Is a periareolar/donut lift (recommendation from surgeon) enough? (Photos)

Dear Original1769,
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

From the front, your nipples appear to be located below your breast fold. Therefore a donut lift may not be sufficient for you based on your wish pic.

The technique I recommend is a lift using The Bellesoma Method. 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Based on your photos, you need the vertical lift. If you want the volume of 300-400 cc implants, fat grafting will not be sufficient.

Peri areola lifts are not very effective in lifting the breast. Due to the skins ability to stretch. A more formal lift with support of a mesh would serve you better. (your breast skin has many stretch marks)
Great job on your weight loss. However it appears that you have very little donor fat to support fat grafting. Usually multiple sessions are required to achieve a augmentation. I would use a traditional lift with mesh support and add an implant based on your bodies proportions. Good Luck