Donut or Lollipop Lift.....that is the sweet question. Deflated A cups desire to be small, relatively perky Cs. (photos)

Had two consultations with very different opinions. One Ps suggests an vertical lift with small anchor the other a periareola lift with areola reduction. Thinking of augmenting with 300 - 350cc Silicone implants. I understand scars are a necessary evil and can accept what is needed to improve the appearance of my breasts. Would welcome any input. Thank You! Stats: 32yr , 133 lb, 5'1", and 2 breastfed children.

Doctor Answers 7

There is more than one way to skin a cat

Neither of your plastic surgeons has given you the wrong answer.  There are advantages and disadvantages to either technique.  Obviously the incision only around the areola sound more appealing as it is a shorter scar, but the down sides include a wider scar, higher risk of oval areola, permanent palpable suture below the areolar edge, and a potentially lower nipple position.  A small anchor pattern will have thinner scarring, more consistently raise the nipple and can more frequently result in a very circular areola.  In good hands either of these techniques can result in a very aesthetically pleasing outcome.  Think about which qualities of each technique appeals to you the most and look at the before and after photos of the two different plastic surgeons. If both of the surgeons have excellent before and after photos go with the technique that appeals to you the most knowing what the trade offs are.  If one surgeon has better before and after photos then choose whomever has the best results and don't worry about the scars.

Donut or Lollipop Lift.....that is the sweet question. Deflated A cups desire to be small, relatively perky Cs.

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue!

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 331 reviews

Need a side view

Both are options that can work. You can do more with the vertical lift VS the circle lift. I usually tell a patient that I can put the implants in and then sit up the patient and look at which lift get the best result. Some times not much lift is needed after implants are in. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 53 reviews

Donut or lollipop lift, very different opinions.

Unfortunately without an examination and clear understanding of your goal we can't break the tie in your conflicting opinions. What we can say is that augmentation with an around the nipple lift is more prone to relapse as the pressure of the implant tends to make the nipple larger. The vertical lift gives more control over the nipple diameter so a smaller nipple areolar diameter is more certain with this lift pattern. 

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 reviews

Donut or lollypop lift

No surgeon can answer this accurately without an examination. Based on your photos, it looks like you would benefit more from having the lollypop lift, but you may be able to stay with just the donut based on a face to face exam.  I also feel you may need to stay closer to the 350cc size, for "perky C cups". I would recommend you pick your surgeon and let them decide in surgery. Different size implants will lift the nipple/areola complex to different degrees, and therefore may change the amount of lift needed.The 2 opinions you received, are not that different from a surgeons standpoint.   

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 18 reviews

Dr Kayser

Thank you for your question. Actually both approaches reduce the areola so the question is whether or not you need the vertical extension scar or not. The advantage of the extra vertical scar is that it does help to gather the excess skin along the lower pole of the breast which actually helps to improve projection and better manage excess skin. Although this may provide a longer scar, this almost always Fades beautifully and is usually less obvious than the scar seen around the areola. I hope this helps and have a wonderful day. Dr. Kayser St - Clair Shores

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 reviews

Donut or Lollipop Lift.....that is the sweet question.

Thank you for your question and photos.  No online reviewer can make a diagnosis or treatment recommendation without an examination and full medical history.  In the photos there appears to be significant tissue laxity and sagging.  If one is considering a small implant that will fill the skin/breast envelope and then there may still be some residual laxity.  Depending upon how large of implant there will be more or less laxity.  A periareolar incision has a limit of improvement to remove laxity.  A vertical incision can correct laxity that a periareolar incision can't. 
An in person exam by an experience plastic surgeon is the best option to determine if ones tissue laxity plus implant will or will not deliver the result desired.  I would start with with a face to face consult with a Board Certified Plastic Surgeon who has experience in breast surgery. During your visit your surgeon should be evaluating your health to determine if you are a good surgical candidate and examining your tissues to get a sense of what type of procedure your tissues will allow. Only with a hands on exam can this be determined. During the consult you and the surgeon should be understanding of the goals and realistic outcomes of your choices. Once an exam and opinion is rendered then you can decide if surgery is right for you. Good luck.

David J. Wages, MD
Peabody Plastic Surgeon
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.