What Breast Lift Should I Consider: Anchor, Lollipop or Donut? (photo)

Best to Pick The Right Surgeon Not the Breast Lift Technique
From the want to be photos you provided you will need an implant exchange with somewhat smaller implants and a lollipop breast lift (mastopexy). This is what works best in my hands and the use of a Lollipop technique can lift your breast to the perkiness you desire. However, other plastic surgeons are more comfortable with an inverted T or Anchor Pattern technique. In general I would pick the best Surgeon and explain fully what you want to achieve rather than the technique. Always insist on a board certified Plastic Surgeon.

The answer to your question lies in letting you surgeon know specifically what you would like to look like following the surgery. For example, how perky do you want to be, what shape do you want to have, etc.?  However from your description  it would appear that a lollipop type lift would be best for you. periareolar lift. Here is a rule of thumb that works for most patients. If you nipple is above your lower breast crease then often a periareolar lift will be sufficient for most patients. If your nipple is at or below your crease then a vertical lift (lollipop lift), inverted T or anchor pattern may be required

With the “#lollipop” #technique, an #incision is made around the areola and another between the areola and breast crease. This technique avoids a long scar in the crease under the breast , which was an older technique known as the “#anchor” or “inverted T.” Such methods create as much as twice the scar and can flatten the breast, creating less forward projection and suboptimal shape. Hence, Dr. Horowitz prefer the “#lollipop” technique or “#donut lift” to avoid more significant scarring, rather than the majority of surgeons in the United States that use an anchor pattern lift.

Good questions.  A vertical lift offers the best combination of effectiveness with minimal scarring.  A "donut" lift does not provide an effective lift and causes tension on the areolar, making it look distorted (it is associated with a high level of patient and surgeon dissatisfaction).  Breat implants will give you the upper pole volume you want.  Either saline or silicone gel will work nicely.  An extra benefit of the vertical lift is that your areolar size can be reduced at the same time.  I"ve attached a link to my website so you can check out results for yourself.

Wow, what a great question.  This is the kind of question that gets debated at what doctors call Grand Rounds.  At these meetings, experts with each technical system (Benelli Mastopexy, Lollipop, or Classical Anchor) will argue which technique will give the best results.  For your purposes, you need to find the doctor you trust and then go with the technique he or she recommends.  

Choosing a Board Certified plastic surgeon, certified by the American Board of Plastic Surgery, a member of the Aesthetic Society, operating only in certified surgery centers, using only Board Certified anesthesiologists, having tons of before and after pictures would be a minimum requirement for the surgeon you are looking for.  Then ask to speak to one or two of his patients that had this procedure already.  Next, sit down with your plastic surgeon and have him or her explain how they do the procedure and why they consider the other procedures they wouldn't do inappropriate.  The surgeon who is willing to break things down in an understandable fashion for the patient is the one you are looking for. 

As to which technique is correct for you, they all would work depending on so many variables, choose the right surgeon and the technique will follow.

You can undergo a circumareola approach using a donut shaped incision.  This will allow implant placement, elevate the breast tissue and elevate the nipple.  This should all be done higher on the chest wall and the horizontal alignment of all 3 adds projection.  You definitely DO NOT want any vertical scars on the breasts.  These widen in time and cannot be hidden.  You are a perfect candidate for Breast Augmentation with Ultimate Lift.

Best of Luck,

Gary Horndeski, M.D.

Based on your photographs, I would recommend an augmentation mastopexy, in other words a vertical lift with an implant.  A mastopexy alone will reduce and reposition the areola but due to your loss of weight and parenchyma, the end result may not be as satisfying.  A small implant will provide you with more projection and upper pole fill that will greatly improve the result.  One has to be conservative in choosing an implant size since the competing interests of lifting or reducing breast skin and increasing breast volume with an implant can lead to complications unless adequately assessed. 

After looking at your pictures, I will have to recommend a vertical lift of your breast. The scar looks like a lollipop. I use your own tissue to build the mound of the breast. The technique will pull the lateral chest skin in and up when done properly. I have not done an anchor technique in over 15 years. In my hands, its not necessary.  A vertical scar or lollipop will give you a very round and natural looking breast with less scars. I would recommend gel or silicone implants if you want to be bigger.Thanks, Luis Vinas MD, West Palm Beach, Fl

The optimal plan will depend on the shape and size you are seeking.  I would not recommend a periareolar lift unless you include an implant as well as just the periareolar lift tends to flatten your breast.  If you do not want an implant or to be larger,  a vertical mastopexy with a lollipop scar could give you a better shape with just your own tissue.  Discuss your goals with an experienced surgeon and ask to see examples of his work.  Most patients feel that the ideal shape is worth the added scar.

For women with nipple and breast ptosis (droopiness) that lies below the inframammary fold, a circumvertical (around the areola and a vertical component) mastopexy is a powerful way to provide a youthful shape to the breast. If the amount of skin in the vertical direction of the breast is excessive, the horizontal component may be added to further tailor the breast, although this is an unusual occurrence. Nobody wants more scars in any operation, however the bottom line is the final result from the surgery. Are you willing to sacrifice the final result from your surgery in order to have fewer scars?

If you are happy with your size and volume and not the position of the breast, I would recommend a vertical or lollipop lift alone. It appears that you may too much ptosis or droopiness to the breasts to have a donut lift. If you would like a little larger size, an implant and lollipop lift would give a nice full round shape to your breasts.