What lift do I need? If any? (Photo)

Surgeon said 'donut lift.' After research and photos I'm wanting to back out of that type of lift. I do not want to hate my nipples after a lift I might not need. I'm horrified by photos of that lift. My main concerns are my stretched areolas, asymmetry and lateral nipples. I'm not wanting the risks for a few puny cm of lift. I want a large implant bc I loved my size while breastfeeding. I'm happy to revisit a lift in the future but looking for a reasonable outcome with what I have. Thanks docs!

Doctor Answers 22

Dual plane breast augmentation

Thank you for your question and photos.  You appear you would have a nice result with breast augmentation alone, if done in a dual plane fashion.  This will provide a mild lifting effect and give you the fullness you desire.  What would not be affected would be areola size and lateral displacement.  This would require additional procedures.  I would recommend scheduling a consultation with a plastic surgeon and see what options are available for your case.  Good luck!
For more information on breast augmentation, please visit the link below.


Jackson Physician
5.0 out of 5 stars 7 reviews

What lift do I need? If any?

Implants alone should be fine. I would recommend a circum-areolar incision in case you need a lift later
Internal lifting will be of benefit as well

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.9 out of 5 stars 12 reviews

Breast lift or augmentation only?

I am not sure that you need a lift at all. It is highly possible that you would be happy with the results of a breast augmentation alone, especially if you would like to go with a larger implant. I do not do the donut lift (or Benelli lift). It provides no real lift, and because of tension, it can leave a very wide, unattractive scar. You mentioned that one of your concerns is your “stretched out areolas”. While the augmentation alone will not address your areola size, you probably will not be bothered by them as much after your augmentation. When the volume of the breast increases, it tends to make the areolas look more proportionate. I would suggest consulting with another plastic surgeon, who is board certified, to review your options. Good luck!

Ashley Gordon, MD
Austin Plastic Surgeon
4.9 out of 5 stars 31 reviews

To lift or not to lift that is the question

Thank you for your questions and for your photos. From what you describe, it seems as though you are fine with the location of your nipples. I think one of the most important things is that you have done your research and you are making an educated decision based on that research. With any lift the trade off is going to be better nipple position for scars on the breast. It sounds like you are saying that for a small lift you are not willing to accept scars on your breasts nor the possible complications of that surgery.

From the photos it seems as though you would have a good result with just augmentation alone. You stated that you would be open to revisiting a lift in the future which is very well something you may need. If my patient's nipples are about 1-2cm off, but they are ok with the position, understand they may need a lift in the future, do not want scars on their breasts and I think the breasts wont hang off the implant then I will augment them without a lift. However, if based on physical exam, the nipples are a little too low for augmentation alone, then I basically inform them that a lift is a must.

I think you should definitely relay your concerns to your plastic surgeon and hopefully he is a board certified plastic surgeon! Wish you the best of luck for your surgery!


Ankur Mehta MD 

Ankur Mehta, MD
Sugar Land Plastic Surgeon
5.0 out of 5 stars 16 reviews

Breast lift with implants

Thank you for your question and photos.  I do not think that a lift is needed in your case.  Instead, you can undergo an augmentation with implants alone to achieve and excellent result.  You need improvement in volume and upper-pole fullness which can be achieved with a breast augmentation.

All the best,

Dr. Results
Miami, FL

What lift do I need? If any?

Thank you for your question.  Based on your photos, I don't believe you need a lift.  Implants alone should do.  You have pseudoptosis, not true breast ptosis (side profile) - breast augmentation with implants should do the trick.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

What lift do I need? If any

The implant alone will exagerate the lateral placement of the nipples, and the nipples may look a little low on the new breast mound. If you are willing to accept that, then skip the lift

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Breast augmentation alone

I would say based on these photographs that you could have an excellent outcome with an implant alone, providing you choose the right surgeon and the right implant.

The most sophisticated approach to breast augmentation is through the armpit with a surgical camera (transaxillary endoscopic). Using this modern approach the space can be crafted under direct vision, with virtually no bleeding and no postoperative bruising. Most importantly, the shape of the breast is meticulously created. The other, older methods of insertion are technologically less advanced. Both silicone and saline implants can be placed through the armpit by a surgeon with skill and experience using this approach. The incision in the crease is the oldest method of placing the implants and puts a scar directly on the breast.


HP implants, which are a more modern shape than moderate profile implants, fit most women better. They have a more appropriate base diameter and can be made to look very natural or very augmented, depending on where in the range the implants are filled to achieve a particular volume. High profile implants are the first choice in my opinion. I rarely find an indication to use moderate or moderate plus implants. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of volume, and where in the range the implant is filled.

There are many advantages to sub muscular dual plane placement and very many disadvantages to sub glandular placement. I would see no indication to do anything but sub muscular dual plane. Subglandular silicone implant placement is the historical approach to this surgery, and was widely used in the 1960's. The implant edges are more visible, the risk of rippling is higher, the implant is in contact with the non-sterile breast tissue so the risk of infection and capsular contracture is higher. The interface between the breast tissue and the muscle is blurred so the implant interferes with mammography more than sub muscular placement. The blood supply surrounding the implant is worse so the risk of capsular contracture is higher. The support for the implant is less so there is more long term shape abnormalities and sagging. The look of a sub glandular implant is much less appealing than a sub muscular implant. The placement of sub glandular implants makes any subsequent revision surgeries more complicated and less successful. There are no advantages to sub glandular implant placement.

The choice between saline and silicone is one that requires a complex discussion of all of the advantages and disadvantages of both implants. The issues to be considered are safety, density, mobility, rippling, rupture rate, consequences of rupture, detection of rupture, need for follow-up care, cost of follow-up, appearance, feel, sensation of heaviness, radio-density, mammograms, and costs, among other things. There are advantages and disadvantages of both products. The decision will ultimately be up to you based on what is appropriate for your particular situation. Beautiful results can be obtained with either implant.

The best way to determine the size that fits your personal perception of the perfect breast is to try on sizers. This way you can see how they fit on you, how they add to your current volume, and whether they fit your frame. Although the surgeon can guide you, only you will be able to tell what is the right size. Try on sizers. Measuring a diameter and then telling the patient what volume they can have (in high, moderate or moderate plus implants) in my mind is backwards. The patients should be allowed to choose the volume. Then the surgeon carefully considers the base diameter, projection, profile, manufacturer, and fill material that will achieve the patients goals of size as well as qualitative look (natural, intermediate, or bold upper pole fullness or projection), all the while taking into consideration the patient's anatomic features that will affect the outcome. The experience of the surgeon and the degree to which they explain the options to you is of utmost importance. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of implant. Don't let the doctor tell you what would look good on you. They cannot tell what you perceive to be the best size. There is no maximum. That is up to you.

I don't think a lift is necessary

I think you will do great with an augmentation, but the key thing is to choose the right implant and have the pocket dissected appropriately.  There is nothing you can do about your lateral nipple position if you don't allow for an incision.  If you choose the wrong implant and are dissected medially too much and with the wrong width implant, your lateral position can actually be accentuated and look worse.  Make sure you see a surgeon that feels comfortable with all types of implants and points these things out to you during your examination!  Hope this helps.

BTW, I think you will look awesome with the right implant.  They may have to back off and give you different sizes/projection because of your asymmetries, but you CAN NOT have them choose implants with significantly different widths!!!

-JGH

To lift or not

I think it is important here to point out the asymmetry that you currently have between your breasts. One nipple is significantly lower than the other. While one breast should do quite nicely with augmentation alone, if you simply augment both breasts, you run the risk of augmenting the asymmetry as well. This may be acceptable to you, and you may be happy enough just with the augmentation, but keep this possibility in mind. The key to a doughnut lift is selecting the right patient. Some patients only need a crescent lift, some need a donut lift, some need a lollipop lift, and some need and anchor lift. In the properly selected patient, with meticulously executed technique, the doughnut lift gives an excellent result. Whether or not you are a candidate can only depend on more extensive conversations and examinations with her plastic surgeon.
Best of luck!
Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 52 reviews

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