Should I redo a lift to help scarring that hasn't improved since implants and a donut lift a year ago? (photo)

Question

I got a donut lift with implant and got is scarring and no lift.. it's been a year and the scar has not gotten any better. Please help what should I do?

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.  Based on your photograph, I would recommend a surgical scar revision with areolar reduction using a deep gortex purse string suture and a smaller implant to reduce tension.  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.   
 
 Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It is hard to tell from the limited photos, schedule an email, Skype, or in-office consultation with a board certified plastic surgeon for proper evaluation.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Unfortunately without a full series of photographs that show your breasts it is difficult to make definite advice.  In most cases if excess skin is still present, then a re-do of your breast lift can be performed successfully.

John L. Burns Jr., MD · Answer

A "donut lift" or periareolar mastopexy can tighten the breast skin envelope but generally does very little to actually lift the breast.  Transitioning to a full scar mastopexy should improve the periareolar scars and give you the amount of lift you want.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. The picture you have provided is limited. It would be useful to see standard photos for better advice. This is not an uncommon occurrence with a donut lift, which often leads to areolar stretching. You might benefit from a breast lift revision. You should speak to your board-certified plastic surgeon for a full
evaluation and advice. Best,
Pejman
Aflaki, M.D.
Johns
Hopkins-trained double board-certified plastic surgeon

Tim Neavin, MD · Answer

Thank you for your question and for your photos. Based on your photos provided, you are an ideal candidate for breast augmentation repair. I would advise you to schedule a consultation with a board certified plastic surgeon for a detailed examination to discuss all possible treatment options and what your expectations are.

Gerald Minniti, MD, FACS · Answer

This surgery has removed A LOT of skin, making this a very difficult problem.  Bottom line: you need a much smaller implant, and a conversion to the type of lift you needed in the first place: a formal lift that involves more than a periareolar incision. You should really see a revision breast expert.

Payman Danielpour, MD, FACS · Answer

Thank you for your question.Unfortunately the procedure has this scarring very frequently.  I recommend that you have a few sessions of microneedling and see if that helps.  If not, then a scar revision.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to revisionary breast surgery.  Unfortunately, you had a poor outcome with a poor operative plan that was performed poorly.  In the best of hands, this is going to be a very difficult fix, however you should be held the have a significant improvement in the appearance of her breast and your scarring.  Your surgery may require 2 stages to get you to an excellent result.  Best wishes to you.

Daniel Barrett, MD · Answer

Dear KNMurga,
based on your photo, it looks like you have severe scarring and you will most likely need breast lift revision in order to get the best results. 
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.
If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery