Subglandular Implant - Lollipop Lift Now or Later?

After breastfeeding my DD breasts are now droopyC/D and assymetrical (almost half a cup). One dr suggested to go submuscle with a short scar (lollipop) lift with 290cc or 320cc. The other subglandular 320cc on one side and 350cc on other side (to even them out) with the possibility of a periaerolar lift. I obviously want to avoid scars but don’t want to end up with large droopy breasts. SN-N22cm IM-N10cm I'd like to be full D to DD. I am 6ft. Please help.

Doctor Answers 14

Subglandular Implant - Lollipop Lift Now or Later?

You have several issues to address, asymmetry, droop and inadequate volume. In my practice I would not suggest trying to correct all of these on the same day. I suggest doing a lollipop scar lift and allowing it to heal for a few months before doing a sub muscular augment. The scars will heal better, and you are far less likely to need a touch up or revision later. After healing your augment can be done just as it would be for any other patient.

Columbus Plastic Surgeon
4.5 out of 5 stars 16 reviews

Mastopexy with implants

If you do not want a mastopexy, implants should go subglandular or you will have what we in the plastic surgery industry call the "double bubble effect."  Ideally, for perfect breasts, I would advise a mastopexy (lollipop or anchor, not periareolar)  with an implant either subglandular or submuscular but you have to realize that breasts drooping is genetic, they're probably going to drop again regardless of where the implant are located. If they're subglandular, the implant will go with the breast. If they're submuscular, the implant won't drop.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 45 reviews

What are the option for sagging breasts after breast feeding.

It seems that you have significant sagging of your breasts as well as the asymmetry.  You appear fit and trim, and you stated your breasts were C/D cup currently. 

For an optimal result, this combination of findings usually requires a breast lift with a lollipop style incision at a minimum.

You need a consultation with a plastic surgeon who can examine you and discuss the treatment options that will best meet your needs.  

Fredrick A. Valauri, MD
New York Plastic Surgeon

Lift with implants

Thanks for all the great info.  You may be able to have implants with a periareola  lift.  But then again a small vertical incision  may be required if the breasts appear too loose.  An exam would be helpful, but the photos and info help.  You look very thin, and I would definitely go under the muscle to help minimize the risk of rippling superiorly.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Lift now or later?

Thank you for posting the photographs, it is very helpful.  Looking at the photos, I would say that you need a lift now as implants alone will not be able to tighten the skin adequately.  The type of scarring - periareoloar, lollipop or inverted T - is down to the individual surgeon to some extent and the degree of lift needed.  Whatever technique you have, it will leave you with a scar around the nipple, which is the most obvious one.  Good luck.

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 13 reviews

Add the vertical scar

Subglandular placed implants in attempt to address ptosis in my personal opinion is a bad idea.  Eventually as you astutely have noted, the implants will droop.  A vertical scar mastopexy with submuscular implants is what I would reccomend.  On my website you will find an animation video explaining the technique.  Good luck.

Breast lift with augmentation

I think the first surgeon's recommendation is better. You have a degree of ptosis (sagginess) that can't be corrected with just impants (or a periareolar lift). If you want enhanced volume with implants, you need also to have a lift like the vertical scar ("lollipop") lift.

James W. Ward, MD (retired)
Arlington Plastic Surgeon
5.0 out of 5 stars 3 reviews

Lift or implants?

I would recommend a lift only or a lift with small implants of approximately 225cc.  I believe you will have to accept some scars if you want to achieve a more ideal shape.

David Stoker, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 29 reviews

Subglandular implant - lollipop lift now or later?

Hello! Thank you for your question! These two procedures can safely and effectively be performed in one setting, given you are healthy and without medical comorbidities to prevent such. Staging the procedures to have them done at various times will likely not have any cost benefit for you. When you combine procedures, there is often a discount that is provided by the surgeon for multiple procedures. Also, when having multiple procedures performed at the same time, you save on anesthesia and facility fees, which otherwise are paid for with each individual procedure. In addition, you may benefit by the single recovery time. Cost of these procedures will vary amongst plastic surgeons in addition to geographic location.

However, more important than the financial aspect, your plastic surgeon will have to determine for you if the viability of the breast as well as nipple-areolar complex may be placed at jeopardy if done at the same time. If for this reason, it would be wise to stage these procedures.  You must take caution when having a subglandular implant and lift at the same time, as the vascularity can get compromised much quicker than a submuscualr implant/lift.  Without an examination, it is difficult to tell you what to recommend.

Certainly it is you decision as to whether you have your procedures performed in one or multiple stages, but your surgeon will give his/her recommendations. Consult with a plastic surgeon well-versed in breast surgery who will discuss and examine you, while assisting you to decide which procedure will be the best option for you. I would discuss your concerns with your surgeon and see what your options are - sometimes multiple consultations with board-certified plastic surgeons is helpful for you to decide. Hope that this helps! Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Sub-Muscular Implant Placement with Lolli-Pop Lift

A variety of strategies have been utilized to avoid scarring that is frequently associated with breast lift surgery. In many cases these alternate strategies compromise the patient’s aesthetic goals.

                  The correction of breast sag requires the removal of excess skin. The more severe the breast sag, the greater the amount of excess skin and consequently the greater the need for extensive incisions. It’s important to realize that every patient is unique and because of this, treatment needs to be individualized.

                  In this particular case, placement of a breast implant on top of the muscle would avoid excess breast scars. Unfortunately, this treatment option is often associated with significant secondary problems. In most cases treated in this manner, breast sag isn’t totally corrected by implant placement alone. In addition, implants placed in this position don’t have the support that’s typically provided by sub-muscular placement. Over the course of time, they tend to drift in a downward direction, thinning the skin and breast tissue as they drop.

                  Eventually, a large percentage of these patients will need breast lift surgery. Under these circumstances, a much more extensive procedure will probably be required and result in even more scarring then was originally contemplated. In addition, the potential for scarring and complications is often increased because the soft tissue has been stretched and thinned.

                  Under these circumstances, sub-muscular implant placement with a lolli-pop lift is probably a better option for you. Although this procedure might be associated with longer scars, it avoids the large droopy breasts that concern you. It also avoids the potential for even more problems at a later date. 

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.