I want to avoid the lollipop lift. Can I get away with a donut lift and 500-550cc ultra high profile silicone? (photos)

Hello, thank you for your question. It seems like you can benefit from a breast lift with implants. A breast augmentation and a breast lift work hand and hand to enhance the overall shape and size of a woman’s breasts. These procedures are ideal for increasing the size of the breasts while restoring balance and youthfulness to a woman’s bust. Schedule an email, Skype or in-person consultation with a board certified plastic surgeon for proper evaluation.

Hello and thank you for your question and sharing your photos. You do have significant ptosis and therefore  not a candidate for donut lift. I would recommend at least a lollipop-type incision pattern, and more likely an 'anchor' lift, as it will result in a more natural shape and long-lasting lift. In my experience, peri-areolar (donut) lift tends to flatten the breast and over time areolas can stretch out giving an unnatural appearance. The vertical incision of a lollipop lift heals very nicely and become less noticeable over time. I would seek consultation with a board-certified plastic surgeon for a full evaluation and advice. Best,
Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

The short answer to your question is yes.  You have a Type II tuberous breast, and therefore you are missing the inferior lateral and inferior medial aspect of both breasts.  A circumareolar or Benelli mastopexy with a slight lowering of the inframammary folds on both breasts will allow you to move your nipple areolar complexes upward, get rid of the pouty nipple on the right side, and only have a scar around the areola which can be camouflaged by a nipple pigment matching tattoo.If you were my patient, I would not put the implant in at the same time because, while the circumareolar mastopexy causes minimal scarring, it doesn't become strong enough to hold the weight of a large implant for about 4-5 months.This 2-stage procedure gives excellent results.  

I have not done a lollipop lift in 25 years and do not recommend the technique.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices.  8% fail within in the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Hello there I think that combination is likely to leave a result that is far from ideal for you .So I would strongly suggest you don't go down that path .CheersTS

I know you don’t want to hear it but you really do need the lollipop lift along with implants to give you the optimal shape.  The doughnut lift just will not be able to change the breast skin envelope enough to give you the kind of nice round perky breasts that you desire (especially the wish pics you are  showing).   I think you would be disappointed in the shape if you decided to go with the doughnut lift and even more disappointed (and even depressed if you went with implants alone without a lift).   In the end you just have to decide what is more important to you- ideal breast shape or avoiding scars.   in your case unfortunately you can’t have both.

No matter how large or how highly projecting an implant is, it cannot rotate a nipple into a pleasing position on the breast mound In a truly sagging breast, and a donut lift does little to help. Worse, the tension on the circular scar typically makes for a lot of unpleasing side effects: thick and raised scarring, re-expanded areola, irregularly shapes areola, flattening  of the breast mound, and pleating of the breast skin around the areola. In the right person it works well, but too often it is misapplied to women with breasts like yours, leading to dissatisfaction. As a revision breast specialist, I see many women who are regretful off their decision to do a donut lift and not get what they really need, a formal breast lift. 

The original "donut" lift was developed by Dr Benelli, whom I had the pleasure of speaking with at a meeting 15 years ago.  The operation was never intended to lift a breast with too much sagging, and certainly never meant to hold the weight of an implant.  Doing so can result in a widened areolar scar, a stretched areola, and a flattened and unnatural shape to the breast.  Your anatomy is a good for a lollipop lift (I do a Lejour technique) with a modest implant.You'll have to decide which bothers you more...a breast scar or your current shape.

I agree you need a lift of some type. Although the donut scar sounds more appealing, the areola tends to stretch out and the scars widen. The lollipop lift scar heal much better than the donut and gives you better lift. That’s why many surgeons gave up the the donut. The lollipop lift is far better and the scars heal even better.

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a vertical or wise pattern breast lift.  I rarely recommend a Bennelli or circumareaolar (donut) lift.  Over time, the areola tends to enlarge with a thickened scar.  The other even worse problem with a circumareaolar lift is that it flattens out the shape of the anterior breast over time.  A vertical or wise pattern lift with an implant can result in a very nice shape if good technique is used.    The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. 

Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon