As an African American I'm terrified of bad scarring. Is it possible to achieve my desired look with minimal scarring? (photos)

Question

I would like to get a breast implants with a lift. Ideally, I would like to have a crescent or donut incision. A bigger size as well is ideal, but the shape (beckoning) is the most important thing. I have included photos of me and my desired look. I would like to know if it is achievable and where the incisions would likely have to go.

Brian K. Reedy, MD · Answer

Thanks for your question! I'm not sure that your wish photos are totally achievable. You have a more complex case given that you have tubular breasts. To get closer to the desired look, I would likely recommend a breast lift with a lower profile implant. You will probably never have that much lower pole fullness, but I still think you can get a beautiful result. Good luck!

Finny George, MD · Answer

Hi, thank you for sharing your question. Based on your photos, you are a great candidate for breast augmentation and it is unlikely that you will need a lift procedure. The exact size and shape of the implants can only be determined after measurements are taken by your plastic surgeon. I hope this helps.

Chul Hwan Seul, MD, PhD · Answer

Thank you for your question. Considering your breast ptosis condition and areolar size, crescent mastopexy is not likely to be suitable. I recommend periareolar (donut) mastopexy with implant augmentation. Scars remain around the areola after surgery. Although periareolar incision can be used for implant insertion, the recent trend is to use inframammary incision (under breasts) to reduce infection rate and capsular contracture rate. Surgery may not achieve the exact desired breast shape; it is expected to significantly improve the current breast shape.

Sacha Obaid, MD · Answer

Thank you for your question.  I would recommend discussing with your plastic surgeon your concerns and discussing postoperative scar therapy.  There are numerous lasers as well as scar injections that can be performed after surgery to help maximize your results and decrease the potential for hyper-tropic scarring.  Best of luck to you.

Casey Anderson, MD, FACS · Answer

Your breasts have some tuberosity so to achieve the look you have attached likely requires incisions around the areola. So long as this is done with minimal tension, you have a good chance of well healing scars. There is always a risk of hypertrophic or keloid scars. You will have to determine if that risk outweighs not having the procedure.

Gerald Minniti, MD, FACS · Answer

Your skin appears thick and tightly elastic, and the addition of an implant will make the tension too great for an immediate breast lift. Regardless, surgeons you consult will recommend doing them at the same time. Do not. Your scars will not be fine or inconspicuous. I highly recommend you first get breast augmentation without a lift and wait, perhaps a long time (one year, two?) until the implant does its work: to expand the lower pole of your breasts and relax your tight tissues. At that point, you might benefit from a periareolar lift (please, only a donut, not crescent).

Gary M. Horndeski, MD · Answer

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person evaluation with a plastic surgeon to be measured and discuss your goals. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ronald J. Edelson, MD · Answer

A donut type lift will risk thick scars. The lollipop type lift tends to form better scars and I think is a better choice.

Harry T. Haramis, MD, FACS · Answer

Unfortunately, scars are a trade off.

A small scar under the fold can place implants and allow for internal reshaping of breasts. Dual plane with release of lower tissue will improve shape.

In my experience, you can avoid larger breast lift scars this way. If necessary during surgery, a crescent can raise areolae.

​An exam and consultation with a plastic surgeon is recommended to further discuss your best options and expectations.

As an African American I'm terrified of bad scarring. Is it possible to achieve my desired look with minimal scarring? (photos)

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Answers (19)

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