Height:5'7 1/2 Weight:127 BEFORE STATS: Bra Size-32C,BWD:14,(R)Breast from Sternal Notch:23 (L)Breast from Sternal Notch:21 AFTER DONUT LIFT & AUG. STATS: Bra Size-32DDD,(R)350cc's(L)400cc's Mod+ unders. SEEKING: Stronger lift w/ less loose skin, firmer, perkier, & more upper pole fullness. Ultimate wish would be for breast not to drape too excessively over the crease(hey, a girl can dream!). Which lift would afford me most of my wishlist? CC & Profile suggestion? Are examples achievable for me?
Which Lift Would Be Appropriate Lollipop Lift or Full Lift? Ideas On Cc's & Profiles? (photo)
Doctor Answers 24
"Lollipop" or "full" doesn't matter as long as it allows better breast shaping and lift
Thank you for submitting all the information and photos. It makes it much easier to give a good answer.
Your situation is quite common. A reasonble decision was made to proceed with augmentation/mastopexy for you and a circumareolar only or "donut" mastopexy was chosen. Unfortunately, the trade off of "no scar" or less scar (avoiding any vertical-"lollipop lift" or inframammary crease-"full lift" scar) is that the breast can only be lifted so much without modifying the breast tissue itself rather than just reducing the skin.
With the addition of the vertical scar or if needed, the transverse crease scar (the final decision can be made in surgery), it is possible to get to the breast tissue/gland itself which can then be dissected and shaped with sutures. This allows the surgeon to shape the breast independent of the implants, thus enhancing both your the initial breast shape and degree of lifting as well as hopefully yielding longer term results.
The two results you posted as examples are quite reasonble for you.
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Breast Lift with Breast Implants: The right lift for the right size
The lollipop versus full lift or mastopexy depends on the amount of lift you need. It looks like and sounds like you need a significant lift and despite the attraction to the lollipop lift, most vertical type mastopexy techniques do need skin removed from the lower aspect of the beast to refine and tighten that border of the breast. If you think about it, lifting the nipple areolar complex increases the distance between the nipple and the fold, which gives the appearance of the sagging breast. This needs to be shortened with a full lift and maybe consider a downsize in implant volume. Do not shy away from a full lift IF you need it. I hope this helps.
Lift vs larger implants
I think that you have a rather large implant which will only stretch out your breasts and make them sag more long term.I just read an article where a plastic surgeon compared thousands of differentlift/breast reduction techniques to see which ones gave "perky" breasts and the answer was NONE.I think you may tighten them upo with a small lollipop lift but I would also put in smaller implamts.
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From my perspective you had two things done which resulted in a predictable result.. You had a donut type or peri areole lift which often leads to an areola that is stretched out and did not achieve the lift you expected. I think you also had implants placed which were too large. I would advise performing a full mastopexy and replace th implants with a smaller size, in the 275 to 325 ccrange. This will result in smaller but more perky breast and a result that holds up better in the long term
Perkier Breasts Without Lollipop or Full Lift
You will need the implants removed and smaller implants placed. At the same time, the pockets must be plicated laterally and inferiorly to elevate the implants and maintain the cleavage. You will need your breast tissue elevated with internal sutures and the areolas elevated with an eccentric donut mastopexy. The goal is to align all 3 elements, the implant, your breast tissue and your areola, in the same horizontal plane. This can all be done through a circumareola incision not requiring either a lollipop or full lift. Reducing the size of the implants would make them more stable long term and the lift would create more upper pole fullness resulting in more perkier breasts.
Best of Luck,
Gary Horndeski, M.D.
You scar "scare"
I clearly understand that most patients are fearful of the vertical scar, however the circumareolar option has limitations. Given your photos- you will get a better result with a circum-vertical approach. In general a smaller silicone gel implant will cause less stretch effect, and decrease the recurrent sag potential.
How much lifting required after breast augmentation
Based on your pictures, you would most likely require, at the very least, a "lollipop" mastopexy. There is a very good chance that in order to achieve the perkiness that you indicated you desired, a traditional mastopexy with an incision underneath the breast tissue would be the best choice for you. Ultimately, this should provide you with the best overall shape and longevity to your results.
Shopping for the Answer you want to hear?
You didn't like what was said last time, hoping to hear what you want this time around? You are now posting photos of others with nearly the same size implants that you have, yet you don't see the obvious: on the others the implants do not extend out past their rib cage nearly as much as yours do. By looking at photos of others and seeing 'what they got', will not translate into what you'll get, and you will not benefit from that kind of decision making.
I can't blame you for reposting, many of the responding doctors differ in opinion, but most are telling you the obvious: go smaller, get a full anchor lift. This is the only way you'll look remotely like the photo of the model farthest from you above. By the way, a vertical lift is being espoused by a few doctors, one even going so far as saying it is the superiour lift. Well, that just isn't true. The December issue of Plastic and Reconstructive Surgery had a very nice article looking at photometric analysis of different lift and reduction techniques. The traditional anchor gives the best lift in the bottom of the breast with the most upper pole fulness and projection, and this correlates well with what I see in my practice. There is a place for the vertical lift though, once again the proper patient characteristics will dictate which lift is most appropriate.
Now stop asking us, and get out there to see a few breast surgery experts! If you need a few names of surgeons even remotely near you, I will be happy to give them to you.
Best of luck!
Thanks for posting pictures, it makes it more informative when answering questions. Based on your size and your expectations, I would recommend a full lift / mastopexy to achieve the best size and shape.
Secondary breast lift
The 'secondary' surgery (second procedure that must consider the changes incurred by the first operation) is certainly more complicated than the original surgery and choosing the correct approach is critical to success. I believe that you will absolutely require a 'full lift' to improve your breast shape / position. The exact length of the incisions required to remove excess skin will be determined at the time of surgery, after a new (smaller) implant is placed and the 'pockets' / capsule space is altered internally to improve the implant position. The capsular tissue as well as breast tissue is restructured internally to support the breast and implant, the skin is then 'redraped' (not used for significant support). Therefore, careful attention must be paid to restructuring the internal components ( breast and capsular tissue) and removing the appropriate amount of skin to both reposition the nipple and reshape the breast.
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.