A periareolar mastopexy or nipple lift, is essentially a minor breast lift A surgical incision is made at the junction of the areola and normal paler breast skin or within the areola if you want to reduce the diameter of your areola. Another surgical incision is made in a wider circle around it and the intervening disc or donut of skin is removed. The skin edges may be lifted off the underlying breast tissue to reduce tension on closure and the two circles of skin are brought together with multiple layers of sutures. Skin laxity in the breast is reduced, the nipple is lifted and the circumferential scar around the areola hides in this junction between it and the surrounding paler skin. Will the nipple be lifted? The areola can only reliably be lifted 2 – 3cms with this procedure. Attempts to raise the nipple more with this procedure will often give a sunken look to the areola. The wider the piece of skin removed, the more the outer circle needs to be gathered to meet the inner circle which gives more puckering to the scar. Also, wider excisions give more tension on the scar which leads to a wide or flared scar. More importantly, the increased tension can cause wound breakdown or even areola death. The sunken areola look and poor scar potential has moved many specialist plastic surgeons away from this procedure. It can, however, prove a useful tool if used judiciously for example in a patient with mild breast sag, having a breast implant where a breast implant alone will not suffice to bring the nipple up into a youthful look. Here a nipple lift may avoid the scars of a formal breast lift and the implant behind it may decrease the sunken areolar look. The implant does, however, increase tension on the wound so again good results with this combination can usually only be reached if a small lift and skin tightening is proposed. If skin laxity is significant with significant loss of volume, a formal breast lift procedure may be required with your breast augmentation to achieve a safe, predictable and aesthetic breast rejuvenation. Periareolar Mastopexy or Nipple Lift with Dr Sawhney Our principal surgeon Dr Raja Sawhney will assess your individual situation, desires and risk factors. He will then explain the options, relative risks and benefits of each before coming to a decision with you on a plan for your chosen procedure. It is imperative that smoking is avoided for six weeks before and after your surgery to reduce risks of wound breakdown if a nipple or breast lift is required. 3D-imaging with VECTRA cannot predict nipple or breast lift capacity of an implant in a patient with breast droop or sag. If you have significant sagging, breast augmentation alone may not lift the nipple and areola enough. The result is a breast that droops over the implant, known as a snoopy deformity. If the nipple only needs moving up under 2cm and there is not significant skin laxity, a nipple lift may suffice. If laxity is more significant a breast lift may be required with your breast augmentation to avoid a snoopy deformity.