So far I have seen 3 PS's for breast lift/tummy tuck consult. 2 of 3 said anchor scar for breasts. One said donut scar, which surprised me (one of the PS's who said anchor said he revises a lot of donuts). I don't want implants and all three said I would get a decent result without implants. Age 62. 60 pound weight loss patient. Currently 36B. At highest weight, 36DD. I'm content to be a B cup.
Answer: Anchor scar is required for a full lift I understand it can be confusing to see multiple consults and get different opinions. Based on the photo, a donut lift would provide a wholly inadequate lift. The benefit of the technique is less scars, but the problem with this technique is less lift, and more flattening of the breast if you try to get more out of it than it can offer. This technique is limited in the amount of lift it can offer, and at most it would raise your nipple position 2 cm higher than it currently is, which is not much, and not enough to reshape your breasts and provide an adequate lift. A full anchor scar would be needed for a full lift, and would not only raise the nipple, but would also reshape the breast to a perkier shape. Even if no breast tissue is removed, you will feel the breasts are smaller, since a large amount of skin has been reduced, and the breasts now sit in a compact shape. The skin takes up a lot of room in a bra, so your cup size may go down. This is all fine and good, as long as you are aware and not looking to maintain the same amount of volume in a bra, or increase the volume. I have included patients who had a lift with and without implants on my website, and there are photos of donut lift alone, as well as anchor scar alone, and this may help you get a sense of who is a good candidate for each type. I agree you could get a decent shape and size without implants, but the "perfect size" is very subjective, so without talking to you further it is unclear if the result would meet your expectations in terms of final volume, regardless of which surgeon you chose. Please make sure you choose a board certified plastic surgeon with experience doing both types of breast lifts, and with before and after results you like. Patients who have lost a lot of weight also can have different elasticity to the skin, which has to be taken into account when planning a lift as well.
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Answer: Anchor scar is required for a full lift I understand it can be confusing to see multiple consults and get different opinions. Based on the photo, a donut lift would provide a wholly inadequate lift. The benefit of the technique is less scars, but the problem with this technique is less lift, and more flattening of the breast if you try to get more out of it than it can offer. This technique is limited in the amount of lift it can offer, and at most it would raise your nipple position 2 cm higher than it currently is, which is not much, and not enough to reshape your breasts and provide an adequate lift. A full anchor scar would be needed for a full lift, and would not only raise the nipple, but would also reshape the breast to a perkier shape. Even if no breast tissue is removed, you will feel the breasts are smaller, since a large amount of skin has been reduced, and the breasts now sit in a compact shape. The skin takes up a lot of room in a bra, so your cup size may go down. This is all fine and good, as long as you are aware and not looking to maintain the same amount of volume in a bra, or increase the volume. I have included patients who had a lift with and without implants on my website, and there are photos of donut lift alone, as well as anchor scar alone, and this may help you get a sense of who is a good candidate for each type. I agree you could get a decent shape and size without implants, but the "perfect size" is very subjective, so without talking to you further it is unclear if the result would meet your expectations in terms of final volume, regardless of which surgeon you chose. Please make sure you choose a board certified plastic surgeon with experience doing both types of breast lifts, and with before and after results you like. Patients who have lost a lot of weight also can have different elasticity to the skin, which has to be taken into account when planning a lift as well.
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Answer: Breast lift Absolutely forget the donut lift you need a full anchor. Truly hard to conceive a donut lift doing anything at all.
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Answer: Breast lift Absolutely forget the donut lift you need a full anchor. Truly hard to conceive a donut lift doing anything at all.
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November 14, 2017
Answer: Breast lift Based on your picture it looks like you are a good candidate for a full breast lift and no implant, I believe you can get a great result,consult with a board certified PS.
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November 14, 2017
Answer: Breast lift Based on your picture it looks like you are a good candidate for a full breast lift and no implant, I believe you can get a great result,consult with a board certified PS.
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November 13, 2017
Answer: Breast Lift Based on the photos, it looks like you would benefit from a full lift (anchor scar). The lift will raise the position of the nipples so both are aligned and pointing straight ahead, not downwards. However, if you you're looking for some upper pole fullness, an implant will help you get a fuller look.
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November 13, 2017
Answer: Breast Lift Based on the photos, it looks like you would benefit from a full lift (anchor scar). The lift will raise the position of the nipples so both are aligned and pointing straight ahead, not downwards. However, if you you're looking for some upper pole fullness, an implant will help you get a fuller look.
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November 14, 2017
Answer: Breast lift type decision and scar Thank you for the question! It is always difficult to balance the extent of surgery versus the desired results. As surgeons and patients we are generally best off with "as much as necessary and as little as possible." You have two main decisions: 1. Implant versus non-implant: Since you have enough natural volume for a B cup, there is no real benefit to an implant and staying with just a breast lift simplifies the surgery, lowers the cost as well as the risks and avoids issues related to implants. Here simpler is better. 2. Extent of scar with a lift: In this case I agree with the majority opinion of the surgeons you saw. An anchor scar would be my strong recommendation and I think any approach with less scar will have significant compromises in terms of shape and areolar stretch. The donut approach works for very minimal lifts but can lead to flattening of breast projection and long term stretching of the areolar diameter in more extensive cases (which is the category you are in). Here more extensive is better in your situation. Patients understandably worry about the extent of the scar with breast lifts and good surgeons are always trying to minimize scar length and appearance. At the end of the day, I find that patients really want the best shape and projection for their lifted breasts and also that their worries related to the extent of scars fade into the background. The most visible scar is the one around the areola in any case and almost all breast lift designs incorporate this. Some patients are prone to hypertrophic or keloid scars and it is a longer discussion as to the trade offs in their case. I tried a lot of donut mastopexies when they were popularized 20-25 years ago and the results in patients with grade 2-4 ptosis were never as good as a lollipop or anchor scar (in my hands). I think I have revised most if not all of those surgeries over time and I am pretty sure I am not alone in this. Recent emergence of "auto-augmentation" (moving some of the droopy breast tissue as far up vertically as it will reach) has improved the ability of conventional lifts to fill in the upper pole of the breast and create a look that can rival an implant in some patients. I would trust the two surgeons who suggested the anchor procedure in your case (60 lb weight loss and grade 3/4 ptosis) and pick the one you had the best feeling about.
Helpful 1 person found this helpful
November 14, 2017
Answer: Breast lift type decision and scar Thank you for the question! It is always difficult to balance the extent of surgery versus the desired results. As surgeons and patients we are generally best off with "as much as necessary and as little as possible." You have two main decisions: 1. Implant versus non-implant: Since you have enough natural volume for a B cup, there is no real benefit to an implant and staying with just a breast lift simplifies the surgery, lowers the cost as well as the risks and avoids issues related to implants. Here simpler is better. 2. Extent of scar with a lift: In this case I agree with the majority opinion of the surgeons you saw. An anchor scar would be my strong recommendation and I think any approach with less scar will have significant compromises in terms of shape and areolar stretch. The donut approach works for very minimal lifts but can lead to flattening of breast projection and long term stretching of the areolar diameter in more extensive cases (which is the category you are in). Here more extensive is better in your situation. Patients understandably worry about the extent of the scar with breast lifts and good surgeons are always trying to minimize scar length and appearance. At the end of the day, I find that patients really want the best shape and projection for their lifted breasts and also that their worries related to the extent of scars fade into the background. The most visible scar is the one around the areola in any case and almost all breast lift designs incorporate this. Some patients are prone to hypertrophic or keloid scars and it is a longer discussion as to the trade offs in their case. I tried a lot of donut mastopexies when they were popularized 20-25 years ago and the results in patients with grade 2-4 ptosis were never as good as a lollipop or anchor scar (in my hands). I think I have revised most if not all of those surgeries over time and I am pretty sure I am not alone in this. Recent emergence of "auto-augmentation" (moving some of the droopy breast tissue as far up vertically as it will reach) has improved the ability of conventional lifts to fill in the upper pole of the breast and create a look that can rival an implant in some patients. I would trust the two surgeons who suggested the anchor procedure in your case (60 lb weight loss and grade 3/4 ptosis) and pick the one you had the best feeling about.
Helpful 1 person found this helpful