I have simplified the process of understanding breast lift by creating three categories of lift and then I added the option of a breast implant that can be done at the same time resulting in the six choices.

The categories take into account the scars on the breast, the length of time the procedure takes, and accordingly the cost of the procedure.

The goal of the breast lift is to have a firm breast mound and a nipple-areola complex that is sitting on top of it. Therefore, when we are looking at a breast for the possibility of lifting it, we need to look at the nipple areola complex and decide:

Does it need to be raised?
Does it need to be made smaller?

We also need to look at the breast mound and decide:

Is it large enough?
Does it need to be lifted as well?
What is the quality of the skin envelope and supporting structures?

It is important to understand at this point of the conversation that there are certain landmarks on the chest that cannot be altered easily. They are the supraclavicular notch, the clavicle and very importantly the inframammary fold. It is where the breast tissue attaches to the chest wall underneath the breast. This delineated area on the chest wall is what is called the footprint of the breast on the chest wall, and it cannot be altered.

In a level one lift only the nipple areola complex is moved up to be on the top of the breast mound. It is frequently done in combination with a breast augmentation procedure. The implant will end up being above the inframammary fold and we will need to place the nipple areola complex on top of it.

In level to lift we address the nipple areola complex and we start to address the mound making it firmer and in better position with respect to the footprint of the breast, and the infra-mammary fold.
To achieve that, a scar around the areola is not sufficient and it is extended in a vertical fashion to allow access to the lower part of the breast and tightening it creating a durable support.

In level three breast lift there is a lot of extra skin and tissue laxity. The inverted “T” scar allows access to most of the breast for elevation and reshaping. Some of the extra skin is used to create an internal bra. Some of the extra skin is removed.

The resulting scar has the shape of an anchor. The round part from the nipple elevation and the rest from the breast reshaping.