Would an areola reduction / donut lift help achieve a small, natural lift or am I at risk of scarring and stretching? (photos)

Dear Vega637,
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

You are not a donut lift candidate. Your breasts are too ptotic and a donut lift will ruin the possibility of getting a truly aesthetically pleasing result. The scars from a formal mastopexy on you would be fine and white, and the proper position of the nipples would be impossible otherwise.

A periareolar mastopexy (donut uplift procedure) will facilitate areola reduction and improved symmetry, but it will not adjust the position of the breast on the chest wall - i.e. it will adjust the skin but not the underlying gland. The scar is usually well hidden around the areola. There are surgical techniques that can be used to minimise the risk of stretching and disguise the scars.

The vertical lift would do much better for you and position the breasts in the proper location. With the breasts lifted, your areolar reduction will be more successful since breast tissue won't be pulling on them. You are too saggy for the doughnut lift.

Based on the submitted photos you aren't a good candidate for the donut/periareolar mastopexy. This would not give you enough improvement in shape, would not really change the nipple position significantly, and could stretch over time. I encourage you to visit with a board certified palstic surgeon near you to explore your options.

All breast lift procedures that include skin excision can reduce the size of your areola.
There are basically three approaches to standard mastopexy surgery. The simplest form is the donut lift a.k.a. Benelli lift. This should be limited to lifting the nipple 1 cm or less.
It is not a good procedure for patients who need extensive surgery.
In regards to areola reduction it depends on how small you want to go.
I’m not a big fan of the donut approach because it begins to compromise breast shape and has too many side effects.
The procedure should only be used when small changes are needed.
The next approach is removing more skin with the vertical scar sometimes called the lollipop lift. This allows a longer scar to absorb the skin tension and significantly decreases the chance of all the undesirable side effects associated with the donut lift.
Left sometimes called an anchor lift for Wise pattern Add a long scar along the bottom of the breast.
This allows for a much more aggressive lift, and the removal of more skin.
The longer the scar the more skin there is to absorb attention from the procedure.
A lollipop lift is probably correct for your needs, but you’ll find different opinions on different providers.
I suggest having multiple in person consultations with plastic surgeons in your community, who seem to have a lot of experience with breast surgery.
Bring pictures of yourself for each consultation.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients Who had similar body characteristics to yourself.
Highly experienced surgeons should have access 100’s or possibly even thousands of before, and after pictures to choose from.
Buying a quality collection of before and after pictures, you should begin to develop a pretty good idea of what your results are likely to look like, including from different approaches.
Once you commit to a donut lifts it becomes more difficult to convert to a more involved lift later if you don’t like the outcome. It’s not ideal to go from a donut lift to a lollipop lift but it can be done.
The donut lift is used too often on patients who need a more involved procedure.
Focus your efforts on provider selection by having multiple consultations.
I generally recommend people avoid virtual consultations and instead of focus exclusively on in person consultations whenever possible.
And the hands of the right provider you’ll be guided to have the correct procedure and the chance of a high-quality outcome goes up significantly.
In the end, provider selection is the most important variable.
The biggest mistake I see patients make is having only one consultation before scheduling surgery.
Best,
Mats Hagström MD