Feeling saggy and disappointed/frustrated-after donut mastopexy/implants. Will they get better when swelling goes down? (Photo)

The periareolar mastopexy popularized by Benelli and Goes few decades
ago is the most frustrating novelty and progress in cosmetic surgery
(followed closely by endoscopy).Essentially these are the flaws of the periareolar mastopexy in the best hands and correctly executed:-flattened breast, "fried egg"-shaped-"sun beams" around the areola due to the folds made to encircle a large circular edge downsized to a tiny periarolar edge of the wound-overtension of the scar, leading to hypertrophic scarring of awful cosmetic quality, if not keloyd-this overtension enlarges the areolas looking like cookies, furthermor elongated vertically most of times-cutting away sking all around the areola leaves the areola in the same place, this means no uplift of NAC at allYou
are not the first and will not be (unfortunately) the last to become
victim of the seducing "scar-less" uplift. It is not a matter of finding
the "best surgeon" to perform it, it is question of finding a surgeon
who does not practive this technique.Viewing your images you
don't need a lift AT ALL, your ptosis was minimal, just for breast
augmentation only, through hemi-perirareolar approach, anatomical shaped
implants with macrotextured shell and cohesive gel filler, in
subfascial plane.

Thank you for your question and photos.   It is far too early to make any definitive statements about your final outcome.  It usually takes about a year until all the elements settle and scars become stable.  So far it looks like you are healing well.  Please follow your Board Certified Plastic Surgeon's instructions.  Please let them know of your concerns.  Together you will get through this process, hopefully with an outcome that you like.Jeffrey J. Roth, M.D., F.A.C.S.Board Certified Plastic SurgeonLas Vegas Plastic Surgery

The period of time immediately following the combination of breast lift and breast augmentation surgery is characterized by rapid change. During this dynamic period of time, swelling, muscle spasm, inflammation and the healing process itself all contribute to changes in the appearance of a woman's breasts. In some cases, swelling and muscle spasm can displace the breast implants in a superior direction when implants are placed beneath the muscle. This can result in an artificial upper breast fullness and inferior malposition of the nipple areola complexes. Based on your pictures, I believe this is a distinct possibility.In some cases, superior implant displacement may be due to inadequate dissection of muscle insertions of the inferior portion of the breast pocket. There's no evidence that this has occurred in your case. With time, assuming adequate pocket dissection, these implants might return to a more normal position. Sometimes the use of a bandeau superiorly and massage can facilitate this process.It may takes 3 to 6 months for these implants to drop into a normal position. If no progress has occurred by then, revisional surgery may be necessary. This would involve recreating the lower portions of the breast pocket.It's important to have good communication with your plastic surgeon. Make sure he's aware of your concerns. He's familiar with the specifics of your surgery and will be able to give you appropriate direction.

The
periareolar lift, more commonly referred to as a donut mastopexy, does provide
a small amount of improvement as far as lift is concerned, but it’s limited
compared to a traditional mastopexy. It’s too early to guess at your final
results at only one week post-surgery, but your breasts are more likely to look
softer and fuller rather than higher and firmer as swelling decreases. I advise
my patients to wait at least 6 months before considering a revision procedure.
If, after that time, you still feel dissatisfied with your results, I suggest
visiting your surgeon again to see what options he or she advises.

You had a periareolar lift which is the minor form of lifting when compared to a full lift which is a major lift with more scars. Implants will not lift the breasts.It would be best to heal for 3-4 months and let the swelling go down. Quite possibly, you will want to consider having a full lift to better elevate the nipples and tighten the loose lower pole skin.