Would a “donut” or crescent lift with implants be sufficient for me? (Photo)

Question

Hi, I’m 21 years old and looking at getting a breast augmentation with a nipple lift. I have sagging breasts and I think lower than ideal nipples due to weight loss. I have had a consult with a plastic surgeon and they told me I have grade 1-2 Ptosis and discussed the option of a full breast lift or just getting implants alone ( thinking 535 UHP). I am worried if I proceed with implants alone I will end up with snoopy boob. Would I be a good candidate for a donut lift with my BA. Bra size 14b-c

Vasileios Vasilakis, MD, FACS · Answer

Thank you for the question. You do have true ptosis and a breast lift in combination with the augmentation is indicated. But, you are only 21, so you should strongly consider having a breast augmentation without a lift. Your surgeon will be able to fill the lower poles of the breasts and raise the nipples by approximately 1 cm, which can be enough. If you are not happy, you can always undergo a lift in the future, but once you have a lift the scarring and effect is permanent. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Finny George, MD · Answer

Hi, thank you for sharing your question. It is hard to say from the photos but you may not need a lift at all. Implants alone will raise the nipples enough to preclude the need for a lift. I hope this helps.

Gary M. Horndeski, MD · Answer

The crescent or donut lift would not be effective. 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.

Ronald J. Edelson, MD · Answer

You would definitely need a formal breast lift. A crescent or donut will do nothing. On the other hand when considering the scars required for a lift you might not want that done at such a young age.

Daniel Barrett, MD · Answer

Dear Forceful869892,
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. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jules Feledy, Jr., MD · Answer

Your photos suggest that you have a slightly trickier situation in that you have breast pseudoptosis with loss of the upper pole volume and high lower breast folds (inframammary folds). You would benefit from additional volume in the form of an implant - this will help the overall breast volume but especially your upper pole volume. But you are absolutely correct that a skin procedure is needed. If you only have the implants placed, you are likely to have the tissue descend over the implant. Especially over the next few years. The nipple areola needs to be centralized. I am hesitant on the 'donut lift' as there will be circumferential pulling on the areola. And the scar tends to be very thick. Please discuss the possibility of a 'lollipop lift' with your board-certified plastic surgeon. This is designed for women who require a medium amount of surgical correction. It involves a surgical incision in a ring around the areola, as well as a straight incision running from the bottom of the areola to the middle of the breast crease. I think this will be a better option for you. Respectfully, Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery

Connie Hiers, MD, FACS · Answer

Don't choose the crescent lift since it can change the shape of your areola. You might do well with the doughnut lift, but measurements are needed to be sure. I would suggest not going with such a large and heavy implant, but something that fits your frame and tissue.

Eric Maiorino, MD · Answer

Given the degree of ptosis that you have I would strongly consider a full mastopexy to better reposition your breast mound on the implant. My concern for you would be that a donut lift would not provided enough upward movement or last long enough once things settled, running the risk of a snoopy deformity like you said.