Types of Mastopexy: Crescent, Lollipop & Anchor Techniques Explained

Mastopexy, also known as a breast lift, is a surgical procedure that addresses breast sagging by removing excess skin, reshaping breast tissue, and repositioning the nipple and areola when appropriate. While the overall goal is to improve breast shape and position, not every mastopexy uses the same surgical technique.

Depending on breast anatomy and the degree of sagging, a plastic surgeon may recommend a crescent, periareolar, vertical (lollipop), or anchor (inverted-T) mastopexy. Each technique involves a different incision pattern and offers distinct advantages and limitations.

At Dr. Shaun Parson Plastic Surgery & Skin Center, double board-certified plastic surgeon Dr. Shaun Parson evaluates each patient’s anatomy, skin quality, and aesthetic goals to develop an individualized surgical plan. Understanding the available techniques can help patients make informed decisions about their options.

What Is Mastopexy and Why Is It Performed?

Over time, breasts may lose some of their original firmness and position. Pregnancy, breastfeeding, weight changes, genetics, and aging can all influence breast tissue and skin elasticity.

As supporting tissues stretch, the breasts may begin to sit lower on the chest. The nipple and areola may also move downward. Plastic surgeons describe this condition as breast ptosis.

Mastopexy addresses these changes by reshaping the existing breast tissue and removing excess skin. The nipple-areola complex may also be repositioned to create a more balanced appearance.

A breast lift alone is not designed to significantly increase breast size. Instead, it primarily improves breast position and contour. Patients who also want additional volume may consider breast augmentation with a lift.

Understanding Breast Ptosis: How Surgeons Evaluate Sagging

Before selecting a mastopexy technique, a plastic surgeon evaluates the degree of breast ptosis. One important measurement is the position of the nipple relative to the inframammary fold, the natural crease beneath the breast.

Breast ptosis is commonly categorized into several grades:

• Grade I (mild): The nipple sits at or slightly below the breast crease but remains above the lowest part of the breast.
• Grade II (moderate): The nipple sits below the breast crease but remains above the lowest contour of the breast.
• Grade III (severe): The nipple sits at or near the lowest point of the breast and often points downward.

Some patients experience pseudoptosis, in which much of the breast tissue sits below the crease while the nipple remains relatively elevated. This can create a deflated appearance without the same degree of nipple descent.

These distinctions matter because a patient with mild ptosis may require a very different approach than someone with significant skin excess following pregnancy or substantial weight loss.

The Four Mastopexy Incision Techniques Explained

1. Crescent Mastopexy: Minimal Incision, Limited Correction

A crescent mastopexy uses a curved incision along the upper border of the areola. A small crescent-shaped section of skin is removed, allowing the nipple position to be adjusted slightly upward.

This is among the least extensive mastopexy approaches. However, its lifting capability is limited, and it is not suitable for most patients with significant breast sagging.

Who May Benefit From a Crescent Lift?

A crescent lift may be considered when the nipple requires only a very small amount of elevation and the overall breast shape is otherwise satisfactory.

Although the incision is relatively short, the technique can have limitations. Excessive tension may distort the areola, and it does not provide the extensive tissue reshaping possible with vertical or anchor techniques.

Patients should not choose a crescent lift solely because it involves less scarring. The selected technique must also provide sufficient correction.

2. Periareolar Mastopexy: The Donut Lift

A periareolar mastopexy, sometimes called a donut lift, uses an incision around the entire border of the areola. A ring of surrounding skin may be removed before the incision is closed.

This approach can provide limited nipple elevation and may be useful in select cases where the areola also needs to be reduced in size.

However, periareolar mastopexy is generally not ideal for patients requiring substantial lifting or reshaping. Potential drawbacks include widening of the areola, flattening of breast projection, and visible scarring around the areolar border.

The donut lift and crescent lift are sometimes discussed together because both use incisions near the areola, but they are different techniques with different surgical applications.

3. Lollipop Mastopexy: The Vertical Breast Lift

A vertical mastopexy, commonly called a lollipop lift, involves two incision components: one around the areola and another extending vertically from the areola toward the breast crease.

The resulting incision pattern resembles a lollipop.

This technique allows the surgeon to remove additional skin, reshape breast tissue, and elevate the nipple-areola complex. It is often considered for patients with moderate sagging, although suitability depends on the individual anatomy.

Advantages of Vertical Mastopexy

• Allows more substantial reshaping than limited-incision techniques.
• Can improve breast projection and contour.
• Permits repositioning of the nipple and areola.
• Generally avoids the horizontal breast-crease incision associated with an anchor lift.

Vertical mastopexy does leave permanent scars around the areola and down the lower breast. In some cases, temporary gathering or puckering of skin may be visible during early healing before the breast settles into its new shape.

Although a lollipop lift offers more reshaping flexibility than a crescent or donut lift, patients with substantial skin excess may require a different incision pattern.

4. Anchor Mastopexy: The Inverted-T Breast Lift

The anchor mastopexy, also called an inverted-T or Wise-pattern lift, is commonly used when significant skin removal and breast reshaping are necessary.

This technique involves three incision components:

• A circular incision around the areola.
• A vertical incision extending toward the breast crease.
• A horizontal incision along the inframammary fold.

These incisions form a pattern resembling an anchor or inverted letter T.

The additional horizontal incision provides greater flexibility for removing excess skin and reshaping the lower breast. This can be especially helpful for patients with substantial ptosis, stretched skin, or significant changes following weight loss.

Why Would a Surgeon Recommend an Anchor Lift?

Some patients are concerned about the longer scar pattern associated with anchor mastopexy. However, a shorter incision is not always capable of producing the necessary reshaping.

When significant skin laxity is present, the anchor technique may offer more control over breast contour and skin removal. The tradeoff is a more extensive permanent scar pattern.

The anchor incision pattern is also commonly used during breast reduction procedures because both tissue removal and skin tightening may be required.

Mastopexy Technique Comparison

How Does Dr. Parson Determine Which Mastopexy Technique Is Appropriate?

There is no single breast lift technique that is best for every patient. The surgical approach depends on a combination of anatomical findings and the patient’s goals.

During an evaluation, Dr. Parson considers factors such as:

• The amount of breast sagging and skin excess.
• Nipple position relative to the breast crease.
• Existing breast volume and tissue distribution.
• Skin quality and elasticity.
• Breast symmetry and areolar size.
• Previous breast procedures or scars.
• Whether the patient desires additional volume or a smaller breast size.

The ideal surgical plan balances the desired breast shape, amount of correction required, and anticipated scar placement.

Mastopexy vs. Breast Reduction: Understanding the Difference

Mastopexy and breast reduction share several surgical principles, including skin removal, breast reshaping, and possible nipple repositioning. However, their primary objectives are different.

Mastopexy focuses on elevating and reshaping the breasts while generally preserving most of the existing breast volume.

Breast reduction removes a more substantial amount of breast tissue, fat, and skin to decrease breast size and weight. This may be appropriate for patients who experience discomfort associated with large breasts or simply desire a smaller size.

Because both procedures can involve similar incision patterns, the difference is not determined by the scar alone. Instead, it depends on the amount of tissue removed and the intended surgical outcome.

Patients who are unsure whether they need a lift or reduction can learn more on our breast lift and reduction service page.

Can Mastopexy Be Combined With Breast Augmentation?

Yes. Mastopexy can be combined with breast implants when a patient wants both elevation and additional breast volume.

Following pregnancy, breastfeeding, or weight loss, some patients notice that their breasts have lost upper-pole fullness. A lift can improve position and reshape existing tissue, but it cannot fully replace volume that has been lost.

In these situations, combining a lift with augmentation may be considered. The procedure requires careful planning because breast implants introduce additional weight and affect the tension on breast tissues.

Not every patient needs implants, and combining procedures is not appropriate in every case.

Explore our breast lift with augmentation page for additional information.

What Do Mastopexy Scars Look Like?

All mastopexy techniques involve permanent incisions and scars. Their location depends on the technique selected, while their eventual appearance is influenced by skin type, genetics, healing, and postoperative care.

Initially, scars may appear pink, red, raised, or more noticeable. They often soften and fade over the following months, although complete disappearance is not possible.

Patients undergoing a vertical lift typically have scars around the areola and down the lower breast. An anchor lift adds a horizontal scar along the breast crease, which may be partially concealed by the natural breast fold.

Scar care is an important part of recovery. Dr. Parson’s postoperative recommendations may include surgical tape and appropriate scar-care products once incisions are sufficiently healed.

Patients should follow their specific postoperative instructions and avoid applying products to healing incisions without approval.

What to Expect During Mastopexy Recovery

Recovery varies depending on the technique, the extent of reshaping, and whether additional procedures are performed. Most patients experience temporary swelling, bruising, tightness, and discomfort after surgery.

The First Week

During the initial recovery period, patients generally wear a supportive surgical bra and limit strenuous activity. Short walks are encouraged as directed, while lifting, pushing, and pulling restrictions may apply.

Patients with desk-based jobs may be able to return to work in approximately one week, depending on their comfort and their surgeon’s instructions.

Weeks Two Through Three

Swelling and discomfort generally continue to improve. Patients may gradually resume additional daily activities as permitted. Surgical bras, incision care, and activity restrictions remain important during this period.

Weeks Four Through Six

Many patients begin returning to more demanding activities and exercise with surgical clearance. Running, heavy lifting, and upper-body workouts may require a longer restriction period.

Breast shape continues to evolve as swelling resolves and tissues settle. Scars typically mature over several months to a year or longer.

View Mastopexy Before-and-After Patient Examples

Before-and-after photographs are a useful way to understand how breast shape and position can change following surgery. Dr. Parson’s website includes galleries of actual breast lift patients, as well as patients who underwent combined breast lift and augmentation procedures.

When reviewing gallery examples, consider the amount of sagging present before surgery, changes in nipple position, breast contour, and overall symmetry.

It is important to remember that photographs do not always reveal the exact incision technique used. Crescent, vertical, and anchor mastopexy cases should only be identified as such when the patient’s surgical technique has been confirmed.

Watch: Dr. Parson Discusses Types of Breast Lifts

For additional education about breast lift techniques, Dr. Parson’s breast surgery video library includes a discussion of the different types of breast lifts.

Watch Dr. Parson’s Breast Surgery Educational Videos

Frequently Asked Questions About Mastopexy Techniques

Why Surgical Experience Matters When Choosing a Mastopexy Technique

Breast lift surgery requires careful consideration of breast anatomy, tissue support, skin quality, and long-term changes in breast shape.

Dr. Shaun Parson is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery. His experience in aesthetic breast surgery includes breast lifts, breast augmentation, breast reduction, and revision procedures.

At Dr. Shaun Parson Plastic Surgery & Skin Center in Scottsdale, Arizona, consultations focus on understanding the patient’s concerns, reviewing available surgical options, and establishing realistic expectations.

Whether a patient requires a limited lift or a more extensive mastopexy, the surgical approach should be selected based on anatomy and desired outcomes rather than incision length alone.

This article is intended for general patient education and does not replace an individualized surgical consultation. Surgical outcomes, risks, and recovery vary by patient.