Had donut lift- not happy with results. What are my options? (photo)

Congratulations on having had breast lift plus implant surgery. Thanks for including photos; they help me advise that you appear to have had well-performed surgery by a plastic surgeon who is thoughtful about (unnecessary, and you can never take it back) scarring.Based on the degree of ptosis (droop) you exhibited prior to surgery, and the (early) post-op appearance, your surgeon appears to have given you both lift and fullness. Complete correction of sagginess is unrealistic, since you still have the same skin and same laxity you did before surgery, just with some skin removed, your nipple/areola position raised somewhat (donut lifts do not lift much; crescent "lifts" do not lift much at all, IMHO, and full lifts require more scarring), and with increased breast fullness restoring what you lost breast-feeding.This is a pretty good trade-off, actually, though we will have to see how your scars fare at 6-12 months.If you thought you were getting high, round, "fake" looking breasts, you will continue to be unhappy, and I hope you don't fall prey to an unscrupulous surgeon who tells you what you want to hear. Unless you develop capsular contracture (which you DON'T want because of the hard feel, even though you may like the look), a teardrop shape is what you have and what you will continue to have.Tightening the skin more via circumvertical (lollipop) lift will add more scars, and your skin will eventually stretch and loosen into a teardrop shape again, only NOW with more scars. (Unless, of course, you are unlucky enough to get that capsular contracture that gives the Baywatch coconut look, but feels like you're hugging someone with croquet balls in her vest pockets. BAD!)I think your doctor was wise; additional skin tightening can be done as you age, and indeed can be done in 6-12 months when your healing is complete, but be patient until then. Soft, beautiful, and with minimal scarring is not s bad outcome. Best wishes! Dr. Tholen

Hi Debird,You appear to have gotten a nice lift and have a nice result!   No cause for alarm.  You are still very, very early for such a complex procedure.The scars will fade and the implants will drop down in their pockets.  Since your nipples are very slightly below center, you could wear an elastic breast band to "remind" the implants to drop.  I would wait at least six months.  Keep your surgeon in the loop regarding your concerns.  You definitely have less scarring compared to the lollipop design, so you can feel good about that.  So ride it out.  Then step back and look at things in six months.  If you want your nipple higher, then, discuss with your PS because your nipple height directly relates to how high the implant is in the pocket, and your implants will settle in over time.  All the best, "Dr. Joe"

Hello,Considering your appearance before surgery, your surgeon did a really nice job.  However, I understand your desire for more lift with regards to nipple position and lower breast mound.  Additionally, I disagree with your surgeon and Dr. Tholen; when considering a breast lift, scarring is never a factor to determine the most appropriate type of lift. The decision is solely made on the amount of vertical and horizontal excess skin that needs to be treated. In fact, when the Benelli or donut lift is used on a breast that needed a more formal mastopexy, frequently more prominent scarring is the result.You should be able to get a really nice result is you so choose, or you can do nothing and enjoy what you got, which is pretty good. Best of luck!

The donut lift is just not a good lift for most women.  It can lead to poor/widened scarring, flattened breasts and enlarged areolas, among other problems.  Since you just had surgery, it is best to wait at least 3 months before pursuing a re-evaluation for revision.  If you choose to have a consultation with a new board certified plastic surgeon, will need your operative report from your previous surgery.  It is best to revisit your current plastic surgeon for advice and recommendations.  Waiting longer is always better to give your body a chance to full heal and re-evaluate the results.  Best of luck to you!

Although I understand your concerns, it does appear based on the photographs, that your plastic surgeon has done a nice job for you. I would suggest that you continue to exercise patience and evaluate the outcome of the procedure approximately 6 months after it was performed. Then, if still concerned, communicate your concerns and goals with your plastic surgeon who (based on physical examination and a clear communication of your goals) will be in the best position to advise you. Exactly what operation will be offered to you will depend on your examination at that time and exactly what your goals are. You may find the attached link, dedicated to revisionary breast surgery helpful to you as you learn more about options. Best wishes.

It is far too early to make any real judgement about your current result.  I would advise you wait at least three months before really determining whether you need or want further surgery as thing can change a lot in that time.  My personal experience with the donut lift is that it does reduce the size of your areola and it does lift the nipple well, both of which have been done nicely in your early pictures.  If you want to truly reshape the breast I would recommend a vertical or lollipop lift, keep in mind that the bigger your breast are, the more they will sag over time regardless of what type of lift you have.  Talk with your doctor honestly, but you have to wait at least three months to really make a decision

Certainly 2-3 more months need to pass before deciding on the results. After that, you could consider changing the breast lift to a lollipop type of incision

I would agree with the response I see that indicate that your result looks appropriate for the procedures done. The problem may be in the expectations of what procedure does what and what the expected result would be. Breast implants are only pillow volume and do not actually lift the breast but only fill it out. This fills in the upper pole of the breast, gives it forward projection, and can simulate a lift by filling out the lower pole, but does not actually reposition the nipple-areola or breast gland. A donut mastopexy or lift is not a true lift of the breast. It can resize and reposition the nipple-areola but it does not move the breast up on the chest. Only a true mastopexy can do this and the minimum incision to carry it out is a lollipop incision. Breast lifts to not fill out the upper pole of the breast, do not give it forward projection, and actually have a flattening effect on the center of the breast. Given the fairly minor degree of droop to the breasts and the effects of the implant, a donut mastopexy was a reasonable choice for your procedure but a true lift of the breast itself requires a more involved incision and procedure and you still might not be satisfied with the result. I would also not advise jumping into a revisional procedure.

I would not consider any revisions before 6 months. At that point your options will be either: having a bigger implant, revising your current lift or having a lollipop (vertical) lift. Meanwhile, I recommend you adhere to your follow ups and be upfront about your concerns with your surgeon. 

Thank you for your question.  I agree that your doughnut lift and breast implants have given you fullness and your nipple position looks good and symmetrical.  However I also understand your desire for more lift.  I do think a revision lift with a vertical component such as a lollipop lift could improve your result.   I would wait at least 6 months before considering revision surgery.  You want to wait until the implant has distended the skin fully and the inferior pole has stretched  before having a revision.For more information on breast lift with implants please read the following link: