Can I choose a a circumareolar lift with a small implant? (Photos)

Question

I really don’t want the scars of a full anchor lift, and for a long time I’ve thought I’d just do an implant to fill things out, several docs said they would do it. Now I am very certain it would not be best as I do NOT want waterfall look nor do I want to cause more sagging with the weight of a larger implant. additionaly I do not want to have to go in for a second time. So I guess I’ve resigned myself to the fact that I need some lifting. Is there any way I can get away with a nipple incision only paired with a modest implant Or fat transfer? Also should note I do not want my nipple placement ultra high or pointing upward. Thanks in advance!

Gary M. Horndeski, MD · Answer

A better procedure for you and avoids the vertical scars is the Bellesoma. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Frank Agullo, MD · Answer

Whether a circumareolar lift is enough depends on where your nipple sits relative to your inframammary fold, and how much skin has to come off. If the nipple is only a centimeter or two below the fold and most of the problem is lost upper fullness, a donut or Benelli lift with a modest implant can work. I think you fall into this category.

If the nipple is at or below the fold, or the breast hangs well past it, the donut cannot shorten the lower pole. The areola gets stretched flat, the scar widens, and the breast can slide back off the implant, which is the waterfall you are trying to avoid.

A moderate implant, with fat grafting to the upper pole if you want extra fullness, keeps the weight down.

#StayBeautiful,

@RealDrWorldWide

Muge Sevindik, MD · Answer

You have a degree of breast sagging, which we call pseudoptosis. I would recommend a round implant placed above the muscle to provide more fullness in the upper pole, combined with a lift around the areola. This combination can give you a beautiful, fuller, and more lifted appearance.

Tyler Frew, MD · Answer

Hi there,
It can work, but it depends on how much lift you really need. A circumareolar (around the nipple) lift is best for mild to moderate sagging where the nipple only needs to move up a small amount. It gives the least visible scar, but there are trade-offs.
A few educational points. Studies show this technique can flatten the breast shape, and the areola and scar can stretch over time. It also has the highest revision rate of the common lift types, which is important since you told us you don't want a second surgery. A vertical lift, which adds a scar straight down from the areola but no scar along the crease, tends to give a better shape and hold up longer, and you are right that a full anchor lift is not always needed. A modest implant or fat transfer can add upper fullness, and a surgeon can plan the nipple position so it doesn't look too high or point upward.
The honest tradeoff is a smaller scar versus a better shape and fewer touch-ups. An in-person exam is needed to know which lift is right for you.
Try sizers on in a sports bra and tight shirt and ask about 3D imaging like Crisalix to preview the options.
All the best!

Mert Demirel, MD · Answer

A circumareolar lift removes a ring of skin around the areola and nothing else, so the scar stays there. That also defines its limit: it can raise the nipple a little and reshape the areola, but it cannot lift a breast that has truly dropped.
In my practice it is clearly the better choice in four situations: only one side needs a lift, the lift needed is limited, the main complaint is areola asymmetry, or the breast is tuberous. In those cases a longer scar pattern adds scar without adding much benefit. If the sag is larger, pulling a lot of skin through a small circle flattens the breast and widens the scar, and a vertical or anchor pattern is the more honest choice.
A small implant can be added, but it puts more load on the healing, so some people stage it. Earlier surgery and the type of implant, if there is one, change the plan, so I can't settle this from a description. Nipple position, skin quality and base width at an exam decide it. Scars take about a year to mature, and the shape settles over months.

Yasemin Aydinli, MD · Answer

Looking at your photos, your nipples sit below the breast fold and point downward, and most of your breast tissue lies below the fold. A circumareolar (donut) lift can only raise the nipple a short distance, it tends to flatten the breast and widen the areola over time, and it cannot reshape the lower part of the breast. With an implant pushing from behind, the stretch on the areola becomes even greater. Fat transfer will not lift the breast either; it adds a little volume, but the tissue stays where it is. For a result you will not need to revisit, I would recommend a full lift combined with a small implant under the muscle. A proper lift also allows the nipple to be placed in a natural position, not too high and not pointing upward. Keep in mind that your own tissue, even after a lift, never gives the upper fullness an implant gives, so the small implant is what will fill the upper part of your breasts.

Can I choose a a circumareolar lift with a small implant? (Photos)

Answers (6)

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