Donut/peri areola lift - Is my surgeon’s opinion correct, or should I get a second opinion? (Photos)

Question

I have been told during my consultation with my surgeon that he will be giving me a breast lift and implants. However, he has said that he will be doing a donut / peri areola lift only, and that apparently is the only type of lift I am suitable for in his words. I am worried that a simple donut lift will not be enough of a lift for my breasts as they already naturally sag, and I am only in my early 20’s and haven’t gained or lost a large amount of weight ever. I have actually been told I have mildly tuberous breasts, so I’m even more concerned that A) the donut lift will not be enough to support my 295cc moderate + profile implants B) also that the pressure and weight of the implants will cause my areola reduction do not be very successful at all, given that it will only be a donut incision rather than a proper lollipop / anchor lift Could anyone let me know if they think I would actually be suitable for a ‘proper’ lift, and if a donut incision would actually reduce the size of my areolas and not cause them to stretch back out after some time has passed? Thank you!

Miguel Mota, MD · Answer

A peri areolar lift is  a very good option for you and it will eeduce and round out your areoli. I also agree with your surgeon as far as the size of the implants. In cases such as yours I really love doing a new technique called Preservé Breast Augmentation. This technique preserves essential connective tissue that help stabilize the breasts and the implants for longer results. The pocket is make by expansion of the tissue rather then cutting so there is leas pain, faster healing and virtually no downtime. Patients are usually back to normal activities in 2-3 days. 
I will leave a link. It is very interesting and delivers lasting and natural results! 
Beat of luck! 
Dr. Mota

Tyler Frew, MD · Answer

Hi there,
It's very reasonable to get a second opinion, and a good surgeon won't mind at all. That said, a donut lift with implants can be the right call for very mild sagging and mildly tuberous breasts. It all comes down to how far your nipple needs to move and how much loose skin you have.
A few points to help:
- A donut lift works best when the nipple only needs to come up a couple (1-2) of centimeters. If it needs to move more than that, or there's extra skin in the lower breast, a lollipop lift usually gives a better, longer-lasting shape.- For mildly tuberous breasts, an incision around the areola is actually the standard approach, because it lets your surgeon release the tight lower breast and reduce a wide or puffy areola at the same time.- You're right that areolas can stretch back out after a donut lift, especially with the weight of an implant. Many surgeons use a permanent stitch around the areola to help prevent that. Ask yours what they use.- The honest trade-off is that a donut lift has a smaller scar but less lifting power. A lollipop lift adds a vertical scar but gives more control over shape.- To feel confident about your size, try 295cc sizers on in a sports bra and a tight shirt, and ask about 3D imaging such as Crisalix.
An in-person exam is needed for personal advice, so bring these exact questions to your second opinion with a board-certified plastic surgeon.
All the best!

John LoMonaco, MD, FACS · Answer

A periareolar ("do-nut")  lift is a limited technique, and can be tricky when an implant is also planned.  However, your photos suggest it is a good option.  The small lift doesn't support a  lot of pressure from an implant, and areolar effacement (flattening and stretching) can occur if the implant is too large so be sure and discuss this with your surgeon.

Daniel Barrett, MD · Answer

Dear Terrific412956,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donut/peri areola lift - Is my surgeon’s opinion correct, or should I get a second opinion? (Photos)

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