness is graded on a scale from one to three, with one being the least severe and three being the most severe. And the degree of ptosis is judged by the position of the nipple relative to the position of the fold under the breast or the infirmary fold. So a grade one ptosis is considered a minor ptosis.
[02:24] A grade two ptosis is considered an intermediate ptosis and a grade three ptosis is considered a severe ptosis. So just like there are three grades of ptosis severity, there are also three primary types of mastopexy or breast lift. And the first type is called a periareolar mastopexy. and periareolar means around the areola and just like its name implies a periareolar mastopexy is performed by essentially making an incision at the border of the areola and the regular breast skin and then another incision a number of millimeters or centimeters around that one so it actually if you look at the incision pattern looks like a donut where the areola is at the center of the donut. And that's why this kind of breast lift or mastopexy was nicknamed the donut mastopexy. And the skin between the two incisions is removed and the resulting wound is sewn together. And the result of this, due to the geometry of the breast, is that a breast lift results. Now it's a fairly minor lift.
[03:42] We usually say that you can't get more than about a centimeter or two of height of lift with a donut or circumarial or mastopexy. But for someone that just has a small amount of ptosis that has grade one ptosis, it's a very good option because there is minimal scarring and it's a very easy recovery. Now, for people that have more significant ptosis, like a grade two ptosis, we start to talk about what's called a circumvertical mastopexy. And this is just like a circum areolar mastopexy with the addition of an incision that goes down the front of the breast. And that's why the name of this is circumvertical. Circum refers to the circular incision around the areola and vertical refers to the scar or the incision that goes straight up and down the breast.
[04:35] and this is a very powerful operation that can effectively treat grade 2 ptosis. Now for very severe forms of ptosis or very significant breast drooping we move to what's called an inverted T mastopexy also called a Y's pattern mastopexy and this procedure is just like a circumvertible mastopexy with the addition of a horizontal scar under the breast fold. So this pattern of incision really resembles an anchor in a lot of ways. So just to review, for grade one ptosis, a circumarial armastopexy is a great choice for grade Two ptosis, a circumvertical mastopexy is a good option. And I'll just throw in here that a circumvertical mastopexy is often called a lollipop mastopexy because that's what the incision pattern looks like. It's circular around the areola. And then a vertical line extending down from that circle like the stick of a lollipop. And for the most severe kind of breast ptosis, a grade three ptosis, we are often looking at a inverted T mastopexy, also called a wise pattern mastopexy, or even an anchor mastopexy. And as you can imagine, just by listening to these descriptions, breast lift procedures or mastopexies are operations that do cause a significant amount of scarring on the breast.
[06:14] The good news though is that in most people with a well-designed mastopexy, those scars go on to heal very well over time and often become difficult to see. However, it's important to understand that scars do last forever and you will have scars after having a mastopexy. So this is an operation where someone is essentially trading off having scars on their breasts for having a really nice breast shape. And this is a personal decision, and for a lot of people, a breast-lifter, a mastopexy is a really good option. Thanks for listening, and don't forget to subscribe, share the show, and head over to darrensmithmd.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-07-03. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS