How much more should a "donut" lift cost when added to silicone implants?

Question

I am in Los Angeles county and feel like the cost of my surgery is unreasonably high. I have between Grade 1 and Grade 2 ptosis according to the surgeon I used for my consultation and will be getting silicone mentor implants placed under the muscle. I'm also curious to know if it makes sense to do a periareolar incision if I'm doing a donut lift at the same time. I worry about increased risk of capsular contracture if I go through the nipple. All advice would be helpful!

Wayne I. Yamahata, MD · Answer

There are no rules or standards as to how much a procedure should cost. You can obtain average costs from many sources but surgeons are by no means bound by these. Many surgeons will provide "ballpark" estimates over the phone. You might consider calling other offices in your area if you thought the fees were unreasonable.

Eugene Kim, MD · Answer

The cost of a lift varies from doctor to doctor.  It's difficult to say if a lift is necessary without examining you.  If you're not happy with the recommendations of your first consultation you should seek other consultations.

Gerald Minniti, MD, FACS · Answer

Donut lifts are the most litigated (malpractice lawsuits) cosmetic breast procedure in the country. This is because they are done when a more formal lift is necessary. They lead to sometimes irreversible complications including areolar spread, thick scars, pleating, low nipple position, breast mound flattening, and persistent ptosis. Even when a donut lift is performed on the appropriate candidate (only glandular ptosis in a small breast), implants should be placed through an inframammary incision to minimize implant contamination, capsular contracture, and breast scarring. Pricing is dependent on surgeon training and certification, skill, experience, and busyness of practice. There are a lot of surgeons in LA who do 50 to 100 breast augmentations a year at $7000, and a few others who do 200 to 250 a year at $10000. As  you can see, price isn't an issue for many people who perceive the value in paying more.

Robert J. Spies, MD · Answer

I am not aware of the charges provided to you but please realize costs will vary across the country.  It is well known that major cities like LA, New York, Chicago, etc... have higher costs than other areas.  Also, some surgeons may charge a breast lift fee that includes any type of lift and not charge less for different types of lifts.In regards to your other question, a donut lift is performed through a periareolar incision.  It's one in the same. It is known that capsular contracture rates are a bit higher with the periareolar incision but honestly I have not seen that in my practice.Hope this helps.Dr Spies

Daniel Barrett, MD · Answer

Dear Christina15256,
the cost of surgery depends on a lot of factors (type of surgery, number of treated areas, anesthesia fee, surgeon, facility fee, city, etc.). In LA area, breast lift typically ranges from 10K to 15K depending on whether you need donut mastopexy or Lollipop. It would be the best to visit or call plastic surgery offices and ask for a price.
Daniel Barrett, MD

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

Connie Hiers, MD, FACS · Answer

The doughnut lift is done with the peri-areolar scar since the areola needs to be moved higher. The lift does involve more than moving the areola higher because the sagging breast tissue is also moved.  with Grade 2 ptosis, you might need the vertical lift instead. Your surgeon who has examined and measured you will know what will work.

Tom J. Pousti, MD · Answer

Thank you for the question. 
 The most important decision you will end up making is careful selection of your plastic surgeon; ask to see lots of examples of their work and communicate your goals carefully as well. When it comes to cost of surgery, there may be many “variables” involved. The specific surgeon's credentials/experience level (or lack thereof), the specific geographic area you are looking at, the different operations available, the location of the procedure ( quality of surgery facility), type/quality of anesthesia provider, type of breast implants… are some of the potential variables involved.  
Also, it is always in patients' best interest to achieve a certain degree of financial stability prior to undergoing elective surgery of any type. Patients should also keep in mind that additional surgery may be necessary in the short or long term, following the primary procedure that is being performed; this additional surgery may be associated out-of-pocket expenses.
I would also suggest that you do not base your selection of plastic surgeon primarily on costs of surgery; again, keep in mind that additional surgery may be more costly in many ways. Save up for the procedure and have a well experienced board-certified plastic surgeon help you achieve your goals when the time is right.
You will find some average costs of surgery listed on this website and on individual plastic surgeons' websites as well. Best wishes.

Curtis Wong, MD · Answer

are only 1-2% more than going under the breast so with mastopexies, I always go through the nipple approach with Keller funnels to minimize contamination with placement of implants.  As for costs, they will vary and if you're looking for best pricing, you must make phone calls.  I personally despise the Benelli lift and will only use if if there is no other option available as the scars all stretch out and the projection flattens.  In addition, you often will feel the sutures under the areola that was used to cinch the surrounding tissue inwards.  If you can have a lollipop, they are always better in my opinion.

Johnson C. Lee, MD · Answer

Pricing will vary between offices and between geographic locations. There is no set rate as surgeon's are allowed to set their own prices. In order to do a donut lift, the incision is placed around the areola. Therefore it is most reasonable to go through the same incision which has to be made rather than creating a second incision and scar at another location. The risk of capsular contracture through the nipple remains low as long as your surgeon uses a no-touch technique. I personally use a Keller Funnel no-touch technique to make sure the implant never comes in contact with the skin or milk ducts which carry bacteria. Hope this helps!Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Robert A. Hardesty, MD, FACS - Account Suspended · Answer

Dear Ms. Christina 15266, 
Thank you for your question.
Total costs based on several components:A)Location: what part of the country you have your surgery (coastal cities and large metropolitan in general are higher than inland cities)
B)Plastic Surgeons fees: Board Certified Plastic Surgeons and those who are more experienced surgeons are higher than less
C) Anesthesia fees: Board Certified Physician Anestheologist compared to nurses or Nurse Anesthetist are generally more expensive. 
D)Facility fees: Surgical procedures performed in a hospital setting are often significantly higher in total cost than a physicians operating room or a accredited Ambulatory Surgical Centers (ASC) 
I trust your chosen Plastic Surgeons is a experienced and Certified by the American Board of Plastic and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
My best wishes,
R. A. Hardesty, MD, FACSDiplomate and Certified by the Am. Bd. of Plastic Surgerywwwimagineplasticsurgery.comAwardee: RealSelf Top 1004646 Brockton AveRiverside, Ca 92506(951) 686-7600

How much more should a "donut" lift cost when added to silicone implants?

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