Eric Pugash, MD

Hi. You have had an areolar or donut breast lift. Unfortunately, this procedure produces very little actual lift and often results in stretched areolas and ugly scars. It should be called the 'DO NOT' breast lift. I nearly always do a vertical, or lollipop breast lift. This lift narrows and projects the breasts and does not distort the areola. Your breast lift was inadequate, and has led to the so-called waterfall deformity you have accurately observed. You will almost certainly need to have your breast lift redone. Your inframammary scar(s) are below the current crease. This has occurred either because they were placed below the crease by your surgeon, or because the crease has moved up due to capsular contracture around the implant. I recommend you be thoroughly assessed by a plastic surgeon with a large experience in aesthetic breast surgery. All the best.

You do need a breast lift along with augmentation. The Benelli or donut lift should really be called the 'Do Not' lift - it provides little lift, usually results in enlarged areolas and often produces ugly scars. The donut lift should be done as rarely as possible. I nearly always do a vertical, or lollipop breast lift. The anchor lift should only be done in very droopy breasts; in my very busy breast practice I nearly never do the anchor lift. I recommend smooth, round, cohesive silicone gel implants under the muscle. It is important to keep in mind that the larger the implant, the faster your lift will come down. You need to be sensible in choosing your implant size. The combined lift and augmentation is a challenging operation. I advise you to see a very experienced plastic surgeon with expertise in aesthetic breast procedures. All the best.

You have tuberous breasts with significant asymmetry. Without having the benefit of an in-person physical examination which would eventually be needed to arrive at a definitive plan, it appears to me that you would benefit from a breast lift with augmentation using different-sized implants. I nearly always use a vertical, or lollipop breast lift, which reduces the size of areola, raises the nipple, and projects the breast. I suggest you stay away from the donut, or circumareolar lift. The donut lift should really be called the 'Do Not' lift - it provides little lift, usually results in enlarged areolas and often produces ugly scars. The donut lift should be done as rarely as possible. I recommend you consult with a very experienced aesthetic breast surgeon, as this will be a challenging procedure. All the best.

'Crescent' is the only accurate part of the name 'crescent lift.' The procedure produces little useful lift. Moreover, a crescent lift would not deal with the loose skin you have over your lower poles. I nearly always use a vertical, or lollipop lift. This lift is powerful, projects the breast, and can raise the inframammary fold. I recommend you discuss your situation with an experienced plastic surgeon. All the best.

Bonjour. Les cicatrices suite à une réduction mammaire sont souvent épaisses. Elles mettent en général quelques années avant de prendre leur aspet définitif, meme si elles ont tendance à s'élargir. Je vous conseille d'acheter des "silicone tapes" que vous pouvez trouver sur Amazon, par exemple, meme en forme de "lollipop" ou alors d'ancre, selon le type de réduction que vous avez subi. Le plus important, c'est d'etre patient, les cicatrices de ce type mettent plusieurs années avant de devenir plates et pales. Merci de votre question et bonne installation aux E-U!

The First Rule of breast implants is this: the bigger the implant, the bigger the trouble. Large implants damage the breast tissue through excessive weight and stretching; they may make it difficult to fit clothing and to find appropriate lingerie; and I believe they are associated with higher rates of capsular contracture since a large implant cannot really remain under the muscle, where the risk of contracture is reduced. I have found that very large implants often lead to very large, very hard breasts which are difficult, complicated, and expensive to fix. I try almost never to go over 500cc - this can be a challenge in patients with a larger or taller build, since the implant appears smaller, but I think the priority should always be to try to minimize potential problems and to keep the patient (and surgeon) out of trouble. All the best.

You do not need a breast lift. Your breasts will fill out nicely, and will appear to sit a bit higher, once they are filled out with implants. Why add the scars, complexity, and expense of a breast lift? I would also discourage you from adding the crescent lift. This would add a very visible scar when your asymmetry is very subtle. Keep things simple. All the best.

You do need a breast lift along with augmentation. The donut lift should really be called the 'Do Not' lift - it provides little lift, usually results in enlarged areolas and often produces ugly scars. The donut lift should be done as rarely as possible. I nearly always do a vertical, or lollipop breast lift. The anchor lift should only be done in very droopy breasts; in my very busy breast practice I do only a couple of anchor lifts a year. I recommend smooth, round, cohesive silicone gel implants under the muscle. It is important to keep in mind that the larger the implant, the faster your lift will come down. You need to be sensible in choosing your implant size. The combined lift and augmentation is a challenging operation. I advise you to see a very experienced plastic surgeon with expertise in aesthetic breast procedures. All the best.

Hi. There is no perfect way to do breast augmentation - if there were, we would all do it just that way. Most surgeons choose to place breast implants under the muscle as the result looks more natural, there is reduced risk of our #1 complication, capsular contracture, and it makes for easier mammography. Subglandular augmentation, especially in thin patients, often results in unsightly, hard breasts. Many of my patients here on the west coast are workout fanatics. They do well with submuscular implants provided they're professionally fitted with workout bras in specialty stores, and not the mass market chains where so many women buy their bras. Good luck!

Hi. Seroma is unfortunately one of the possible complications of abdominoplasty surgery. It is very likely that at two years you have a seroma cavity that is surrounded by a shell of scar tissue. Even if it were possible to dry up the fluid, the scar tissue 'ball' will leave an area of swelling. It is usually necessary to remove the scar tissue seroma cavity with a surgical procedure. I recommend you ask your surgeon about this. All the best.