Do I Need a Breast Lift?

Dr. Michael W. Gray, a world-renowned cosmetic surgeon (West Bloomfield, Michigan) was asked this very question. “Many women are confused as to whether or not they ‘need’ a lift. First of all, No one ever has to get a lift unless they want a lift! Many women think they need a lift and do not need a lift”. Why do women think this? Dr. Gray explains, many women wear push up bra’s to obtain fullness at the top of their breasts when in clothing! Because of this the thought among women that a lift is needed invades the female culture when in actuality a lift would not be needed at all.

In this situation according to Dr. Gray, a breast augmentation would produce upper pole fullness. Fortunately, many women are so relieved to hear this but unfortunately, there are many women who live there lives unhappy and are wrongly afraid to do anything because they fear a breast lift.

A Breast Lift (mastopexy) is composed of two components, as Dr. Gray explains. There is the Horizontal incision and the Vertical incision. Together they form the “anchor scar”. These two components play a major role and each achieves different results. Dr. Gray explains, The Horizontal scar is the one that actually creates the lift. The Vertical scar is the one that moves the nipple/areola complex from its “old” location to the “New” location. To do this many surgeons may cut the nipple and areola off and “graft” the nipple/areola to the new location. Dr. Gray remarks, “That in all my years in surgery, I have never had to do this!” This method is called a “Free Nipple Graft”. Free Nipple Grafting is almost 100% unnecessary when doing a Mastopexy.

Dr. Gray has developed a procedure where the nipple and Areola will remain attached to your breast tissue and breast-feeding will never be altered. The vertical portion of the scar is where the Nipple/Areola was located and the new location you see is where the nipple/areola goes. The lift of the nipple is limited by the length of the blood vessels supplying the nipple/areola. The Horizontal Incision is the portion of the procedure that actually will eliminate the breast from hanging over the crease below. The crease is called the inframammary crease. This horizontal portion of the procedure is what actually lifts the breast. To understand this better, think of the hanging portion of your breast as your shirt hanging over your belt. If the shirt is tucked in, then there is no more hang. To tuck the shirt inward the excess along the horizontal must either be removed or hidden.

When performing a breast lift the portion is hidden and not removed. When the shirt is tucked inward the hang is gone, but is the shirt gone? The shirt is not gone! The shirt is hidden! Wah Lah! No more excess. The portion of the breast and skin that hangs over the Inframammary Crease is not gone but pushed upward as the skin is tightened. Now that you have some basics, Lets understand if a lift is needed.

If a person has a Low nipple but the breast is not hanging over the crease, they may get away with just the vertical scar (the vertical lift portion of a mastopexy). On the other hand, If someone has a breast hanging over the crease and a low or potentially low nipple they would need both portions of the mastopexy (Horizontal and Vertical incisions). If someone has a breast that hangs over the crease and wants a breast implant, but does not wish a Breast Lift (Mastopexy) then more than likely they will place the implant over the muscle. In this situation if the implant is not placed over the muscle (which means behind the breast) they will most likely develop a “Snoopy dog” deformity. The “Snoopy Dog Deformity appears as a dangling breast, or droopy look.

This occurs because the implant is under the muscle verses over the muscle. This droopy look is similar to the appearance of a water droplet getting ready to drop off the side of a glass. This can be corrected either with a lift or by placing the implant over the muscle if a lift is not desired. So, the real question comes down to whether the patient actually wishes a lift, needs the lift or needs the lift to place and implant under the muscle and have the breast actually look good. This is a personal choice with the patient and is the reason why we call Cosmetic Surgery “Elective”. Patients tell me what they want versus me telling the patient what they have to do.

To schedule a consultation with Dr. Gray call 248-538-3333 or visit