When it comes to a breast lift, or mastopexy, there are three principle ways and breast lift incision patterns used to achieve the lift; a circle around the areola (the donut), and circle on a stick (the lollipop), and the circle on a stick with a long incision in the crease of the breast (the anchor). The choice of which incision is used is based on the degree of the droop in the breast, whether or not an implant is going to be used at the same time, the amount of excess skin, the quality of the breast tissue, and the comfort level and experience of the surgeon with the procedure type.
The goal of the lift is to center the nipple and areola on the breast while at the same time tightening and lifting the breast tissue. In my practice the most common incision pattern used is the lollipop, a circle around the areola then a straight line down the middle of the breast that stops at the fold. For very minor lifts the donut incision can be used and for very droopy breasts with a lot of excess skin the anchor pattern incision tends to be best.
There is a misconception that the nipple and areola are actually detached from the breast during the procedure when in fact this is not done very often. The majority of the time the nipple and areola are kept attached to the breast tissue during the lift. In rare cases of severe breast droop the nipple and areola are detached and re-attached as a graft.