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10 Months Post Doughnut Lift: Symmetrical with Large Areola

After breast feeding two babies back to back, my surgeon completed a donut lift to correct the asymmetry on my *small* breasts. However, now I feel like I have A-cup breasts with D-cup areolae. I realize this procedure presents some limitations, but could the areolae not have been made smaller?

I need some peace of mind from other medical professionals!...I can't help but wonder if he simply never bothered to make them proportional.

Doctor Answers (13)

Areolar stretching after 'doughnut lift'

+2

This is a relatively common problem after a 'doughnut lift'. How much the areola stretches depends on what suture techniques were used and how much skin was removed. However it is relatively simple to reduce the areola if you are unhappy.


Birmingham Plastic Surgeon
5.0 out of 5 stars 5 reviews

Donut (periareolar) lift has dimensional limitations.

+2

A donut or periareolar lift essentially takes a large circle's circumference and sutures this skin length to a smaller circle's circumference. The more the discrepancy between these two dimensions, the more "gathering" or scalloping of the scar. Skin elasticity will only allow any surgeon to do so much. Smaller areolae may indeed be possible with a more aggressive donut lift, but the irregularity and scalloping will correspondingly increase.

This is why you may require a modified (lollipop) vertical lift, or even a full Wise (anchor) lift to achieve satisfactory breast shaping with the areola diameter you desire.

It sounds as if you may also be a candidate for breast implants; even modest enlargement will yield substantial improvement in your appearance. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 116 reviews

Widened areola

+1

Symmetry is the curse of plastic surgery and even though the same operation is done on both sides they frequently heal like they are on two different people. You appear to have some nice improvement as you progress and it is possible that this will continue. You are at the 10  month period and it may be time for a reassessment and possible revision to center the nipple over the implant  and revise the mastopexy.  Possibly converting to a vertical type. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

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Areola Too Big after Breast Lifting?

+1

Thank you for the question and picture.

Unfortunately, what you have experienced is not uncommon. The areola can spread after this procedure depending on factors such as skin elasticity and the amount of “excess” areola skin removed. You will find that additional areola reduction can be done in a straightforward fashion ( usually under local anesthesia).  I would suggest that you communicate with your plastic surgeon in a calm fashion and discuss your concerns.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 702 reviews

Large areola after donut mastopexy

+1

Hi,

I doubt very much that your areolas stretched over time. Judging from your picture, your breasts are not heavy enough to do that. However, the reason he probably chose that size for your areolas is so that you wouldn't have 'pleating'.  Pleating is not pretty. It happens when we are too aggressive, and we take too much skin at one time. Your surgeon probably compensated by making your areolas larger to accommodate a one time lift.  Personally, I prefer staging donut lifts that require significant excess skin removal. What I mean is that in your case, I would have done it twice or as many times necessary to achieve the lift desired. So, you can have him do it again, just with the understanding of a smaller sized areola. Hope this helps.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 123 reviews

Doughnut lift, large areola

+1

If you had a doughnut lift without a permanent pursestring suture closing the larger outer circle around the smaller inside circle, the areola is bound to stretch and become too large.  If you had a true periareolar lift (Benelli) with a pursestring suture and the areola stretched over time, it is possible that the areola was made smaller but the pursestring suture was absorbable and not permanent and didn't last long enough to control the size and it stretched.  If it has always been large since the very beginning, then perhaps it was simply made to large.  Regardless, a revision would be simple and your areola can be reduced to a smaller size appropriate to the size of your breast.  There is a limit, however, when you are having a lift only using a circular scar and avoiding a vertical scar...the smaller you make the areola, the more gathering occurs as the outer circle closes down on the smaller inner circle, and the worse the resulting scar will be.  Nevertheless, there is room for significant improvement in your case, and it is nice that the fix is a simple one.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

Areolar stretching after breast lift

+1

The most common complicationn following a donut mastopexy is stretching of the scar

This can usually  be corrected using the Sub-areolar technique ,which uses multiple sutures under the areola.This technique reduces the risk of areolar stretching in both inital procedures and revisions

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 5 reviews

The Downside of a Doughnut Breast Lift - Flat Breasts with Large Areolas

+1

WE all love "a deal", something for nothing (or close to nothing); Look great without working out, making a lot of money without hard work or risky investments and - getting a GREAT result with a MINI surgery or a non-surgical procedure.

Unfortunately - the world does not work this way. There is NO free lunch out there and everything has a cost. But rather than channeling my inner Milton Freedman (You Tube him if you have no idea who he was), let's address the Doughnut / Round block / Benelli Breast Lift.

The operation was NEVER meant to be used in the VAST majority of women in whom it is used. By removing a doughnut of breast skin in Bull's eye fashion around the areola and stitching the new inner margin (new outer periphery of the smaller areola) to the outer bull's eye margin - the breast is made slightly tighter BUT
1. the protuberant convexity of the dome is ALWAYS flattened
2. The tightening exerts a permanent outer pulling force on the edge of the areolas leading stretching and larger areolas (?was anything done appearance) often with prominent scarring at the periphery.

You CAN have a much nicer appearance by revising and reversing this operation into a Short Scar Mastopexy. It would make the breasts fuller, perkier and reduce your areolas.

Good Luck.

Peter A Aldea, MD

 

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 59 reviews

Doughnut mastopexy

+1

A doughnut mastopexy gathers the breast skin around the areola, and they can stretch out a bit sometimes. They certainly can be revised as well.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

10 Months Post Doughnut Lift: Symmetrical with Large Areola

+1

Yes the areolae can be made smaller in a revision of the donut lift. Discuss with your chosen surgeon. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.