Thank you for your question. Based on your photo I believe you will need a breast lift with a vertical component, Lollipop or anchor to get a pleasing breast shape that will make you happy. I do not think the doughnut lift will provide adequate breast lift for you.
I understand the desire to avoid scarring.I understand that a scar around the areola is more desirable than a lollipop or anchor scar.I understand that removing skin to create a lift, whether in the shape of a donut, lollipop or anchor is doomed to failure and deep patient dissatisfaction.In order for any lift to succeed, the tissue must be lifted or rearranged so that a lift of tissue occurs.With this in mind, a donut lift to me means that your doctor is removing skin to tighten the skin envelope. Your result will include wide scars, flat breasts and unsatisfactory final form.My Tear Drop Augmentation Mastopexy has a circumareolar scar (scar only around the areola) but the lift is done by rearranging the breast tissue. The breast tissue is pulled up and anchored higher on the chest wall. This maneuver yields a fuller upper pole, lifts the nipple areolar complex evenly, and hides any unnatural edge to the breast implant. Further, the implant is placed under the muscle and it helps to keep the breast lifted. With a lift from above technique, the implant is not pressing on the suture repair like many lifts that occurs below the implant. Thats correct, many lifts tighten the breast tissue below the implant. The weight of the implant presses on the sutures and results in stretching and suture failure at times.If you would like more information on this procedure, please read my book "Cosmetic Breast Surgery - a complete guide from A to Double D".
Thank you for your question and the pictures. I would have concerns that the breast augmentation and Benelli breast lift will not be powerful enough to achieve an outcome that you will be pleased with. Although I understand your concerns regarding scarring, most patients would prefer to have an optimized long-term contour and accept the trade off additional scars. Although possibly counterintuitive, a full mastopexy often results in better scarring compared to a Benelli breast lift where all the tension of the breast lift is placed on an incision around the areola only. Be very careful with your decision-making. Best wishes.
A #mastopexy or breast lift operation is designed to improve the shape and position of the breast swithout reducing their size. It is used for #breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an #implant is used at the time of mastopexy. This is called an #Augmentation/Mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.
#FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast. A hybrid operation may use both an implant and fat to provide the best contours of the lifted breast.
I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.
Based on these photographs you appear to be an excellent candidate for a breast lift. I would suggest that you will not get the position shape and symmetry that you would like with an implant. A lift with an implant is controversial for two reasons. First, when you perform a lift you are making everything tight and closing the wounds under tension. It you add the expansive forces of the implant at the same time, you are fighting against yourself. There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars. In the worst case, the wounds will open. So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant. Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure. Or a smaller implant than would be appropriate is used so as to decrease the expansive forces. Either way, you are compromising the aesthetic outcome. Often the outcome is so compromised that a second revision surgery is required. If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation. The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved.
The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple). By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple. By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple. If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop. If the venous outflow stops, the arterial inflow is stopped. If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies.
Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation. Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.
Thank you for your question. In addition to the implants, a donut lift can reduce the size of your areola. But if you're looking to optimize the shape of your breasts, a lollipop (vertical) breast lift would be much better. Be sure to consult with an experienced board certified plastic surgeon. Good luck.
Aloha, It appears that a donut lift with implants will help give you a upper fullness and reduce the size of your areolas. However, you should consider a vertical or lollipop lift to give maximum long-term results. While your concern about scarring is very common, It's a trade off that many women are happy with. Only you and your surgeon can decide what is best for you, including implant size. I recommend that you see an experienced board certified plastic surgeon to review your options after an office consultation and thorough exam. Mahalo, Dr. D