Would a donut lift with 250/275cc implants placed OVER the muscle be a good idea? (photos)

Question

110lbs, 5’5”. I have only been to one consultation and I’m wondering if another doctor would see me and strongly disagree. I like the idea of over the muscle as I have small children, and need a quick recovery. I also prefer a more “sloped”/ slightly lower sitting breast. Looks more natural to me. The doctor I consulted with took my measurements and said I would be a good candidate for subglandular. He does a 50/50 mix of overs vs unders

Jeffrey Lisiecki, MD · Answer

I have a couple of suggestions.  First would be to consider subfascial augmentation, because you look like you have thinner tissue in the upper pole, and subfascial augmentation creates a more natural, softer slope at the top of the implant than subglandular.  It is a newer version of "above the muscle" breast augmentation.  I rarely do donut lifts for a number of reasons, but your nipple is not that low--you may be happy with no lift at all, depending on the size of the implant.  250-275cc sounds like a very reasonable size range, though the exact implant would depend on your measurements and goals!

Martin Jugenburg, MD · Answer

Hello, thank you for your question. If you are looking for just bigger breasts but same positioning of your breast tissue then you can go above the muscle. Discuss your options with your plastic surgeon and be sure to bring in wish pics of someone with a similar frame and size. Feel free to check out website for some before and afters.

Daniel Barrett, MD · Answer

Dear Fearless479765,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

Your selected surgeon sounds like he's stuck in a time warp and telling you things that are verifiably false.  Subpectoral augmentation dose not require more recovery time or cause more discomfort. John Tebbits showed the world in 2001 that patients can be doing all their normal daily activities in a few days or less. This is the case for myself and my colleague who perform this operation in an evidence based best way. My patients take only tylenol and ibuprofen, are lifting their arms over their heads the day of surgery, and are driving their car in 3 days. Implants placed in the subpectoral position have a far lower rate of capsular contracture, a problem that requires a complex revision surgery. From an aesthetic point of view, implant placed in the subpectoral position are less likely to be visible or palpable, especially in the upper and central chest where it is most likely seen in public. This is especially important for someone like you who is very lean in the central chest region. Finally, subpectoral implants are far less likely to form an obvious shelf in the upper pole.  Find another surgeon.

Scott W. Vann, MD, FACS · Answer

If you want a sloped more natural look rather than the rounded top somewhat "fake" look, then you want to go below the muscle. Also the complication rate is also lower with under the muscle. The recovery is slightly longer, but well worth it in my opinion for the look you want and less chance of complications. Good luck.

Zoran Potparic, MD · Answer

Based on these photos, I would say that vertical, lollipop type of lift, would serve you better. Periareolar lift will make your aleady large areolas even larger and create scar you may not like. Shorter scar is not always better. Another consult with a plastic surgeon who does not like donut lift is recommended. Implant size seem to be appropriate to give you 1.5 cup sizes up. Good luck.

Connie Hiers, MD, FACS · Answer

Staying on top of the muscle is less painful and does not show muscle flexing, but you see the edge of your implant.  Under the muscle or fascia would give a better look with more upper breast fullness than in front of the muscle, and there would be less sag potential.

Would a donut lift with 250/275cc implants placed OVER the muscle be a good idea? (photos)

Answers (7)

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