dear, thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by
different factors such as pregnancy, massive weight loss, lactation and aging.
To reaffirm the breasts and restore the natural look your surgeon can perform a
mastopexy or breast lift. A breast lift
restores a firmer, perkier, and more aesthetically pleasing shape to sagging
breasts. This not only can improve a patient’s appearance by restoring her
youthful, feminine proportions, but also help bras and swimsuits fit
more comfortably and attractively. By removing excess, stretched out skin,
reshaping the breast tissue, and raising the nipple & areola into a more
forward position, a cosmetic surgeon can create a more youthful breast
contour. Stretched, large areolae can also be reduced during breast
lift surgery, creating an overall better proportioned, natural looking breast, Actually
the perkiness on a person or another, depends on patients skin and breast
so when disagreements occur prior to any procedure, you can easily find another surgeon who will agree with your plan. If you do not want implants, a vertical mastopexy can easily be done and provide a much better outcome than any Benelli procedure can. If you are wanting implants, you have a very challenging situation as very large implants will make it likely that you will have retained areola in your vertical scar... if you can even pull your tissues side to side after augmentation. So if you're wanting very large implants, you may consider doing your procedures in steps...
There are very clear guidelines as to when A doughnut Mastopexy should be performed versus a vertical lift. I believe you're better candidate to have a proper breast lift using a lollipop incision/vertical lift and will have better long-lasting results. Is difficult to get a proper lift using a doughnut Mastopexy and very commonly the Areolas widen. I would choose a surgeon that is going to give you the proper recommendations instead of having to change his mind. Best of luck.
When the patient knows better than the doctor, you need to find a new doctor!!! You are absolutely not a candidate for a donut lift, and would only be served well with a formal (anchor/modified anchor/vertical) lift.
Augmentation mastopexy is one of the most complex and challenging surgeries to perform, and on average has the highest complication rate. Choosing an ABPS certified/ASAPS member surgeon is important, but they must also show specialization in complex surgeries of the breast. These surgeons do this surgery consistently well and with lower complications. These surgeons either have a great reputation for breast surgery, or can show you dozens of examples like yourself in their before and after gallery.
Please reconsider surgeons.
Best of luck!
Thank you for your question. I agree that the donut lift would have a limited benefit. However, it's not going to be so easy to change your plastic surgeon's mind! Be sure to have consultations with several different experienced board certified plastic surgeons before moving forward. Good luck!
I agree that a donut lift would not be optimal for you. The donut or Benelli lift can accomplish only a small amount of lifting of the nipple position and minimal lifting of your breast tissue. It also tends to flatten the breast which would not be beneficial for you. Also if the closure around the areola is too tight the areola will enlarge again over time or the scar will widen, or both will occur.
If you have requested a larger implant then perhaps your surgeon is concerned that he will not be to do a bigger lift without having excessive tension on the incision lines after closure, It that is the case you would probably better off by having a staged procedure first doing the optimal lift for you and them returning after 4-6 months and placing an implant. That way you will have the greatest flexibility in choosing your implant.
You can't just change your PS's mind as he may not be comfortable with the lollipop and/vertical mastopexy lift. Please chose a plastic surgeon who performs these lifts routinely. Please see examples of your desired lift below.
You are correct that the anchor lift, when compared to the "donut" or Benelli lift, is the best in terms of being the strongest lift, and results in the best scar around the areola and the most long term control over areolar shape and size. If you are willing to have the vertical scar, there is no question that it is the best lift. Unfortunately, in patients with large areolae and fuller breasts, the closure can be tighter, and placing implants in at the same time can cause the incisions to be closed even tighter over an increased underlying volume due to the implant. This greater tension can lead to wider scars or even wound breakdown with delayed healing and worse complications. In those patients, I would recommend the best anchor lift first, and delay implant placement until a second stage 3 months or more later.
In discussions with your surgeon emphasize that the shape of the breast is important and additionally that you will accept the extra skin scarring associated with breast lifts other than a donut lift. It is refreshing to hear from a patient with realistic expectations and who understands that surgery requires incisional scarring to obtain optimal results. Regards.
I think, from the photos, the donut lift might be OK depending on your goals, but I believe I would personally lean more towards one of the bigger lifts. If you simply get in for a follow up consult and explain what you want I bet the surgeon would be OK with a change of plans.