I have been using a 'vertical scar' technique for many breast lifts, which eliminates the long, horizontal incision in the inframammary fold below the breasts. This technique not only eliminates the horizontal incision, but also creates more impressive breast projection and maintains it better over time. The breast lift procedure I perform not only removes breast skin but also moves some lower pole breast tissue to a higher position, increasing the projection of the nipple/areola area. Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'. However, in most patients it is difficult to create sustainable fullness in the upper poles of the breasts by means of a mastopexy alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation. For patients who indicate that they wish to achieve a fair amount of fullness in the cleavage area as a result of their breast lift surgery, I recommend that they undergo augmentation mastopexy. This surgery combines a breast lift with the placement of a breast implant usually of modest size, which produces the most youthful breast profile possible. Another option for adding fullness to the breasts is structural fat grafting in conjunction with a breast lift. If your surgeon is recommending a ‘circumareolar’ or ‘donut’ or ‘Benelli’ mastopexy, insist on seeing as many postoperative photographs as possible. Be sure to view photos six months and a year or more after surgery. I can almost guarantee that you will not like what you see, and that you will not be inclined to have that surgery - which is not truly a breast lift surgery - performed on your breasts. It is not uncommon for a woman to want a breast lift and tummy tuck together. This is often referred to as a Mommy Makeover. Find an ASAPS member who has many, many photos that are appealing to you. Check their education, training and philosophy. Following surgery, many surgeons, myself included will use a V-beam laser to help surgical scars heal quickly. Be in your best possible health before surgery to help ensure the best results and fastest, most comfortable healing experience.

I have been using a 'vertical scar' technique for many breast lifts, which eliminates the long, horizontal incision in the inframammary fold below the breasts. This technique not only eliminates the horizontal incision, but also creates more impressive breast projection and maintains it better over time. The breast lift procedure I perform not only removes breast skin but also moves some lower pole breast tissue to a higher position, increasing the projection of the nipple/areola area. Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'. However, in most patients it is difficult to create sustainable fullness in the upper poles of the breasts by means of a mastopexy alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation. For patients who indicate that they wish to achieve a fair amount of fullness in the cleavage area as a result of their breast lift surgery, I recommend that they undergo augmentation mastopexy. This surgery combines a breast lift with the placement of a breast implant usually of modest size, which produces the most youthful breast profile possible. Another option for adding fullness to the breasts is structural fat grafting in conjunction with a breast lift. If your surgeon is recommending a ‘circumareolar’ or ‘donut’ or ‘Benelli’ mastopexy, insist on seeing as many postoperative photographs as possible. Be sure to view photos six months and a year or more after surgery. I can almost guarantee that you will not like what you see, and that you will not be inclined to have that surgery - which is not truly a breast lift surgery - performed on your breasts. It is not uncommon for a woman to want a breast lift and tummy tuck together. This is often referred to as a Mommy Makeover. Find an ASAPS member who has many, many photos that are appealing to you. Check their education, training and philosophy. Following surgery, many surgeons, myself included will use a V-beam laser to help surgical scars heal quickly. Be in your best possible health before surgery to help ensure the best results and fastest, most comfortable healing experience.

Structural fat grafting to the breasts can provide a wonderful result. I often use fat grafting with a lift in order to add some fullness to the upper pole.

It is impossible to give you ideal suggestions without any photos. But, the concerns you describe could possibly be addressed without surgery. Lines above the lip can be addressed with microneedling, laser skin tightening and / Belotero injections. Crows feet, laugh lines and forehead lines can often be improved with Botox. Looking tired could be from a result of very low body fat (typical of a tri=athlete) fillers like Juvederm, Juvederm Voluma, or structural fat grafting, depending on the area could provide an improvement. Be sure to seek out a plastic surgeon with a plastic surgery medical spa that offers non-surgical options can provide a consultation. A doctor that offers only non-surgical treatments will steer you in that direction. A surgeon who doesn't offer the full range of non-surgical aesthetic enhancements will likely suggest surgery or nothing. Many ASAPS members offer a full range of surgical and non-surgical aesthetic enhancements.