Would I Benefit from a Periareolar Lift and Implants or is Another Lift Best?

Stats: 24/F/Mom of 3 5'7" currently 180lbs, currently in the process of losing 80lbs, goal weight:145lbs bra size: 36D/DD - Deflated, ptosis Center of Clavical to Nipple - 30cm Areola - 9cm diameter (xl) Desired: FAKE PERKY LARGE HIGH FIRM ROUND PORN-STAR BREASTS 34DD/36D Do you recommend subgladular or submuscular for the look I want?Would a periareolar lift suffice or is an anchor or lollipop needed? If I dont get my areola reduced will it stretch EVEN BIGGER after implants?? Cost est?

Doctor Answers (10)

Periareolar lift and implants or another type of lift needed?

+2

You have severe breast sagging or ptosis, and you have not completed your weight loss yet, so this may get worse.  Already you need a full breast lift, in my opinion an anchor lift, and implants to fill out your loss of volume, particularly if you are looking for a fake look.  Also in my opinion, it would be best to have a very effective lift first, and follow that with a breast augmentation perhaps 3 months later or more.  This would offer the best opportunity to have the most effective lift (without the constraints of lifting around a large implant since some relaxation will invariably occur) with the most predictable result and the lowest risk of complications such as incisions coming apart, widened and stretched scars, and nipple loss due to blood supply issues.


Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

Lift and implants

+2

WIth even your arms up in the air,. the areola are pointing downward. You more than likely need a lift with a vertical or "T" pattern closure. I doubt that a periareola lift willbe enough.  An exam would be helpful.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

You would benefit from full lift and staged augmentation

+2
The answers to your questions regarding the lift and augmentation been very informative and cover most of the issues. The only caution would be the size of the implant and the look you want. The picture that you posted as the desired shape shows very large implant above the muscle. This will cause early sagging in your case. Your tissue is thin and would not support very large implant. As long as you are aware of the need for touchup or redo lift that would be ok. You need to wait till you have lost the weight that you want to lose and then get the lift first and then augmentation.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 54 reviews

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Full breast lift vs periareolar

+2

The only time a periareolar lift is applicable is if the nipples are absolutely no lower than the inframammary crease.  You have too much downward droop to get a great result with just a periareolar lift.  Of course the choice is still up to you, but a much better shape will come from the full lift. 

If you go that route, you will probably need to stage the procedures by 3-4 months because to put in a huge implant can put too much stress on the incisions from the lift if done at the same time.  Remember that a lift tightens you and an implant stretches you and if the stretching forces are going to be substantial, it is wise to have already healed the lift.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Would I Benefit from a Periareolar Lift and Implants or is Another Lift Best?

+2

I hope other posting questioneers read your post and see the photos. You did a terrific outline of your issues and the photos show exactly what you are asking. My recommendation is 500 cc aboves with a secondary operation after 3 months of a L-shaped or full lift.

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

Periareolar lifting enough for a few

+2

The problem with some one who has a very large areola, and significant breast ptosis with the nipple pointing straight down is preventing relapse, especially with a full implant pushing behind. We feel that you should consider a vertical lift if you wish the nipple to stay up and a reasonable size. The picture you provide is a suggested result, and for the look you will need a moderate profile sub-glandular implant. A high profile implant may end up looking like balls, and sub-muscular would be nicer over time, though less rounded on the upper edge, less 'fake'.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 27 reviews

Types of Breast Lifts

+2

Thanks for posting your info and pictures.  It is very helpful and informative.  Based on your pictures, you have a good amount of ptosis of your breasts.  A periareolar lift will not be sufficient to give you the best possible final outcome in terms of breast shape and scar healing.  For the best results, I would suggest a lollipop and anchor incision with the implant placed partially under the muscle.  You should still be able to accommodate a large implant that you desire, but all will ensure good tissue coverage of the implant.

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 56 reviews

Periareolar vs other breast lift

+2

Periareolar breast lifts are ideal for lifting the nipples a small distance without the need to remove a lot of excess skin.  The more skin that has to be removed the more extensive the incisions have to be such as a lollipop or anchor incision.  By doing a lollipop or anchor breast lift, the nipples are usually reduced as part of the procedure.  When placing implants after an extensive breast lift, it is safer to stage the procedures and have the implants placed a few months later.  However, if the surgeon is using an anchor incision breast lift and placing implants at the same time, the implant will usually be placed under the muscle to help preserve the blood supply to the nipple as much as possible.  

Adam Hamawy, MD
Princeton Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breast Lift?

+1

Thank you for the question and pictures.

It is likely that you will be best served with a vertical mastopexy ( incision around the areola and vertically down the breast) as opposed to a  circumareola breast lift.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 708 reviews

Periareolar Lift with implants is only rarely a good option

+1

Sometimes you can not have all that you want and this is one of those situations. I never like to disappoint patients but you need to be receptive the opinions of experienced surgeons. You have severe breast ptosis (sagging of the nipple and the breast), asymmetry of your breast volumes and a relatively short distance from the lower edge of the areola to the fold of your breast. This last limitation will not allow your nipple to be reduced in diameter and moved upward while creating a much larger breast. Each of these features needs to be considered in making recommendations.

The desired look would require an over-sized (>350 cc)  round implant, likely in front of your muscle (sub-glandular) and would not allow for a reduction in the diameter of your areola and lift of your nipple and areola to an optimal position at the same time. Implants in front of the muscle will look more "fake" but will also be at higher risk of developing capsular contractures, visible ripples, further thinning of your tissue and accelerated sagging of your breast position. If the areola is decreased in diameter at the same time as a larger augmentation is performed then the front of your breast will become flattened when looking from the side and the areolar scar likely will widen over time. If bulging upper breast poles is what you want then just do the augmentation and at a later date when the tissue has stretched you may be able to have the nipple and areolae better positioned and proportioned. This second operation may or may not be offered or be possible  but you will have the look in a bra that you are after. I personally would discourage you from this approach and not offer a surgery that may be "successful" in the short term but set you up for problems and revisional procedures in a few years.

On the other hand, you can respect your breast tissue limitations and go for an improvement in your shape with a single operation using a smaller implant, sub-pectoral location with a standard breast lift (lollipop or shotened-T) for the best results. If you know that you will only be happy with the type of look in the photograph, then do not have surgery or be prepared for expensive disappointments with attempts to achieve this outcome.

Dr. Mosher

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 9 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.