I completely agree with Dr. Zubowicz. The most heavily abused operation in Breast Lift surgery is the periareolar ("donut", or around the areola) Breast Lift. Unfortunately, the operation is really useful in cases of minimal breast sagging.
As you know, the normal youthful areola diameter is about 4 cm. Unfortunately, it gets stretched out with age and pregnancy. In a periareolar breast lift, a cookie cutter is used to mark a 4cm areola and then an outer circle is drawn around the areola once temporary stitches have "lifted" the breast to its new position. the stitches are then removed and the intervening breast skin is then removed leaving a donut gap which is closed by bringing the WIDER outer circle to the narrower periphery of the new areola. The problem is that in so doing there is buckling and cinching of the outer breast skin just as are seen when the string of a lawn bag is pulled. Although there is some smoothing of such irregularities, often they are permanent, especially in a Breast Lift in which a Lollipop incision should have been used.
The only way to smooth the area is to remove the pleated scar, open the incision and remove the excess skin below the nipple complex with a vertical scar as should have been done during the original operation.
Dr. Peter Aldea