Wanting breast lift and areola reduction. 28 years old, no children, 58kgs/128lbs. My size is a large DD cup/small E cup (Photo)

I have hated my breasts for years, both the sagging and the size of my Areolas. I haven't shown them to previous boyfriends as I am so embarrassed by them. I have been researching and researching and would like to know what the best option for me would be. Would I be a candidate for a donut lift? I really would prefer not to have the vertical scarring. If not I would be open to an implant but is there any way I could keep my size and not increase?

Doctor Answers 14

Breast lift candidate

I would suggest a normal breast lift for you. If you are still concerned over the size of your areolas, I would consider undergoing a reduction for them. Implants would increase your size, so a breast lift would be the best way to go. Book an in-person consultation with a specialist plastic surgeon to discuss the best options for you. Best of luck.

Lollipop Lift

For patients with sagging breasts who are satisfied with their volume and whom desire lifted, perky breasts, a breast lift is the surgery of choice. 

A breast lift is often performed using one of three larger incisions. These include 1) an incision around the nipple areola (peri-areolar or donut), 2) an incision around the nipple combined with an extension down towards the breast crease (lollipop, vertical,  or short scar), or 3) a lollipop incision with an extension horizontally in the breast crease (inverted “T” incision or anchor). The choice of incision is based on multiple factors including patient anatomy, surgical goals, surgeon preference, and patient preference.

Based on your pictures, your entire breast is ptotic, not just the nipple. To lift the entire breast into a perkier position, you would need a lollipo lift, at least. Adding an implant is a possibility, however, an implant adds volume (makes the breast bigger) and it would not significantly change the need for a vertical incision.

See the link below for pics and more info.

In general, all the scars heal well. Every patient, however, is different. A detailed examination will help delineate the best surgical option. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

Lift

I do  not think a donut lift will give you enough lift.  I usually only do those with implants as they have a tendency to "push in" the areola a bit without an implant.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

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Wanting breast lift and areola reduction. 28 years old, no children, 58kgs/128lbs. My size is a large DD cup/small E cup

An implant, by definition, will make you larger. An areolar incision alone will locate the areola higher but will not give significantly new shape to your breast, leaving it essentially where it is at present, with a similar shape and just a better nipple location. Anything more would require at least a lollipop incision.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Breast Lift

Thanks for your question and pictures. A breast lift would definitely make your breasts perkier. From your pictures, I feel that you would not need an implant to achieve your goal.

The incisions for a breast lift depend on the amount of loose skin you have, the amount of breast droop you have as well as the nipple position. I think a donut lift alone would bring up your areolas, it would not address the excess breast tissue that is drooping and you would not have a good postoperative shape. In my experience, a vertical mastopexy (lollipop lift) would help to improve nipple position as well as overall breast shape. An internal brassiere lift would help to bring the lower breast tissue up, giving you a perkier shape. An areolar reduction can be performed safely at the same time as the mastopexy.

So...a couple of things

1. You have really pretty breasts.  I get that they might not be exactly how you want them, but this is coming from a plastic surgeon who does a lot of breast surgery.  Seriously, your breasts are really pretty great.  Could they be lifted and perkier?  Sure- that would require a breast lift and there are many different techniques for that.  Not all techniques and not all surgeons are the same so choose someone that you feel comfortable with and gets gorgeous results on the surgery you are seeking!

2. If you like your volume in a bra, you do not need an implant.  That is great news.

3. Do NOT get a "donut" lift.  They do not look good as a lifting surgery.  It is a technique to use for skin tightening and usually around an implant because the implant can help hold shape and projection which is necessary because the donut lift flattens the breast at the point where it should be the most projecting.  I really am against this lift.  The vertical incision heals beautifully and as the best breast surgeon that I ever learned from used to say "never sacrifice shape for an incision" (or lack of incision in this case).

I hope this helps and if you have any questions, please feel free to contact my office. 

-JGH

Breast lift procedure

A breast lift can do all the things you desire. You will have some scars that fade over time but are always visible. You should not be embarrassed about how you look. Please see a board certified plastic surgeon in your area! Good luck!

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

Vertical lift is the best option for you!

Thank you for the question and photos. You appear to be an ideal candidate for a vertical breast lift. This should reduce the areola size and lift your breasts giving you more projection  while maintaining the same size. The donut lift alone will result in wide scars and a flatter wider shape to your breasts. If you are concerned about the vertical scars they usually heal very well to almost being imperceptible after 6 months to a year after surgery but the advantage is you are getting perkier breasts with long lasting results. 

Please seek a board certified plastic surgeon in your area and look at post-op photos of similar cases. 

Best of luck!

Dr. Khuthaila

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 60 reviews

Vertical incision breast lift is best option

Based on the photos, the best option is the vertical incision or "lollipop" breast lift.  The donut mastopexy will not work.  There is good breast volume, so implants are also not needed.  If at a later date more upper pole fullness is desired, then implants can always be placed, but I would not place them during the lift procedure in this situation.  Always see a Board Certified Plastic Surgeon to maximize the final result.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 73 reviews

Breast lift

Hello and thank you for your question and photos. Giving your concerns and your photos you would benefit from at least a vertical type breast lift. The donut lift is not a good choice for this condition. The donut or binelli lift often results in a wide stretched out nipple with minimal lifting. To combat that problem many doctors will use a permanent suture in their Benelli lift to help maintain the closure this results in a very palpable string under the skin  that you can always feel. 

Frankly, based on the photos your sagging or ptosis is considered grade I ( milder not that severe ). In addition, there is a common misconception about breast sagging and size. Sometimes, patients will need a larger bra to contain the loose skin, but that does not mean the breast really is a DD cup. Based on the photos, your true cup size is more C+ / D- in range. If you are happy with your size, then don't do an implant. 

I realize that no one wants the added scars,  but is necessary to correct the breast shape. There are always tradeoffs to every decision you make.

You should seek several consultations with board-certified plastic surgeons in your area before making any decisions.

As always it is best to be healthy, no smoking, and to make sure any health care concerns you have are managed by your primary care physician.

Best to you


Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 16 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.