How Can I Lift My Breasts Without Much Scarring?

Q: Dr. Eppley, My background is I use to wear a 34I and lost around 85lbs on the past year or so. I’ve had 4 children. No longer wishing for more. I currently wear a 34D that is deflated at the top. I’m wishing for more fullness at the top. I’m okay with larger implants if needed and some sagging. I’m not sure if a periareolar lift is something that could be considered. I would like to keep scaring minimal as possible but I understand that for optimal results it may be required. 
A: Thank you for sending your pictures and detailing your weight loss history…which is very significant as it relates to your breasts. The original large breasted women who breasts become deflated by weight loss always poses an aesthetic dilemma. You simply can not lift your to a satisfactory breast shape by the use of large implants regardless of how much implant volume is placed. Once the nipple is at or below the level of the inframammary fold any size implant will just drive the overhanging breast tissue further down not up. That concept only works when the nipple is above the inframammary fold.
When it comes to breast lifts the circumareolar breast lift only has a very minor lifting effect (1 cm) and it relies primarily on the effect of an implant. So while the scar is appealing it is just not appropriate/effective for your breast lifting needs.
The conclusion is that while an implant is definitely needed to create persistent upper pole fullness of the breasts (lifts do not effectively do so), the key procedure is the lift and only a full breast lift will work. (inverted T scar pattern) Thus the classic dilemma exists in which to get the best/effective result you have to do exactly what you want to avoid…..more breast scars than you want.
Dr. Eppley