I have posted pics of my results at 16 weeks. I have 550 HP a Donut lift and Internal Bra on both. My breasts appear awkward from the front and too large. From the side they are "tipped" or tucked". They feel heavy and low. The pics with my arms raised change the shape and they appear perky and round. My Dr told me that is basically unachievable to have them look like this with my arms down. I would also like to downsize which he strongly is against. All opinions welcome please. Thank you
Is This the Best I Can Expect? (photo)
Doctor Answers (13)
Is the best I can expect for a breast lift / augmentation?
Thank you for your question. It would have been a good idea to have posted your pre-op photos as well. This would have given me better insight into the implant size chosen and the technique used by your surgeon. I personally prefer the vertical scar technique for a good lift, when combined with an appropriately sized implant. You should be aware that the implants may drop further as healing is a progressive process. You should consider discussing this with your surgeon again. Best of luck!
Is This the Best I Can Expect?
You can certainly reduce the size of the implants and have a more extensive lift to get the breasts smaller, tighter, and higher like you describe. Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations, breast lifts, and breast augmentation revision procedures each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA
Breast augmentation together with lollipop lift gives perkiest result.
For the surgery you had, you have a good result. The result you want requires different surgery: smaller implants and a vertical (lollipop scar) lift. Can be done, but you have quite good result already.
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Considering a revision of a breast augmentation and breast lift
Your photograph from the side shows a good deal of breast sagging. I suspect that you had significant breast sagging prior to your surgery. A doughnut or circumareolar breast lift has only limited applications. You can only get about a 2 cm elevation of the nipple at the cost of flattening the breast, loosing breast projection and not getting the center of the nipple over the center of the implant. Your idea of downsizing the implants with a vertical breast lift is on the right track. This will mean additional scarring. I suspect that if you do not opt for a revision your areola will continue to widen out.
Your current results will change with time, but what it changes to might still not be what you want. I suspect you needed a formal mastopexy from the beginning, judging from your appearance now. There is no such thing as an 'internal bra', and that alone should be enough to have you find another surgeon; one who has a great reputation for revision breast surgery as well as lifts and reductions. This surgeon would not only be certified by the ABPS, but also a member of the ASAPS.
Removal and replacement of your implants from the current 550HP to a smaller (to be determined by you and your surgeon) intermediate profile implant could easily be performed, along with a conversion to a formal mastopexy (not 'vertical' mastopexy). This will give you the size you want and the shape you want.
Best of luck!
Best you can get from periareolar breast lift
The around the nipple breast lift is effective for reduction of arolar diameter and modest lift of the nipple over the center of the breast. To really reduce the skin envelope a vertical lift or even a full T pattern will be more effective. A smaller implant might also get you closer to what you want as well.
Donut mastopexy is really just an areola reducing operation
I personally don't believe there is much lifting 'power' in a donut or periareolar mastopexy. The effect I've seen in most patients is flattening of the breast contour and reduction of areolar diameter - not a lot of lifting going on. I'm a big fan of the vertical mastopexy technique - when combined with a REASONABLY sized implant - results are good and long-lasting.
This is a good result all things considered. It is not likely you can achieve the look you display with your arms raised. A vertical mastopexy with implants may give you a closer look like you want. If you down-size, you will need to do a vertical or perhaps anchor type mastopexy. In general the top of your breasts are never going to be any higher than they are. That is just the way your body developed. If you lift the breasts too high to achieve a certain look, the breasts and implants will subsequently drop leaving with a bottoming out appearance and the nipples pointing upward.
This is probably the best you will see with the donut lift
It is possible to approximate the appearance of your breasts with your arms lifted, but not with a donut lift. In order to do this, you will need a vertical mastopexy, or lollipop lift. It would probably be a good thing to downsize your implants also if you do this, because the currently location of your areola will cause some tension across the upper part of the vertical wound closure, and this can cause some flattening of the breast in this location. A smaller implant will probably create a little less of this tension and thus less deformity.
Is This the Best I Can Expect?
Thank you for your questions/photos.
For the type of surgery and size of implant you had, I believe this is as good a result as you can expect. A large implant, especially a smooth implant is difficult to lift and keep lifted. In fact, over time, you will probably notice that the implant is slowly moving downwards. It is possible to down-size to a MP+ for example, but you will definitely need a vertical lift (lollipop) instead of just circum-areolar (donut). Here is an example of an augmentation lift with a vertical lift.
Pablo Prichard, MD
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