Can I Have a Donut or a Crescent Lift to Avoid Large Scars? (photo)

Hi Linita27,

    I appreciate the fact that you want to minimize scarring, but it is critical that you understand the limitation of either the donut or the crescent lift.  

     The crescent lift is performed using a partial circular incision at the top of the areola.  It is designed to elevate the nipple areola position somewhat.  In my experience, it has no place in any setting.  All it does is stretch the areola upwards somewhat with negligible lift of the breast.

     The donut lift involves an incision completely around the areola.  This lift is able to remove some skin around the areola, thereby tightening the skin envelope of the breast in a purse string fashion.  It has some capacity to raise the nipple areola complex, and can only minimally raise any of the droopy breast tissue below the inframammary fold.    In your case if you undergo this procedure, your areola would be a bit smaller, your nipple position would be raised by an inch at  the most, and only a small amount of breast tissue would be raised below your fold.  That is, you will still have a significant amount of breast tissue sitting on your rib cage below your breast fold.

     A lollipop lift involves an incision around the areola,  along with a vertical incision extending from the areola down to the breast crease.  No horizontal incision is used. This lift allows the breast to be raised quite powerfully, so that no breast tissue sits below the fold and a beautiful shape is produced.  In my experience, when this operation is done with very little skin tension, the scar usually heals quite well where it is difficult to see at the one year mark.  In my opinion, that is the lift that will give you the most elevation with the best shape. You also look like you have fair skin which should result in excellent scars.  This lift does not have the horizontal incision which on many occasions does not heal well.

     A note about using implants concurrently.  Implants have two functions.  They increase volume and affect the shape of the breast in that they produce more upper pole fullness and better cleavage.  I disagree with some of my colleagues that feel implants should not be used in lift as implants may stretch the breast even more.  I strongly disagree here.  When implants are placed behind the muscle, with appropriate muscle release, very little force is exerted by the implant on the breast tissue.

     In summary, I think you should strongly consider undergoing a lollipop lift (vertical mammaplasty).  I think an implant should be considered as well>

     Good Luck,

Ary Krau MD FACS

In the zeal to reduce the length of incisions operations have been introduced that are inadequate to deal with ptotic breasts. The picture demonstrates breasts that will not turn out well with a limited incision mastopexy.