Breast lift with implant, donut vs lollipop lift? (Photo)

Question

I consulted with three doctors via email. All of them advised that I was good candidate for lollipop lift with implant. Is it possible to achieve a donut lift with implant to avoid the scar? Thank you alot

Daniel Barrett, MD · Answer

Dear suz1,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

Scott W. Vann, MD, FACS · Answer

I agree with your 3 docs. I feel you will get the superior shape and scar with an implant and vertical lift. Donut lifts flattens the breast and very often  makes poor scars. Good luck.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, I suggest a full lift as well from your pictures, I think it is time to have an in-person consultation to discuss further.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With that
being said, based on your photographs, the best shape and contour could be
achieved with an implant and a vertical or wise pattern breast lift.  I rarely
recommend a Bennelli or circumareaolar (donut) lift.  Over time, the
areola tends to enlarge with a thickened scar.  The other even worse
problem with a circumareaolar lift is that it flattens out the shape
of the anterior breast over time.  A vertical or wise pattern lift with an
implant can result in a very nice shape if good technique is
used.    The size of the implant is based on your desired
breast size/shape, your chest wall measurements, and soft tissue
quality.  This decision should be based on a
detailed discussion with equal input from both you and your
surgeon.   Make sure you specifically look at before and
after pictures of real patients who have had this surgery performed by your
surgeon and evaluate their results.   The most important aspect is to
find a surgeon you are comfortable with. I recommend that you seek consultation
with a qualified board-certified plastic surgeon who can evaluate you in
person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

John LoMonaco, MD, FACS · Answer

The Donut (a.k.a Benelli) lift really does not have the power to lift a  breast that has as long as a fold as yours. It can cause flattening of the breast shape and enlargement of the areola if it is done with too large an implant or in too saggy a breast.

Michael E. Decherd, MD, FACS · Answer

I find that with a donut-type lift you are asking a large circle to be sewn to a smaller circle.  The more the lift, the greater the mismatch.  In my opinion this adversely affects the scar quailty.  With a lollipop, the circles are 1:1, and the excess goes into the vertical limb.  So ironically, the scar quality is better.Good luck!

Joseph M. Perlman, MD · Answer

You are going to get somewhat of a lift with the implant. Depending on the implant size and shape and whether it's placed above or below the muscle will determine what kind of lift you will need. I usually place the implants first, close the incision and set the patient up on the operating room table. I will mark the patient's and at that time determine whether I can get an adequate lift with an incision around the areola (doughnut) or also have to remove skin vertically (lollipop). The distance from the nipple to the inframammary fold should end up being somewhere between 10-13 cm depending on your height as well as your chest dimensions.

Cain R. Linville, MD, FACS · Answer

Donut lifts, or Benelli lifts, are fraught with problems when lifting over 1-2 cm.  You need more of a lift than that, so I'd advise against it.  You need a lollipop lift at least.  The scars will be well hidden.

Trent D. Douglas, MD, FACS · Answer

Thank you for your question and sharing your photos.  Looking and your breast shape, I would tend to agree that your best outcome would be with a short vertical scar "lollipop" lift.  The donut lift does not provide as pleasing a shape and the scars can be more troublesome down the road.  Make sure you take the time to discuss your concerns with your surgeon ahead of time to avoid miscommunication and unmet expectations.  Best wishes on a great result.

C. Bob Basu, MD, MPH, FACS · Answer

Dear suz1:  The answer to you question depends on your baseline anatomy, quality of your breast tissue and skin, the size of the implant you choose, and your overall cosmetic goals.   If you are someone that likes a natural tear drop shaped result with some natural hang, then a breast augmentation will a fuller implant and a periareolar lift might do the trick.  However, if you opt for a more conservative implant or are trying to achieve upper pole fullness, you may need the full lollipop lift. Based on your photos alone and without an exam or understanding your exact goals, I would likely suggest you consider a lollipop lift.  However, a formal physical exam is really required to give you any meaningful advice that "email consults" or the internet alone can not address.  Please visit with a board certified plastic surgeon to learn more about your options.  Best wishes,
Dr. BasuHouston, TX

Breast lift with implant, donut vs lollipop lift? (Photo)

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