10 Months Post Doughnut Lift: Symmetrical with Large Areola

A donut or periareolar lift essentially takes a large circle's circumference and sutures this skin length to a smaller circle's circumference. The more the discrepancy between these two dimensions, the more "gathering" or scalloping of the scar. Skin elasticity will only allow any surgeon to do so much. Smaller areolae may indeed be possible with a more aggressive donut lift, but the irregularity and scalloping will correspondingly increase.

This is why you may require a modified (lollipop) vertical lift, or even a full Wise (anchor) lift to achieve satisfactory breast shaping with the areola diameter you desire.

It sounds as if you may also be a candidate for breast implants; even modest enlargement will yield substantial improvement in your appearance. Best wishes!

Hi,

I doubt very much that your areolas stretched over time. Judging from your picture, your breasts are not heavy enough to do that. However, the reason he probably chose that size for your areolas is so that you wouldn't have 'pleating'.  Pleating is not pretty. It happens when we are too aggressive, and we take too much skin at one time. Your surgeon probably compensated by making your areolas larger to accommodate a one time lift.  Personally, I prefer staging donut lifts that require significant excess skin removal. What I mean is that in your case, I would have done it twice or as many times necessary to achieve the lift desired. So, you can have him do it again, just with the understanding of a smaller sized areola. Hope this helps.

Symmetry is the curse of plastic surgery and even though the same operation is done on both sides they frequently heal like they are on two different people. You appear to have some nice improvement as you progress and it is possible that this will continue. You are at the 10  month period and it may be time for a reassessment and possible revision to center the nipple over the implant  and revise the mastopexy.  Possibly converting to a vertical type. 

Thank you for the question and picture.

Unfortunately, what you have experienced is not uncommon. The areola can spread after this procedure depending on factors such as skin elasticity and the amount of “excess” areola skin removed. You will find that additional areola reduction can be done in a straightforward fashion ( usually under local anesthesia).  I would suggest that you communicate with your plastic surgeon in a calm fashion and discuss your concerns.

Best wishes.

The most common complicationn following a donut mastopexy is stretching of the scar

This can usually  be corrected using the Sub-areolar technique ,which uses multiple sutures under the areola.This technique reduces the risk of areolar stretching in both inital procedures and revisions

WE all love "a deal", something for nothing (or close to nothing); Look great without working out, making a lot of money without hard work or risky investments and - getting a GREAT result with a MINI surgery or a non-surgical procedure.

Unfortunately - the world does not work this way. There is NO free lunch out there and everything has a cost. But rather than channeling my inner Milton Freedman (You Tube him if you have no idea who he was), let's address the Doughnut / Round block / Benelli Breast Lift.

The operation was NEVER meant to be used in the VAST majority of women in whom it is used. By removing a doughnut of breast skin in Bull's eye fashion around the areola and stitching the new inner margin (new outer periphery of the smaller areola) to the outer bull's eye margin - the breast is made slightly tighter BUT
1. the protuberant convexity of the dome is ALWAYS flattened
2. The tightening exerts a permanent outer pulling force on the edge of the areolas leading stretching and larger areolas (?was anything done appearance) often with prominent scarring at the periphery.

You CAN have a much nicer appearance by revising and reversing this operation into a Short Scar Mastopexy. It would make the breasts fuller, perkier and reduce your areolas.

Good Luck.

Peter A Aldea, MD

 

A doughnut mastopexy gathers the breast skin around the areola, and they can stretch out a bit sometimes. They certainly can be revised as well.

Yes the areolae can be made smaller in a revision of the donut lift. Discuss with your chosen surgeon. 

Your aerola is big an can be smaller. Your before surgery picture would have been helpful. Please discuss your concerns with your surgeon . Your aerolas can be smaller .

There is considerable flexibility in the areolar size with an around the nipple breast lift. The tendency is to make the areola smaller in anticipation of relapse. The areola will expand to a degree after the lift, especially if there is pressure from an implant behind it. There is no one 'best' areolar size and the aesthetics is always worth discussing with your surgeon ahead of time so you are not left with a D nipple on an A breast. What is best is what looks best to you.
Best of luck,
peterejohnsonmd