What lift technique do I require? Can I increase size of implant and reduce areola with just a doughnut scar? (Photo)

I have 375cc implants,want to increase to 560cc's, reduce areola size, and have more fullness in the lower pole with the least amount of scars but the best results. I would prefer just the doughnut scar.Is that possible or not good enough?Could I achieve what I want with a vertical lift (lollipop scar)? Or do I have to do a full anchor scar lift? I want my breasts to look better, not worse. Thankyou for your advice

Doctor Answers 10

Areolar reduction

The doughnut type of areolar reduction often doesn't work very well and the scars tend to widen.  You are better off with the lollipop type of lift.  The vertical segment of the scar tends to heal quite well with this technique.


San Diego Plastic Surgeon
5.0 out of 5 stars 25 reviews

Did anyone tell you...?

you suffer from tubular or tuberous breasts deformity?

You need a surgeon who knows how to handle this or you'll get again poor results!

Your case is bad planned from the very first moment you are not correctly diagnosed and your gland is not tailored with specific plastis to correct such tubular breast deformity. Do google about tubular breasts and you'll see, without the need of any surgeon's opinion, that you are a patient of this condition.

I wonder why nobody told/tells you this, it is critical.

Yes, tubular breasts may need multiple procedures until final resolution, this is a fact.

I recommend the use of implants of high adherence, because the lower (absent) pole of the newly built breast will push upwards the implants for months, leading to upper dislocation and causing such need for re-operation. The highest adherence and the model I recommend is the polyurethane coated implants, they make bio velcro with your ribcage and it is nearly impossible they displace upwards, standing perfectly and tightly the upwards pressure of the abdominal skin gained with the (necessary) lowering of the sumammary fold which allows perfect centering of the implants' peaks behind the nipples (a must of harmony in any breast augmentation).

Of course one of the glandular plasty techniques available (or many) must be used to get rid of the conical shape of the gland.

Alejandro Nogueira, MD
Spain Plastic Surgeon
5.0 out of 5 stars 34 reviews

Depends on what you really want

Thank you for the question.  As you can see from the other answers, there is no true consensus on your best option based on photos alone, and consultation with one or more board certified plastic surgeons would be the best way to give you adequate advice. Based on the photos submitted, you have extremely large areolas for your breast size, and only moderate ptosis. You would really need to decide what your ultimate goal is, larger implants and breast size, or a major reduction in your areola size. You could achieve a nice result with your current implant size and either a circumvertical (lollipop) lift, or a circumareolar Lift. If you've decided that she want larger implants, it would be best to exchange the implants without a lift simultaneously due to the significant problems with tension that could lead to early wound he has since, implant exposure or nipple necrosis, or late severe and nipple areola will and scar widening over time.

Wesley G. Schooler, MD
Santa Barbara Plastic Surgeon
4.8 out of 5 stars 17 reviews

What type of lift?

Thank you for your question and photos.  A donut mastopexy is not a very powerful lift.  It does work well for reducing the areola size, but when trying to move the nipple higher, it is good for movements <1cm.  You may be a better candidate for a circumvertical lift, but this will have to be balanced against going to a larger implant.  The larger implant will take up more space, creating a tighter skin envelope.  At times, if the skin elasticity is not that loose and the implant is quite large, all of the pigmented areola may not be able to be removed.  This is something that can only be determined by an examination.  Best of luck.

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 30 reviews

What lift technique do I require? Can I increase size of implant and reduce areola with just a doughnut scar?

Thank you for your question.  As you can see in the majority of the responses already, most surgeons would not recommend increasing implant size so considerably and performing a mastopexy at the same time.  Combining these procedures in a situation such as your's will likely lead to widened scars or a recurrence of enlarged areolas because of the increased tension created by the larger implants.  I recommend consultation with at least two board certified plastic surgeons in your area to learn your options based on a complete history and physical examination.

What lift technique do I require? Can I increase size of implant and reduce areola with just a doughnut scar? (Photo)

A circum-areolar  lift may work well
The problem you may encounter is  that with a larger implant there will be more tension on the scar,having an adverse effect with either stretching of the areolar or widening of the scar

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.9 out of 5 stars 12 reviews

Implant size change and lift

Hi and thanks for your question. It's really not possible to give you medical advice based upon your photos without an examination. These questions are great but need to be addressed by your plastic surgeon. However, your desire to significantly increase implant size and reduce the areolarl diameter may not be possible with a doughnut lift. The increased implant size will place pressure on your doughnut lift and cause the areola to stretch out again. You might want to reconsider such a large implant for your frame. In the end most patients want a natural, aesthetically appealing shape that looks good for many years to come. Too large an implant also predisposes one to recurrent sagging or ptosis. Best of luck!

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
4.7 out of 5 stars 16 reviews

Lift technique

It would appear by your pictures that you really require minimal lifting and with larger implants I doubt you will need much of a lift.  A reduction in areolar size should be accomplished through a doughnut incision but a permanent internal suture is recommended to prevent the areolar from stretching and expanding in size again.  Best of luck with your surgery!

Jeffrey A. Sweat, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 37 reviews

Lift

Thank you for the photos and question and though an examination is really needed, it does appear that a circumareola mastopexy would get the desired result

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 59 reviews

Lifting and reduce areola with a "Donutt lift"

No one wants the addition of a vertical scar, however in your case it would give you the best result. I do a lot of circumareolar "donut" lifts, but also repair a lot too. A donut lift is best if you are just trying to lift the areola 1-2 cm or even out asymmetric areolas. The skin around the areola is not very forgiving and pushing that type of lift leads to either thick scarring or a stretched out areola. In your case, a "lollipop" lift would create an excellent result with smaller areolas, and the best scar. I wish you the best.

Paul E. Chasan, MD
Del Mar Plastic Surgeon
5.0 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.