Asian, 38, 3 children, need breast lift, tummy tightening (Photo)

Dear momofthree123,
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.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

History of Hypertrophic or Keloid scarring is always a significant consideration. The best shape will almost always be achieved with an anchor lift, but you will need aggressive scar treatment (steroid injections, PDL lasers) following the procedure to prevent the above scarring complications, and even this will likely still leave the scars slightly wide or dark. A donut or "lollipop" mastopexy will reduce scarring but you are correct, it is often at the expense of shape. I would agree with the fat transfer but would always favor a wise pattern (anchor) or lollipop lift over a donut mastopexy for shape purposes.

A donut lift may leave you feeling like your nipples are in a low position and will not result in the best overall appearance. A mastopexy utilizing the full anchor pattern scar incision will move the nipples into a higher position and help with the shape of the breasts in the lower pole. Food for thought fat grafting can help but over time you will note that the fat may change and have less of an impact after a few years. I utilize fat grafting in my practice but note that many women note changes after a few years even using a Revolve and a good amount of fat.
In terms of scaring following your scar protocol can help. Good silicone scar cream, silicone tapes, and certain lasers postoperative can help with the appearance. It appears you have good skin quality.

Your breast shape, and your nipple position is actually pretty good. If you scar badly, with hypertrophic scarring, I would avoid a donut mastopexy. This is also called a Bonelli mastopexy and results in a tension repair around the entire areola, which tends to widen the areolar, making it larger and flattening the front of the breast. Because of the tension put on this incision, your scarring may be adversely affected. Have additional consultations with other plastic surgeons. Best wishes.

You have lost volume of your breasts and have some loose skin. A donut lift will leave unsightly scars especially if you make bad ones, right around the areola and there is no way to hide them. Also it makes the breasts flatter. An anchor lift will give a better shape but again if you make bad scars, not recommended for the same reason that you will have scars around the areolas.
Fat grafting will make mammogram's reading more difficult in the future since some of the fat may calcify and mimic cancer.
A tummy tuck is reasonable and the scar is usually manageable with appropriate scar treatments.

Thank you for your query. The reason for recommending a donut lift is to minimise the scar and the reason to advocate against it is to prevent spreading of the areola, that can occur with this technique. Based on your pictures, however, you may not need either . What you have is a pseudo-ptosis of the breasts because of loss of volume and not an excessive drooping or ptosis. A non surgical invasive radio-frequency technique like Thermi Breast or Body Tite coupled with autologous breast transfer can give you excellent results without scars.
Also for your abdomen , i would recommend a mini-abdominoplasty with liposuction. If a muscle repair is required, a floating belly button technique can be employed.
All the best!

you may be well served by a minimal breast lift, but many plastic surgeons consider a doughnut lift to be shorter lasting with a significant possibility of stretching. Also, if you are going to get a hypertrophic scar, the scar around the areola will be the most significant when wearing clothes. A short anchor scar might be the best bet. It might be a good idea to discuss this again with your surgeon or get a second opinion.

Of course doing the breast lifting with anchor scar would provide the best result however, since you have concerns about the scar healing, I'd recommend to go with Donut scar as well and it will provide a good result for you.

For your breasts I recommend The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. This technique will also lift the upper abdomen.

Best Wishes,

Gary Horndeski, M.D.

Hello,
The anchor or lollipop scar type breast lift works wonders. It would give you a great result and you could also have fat grafting performed at a later time to increase the size of your breasts.
I wouldn’t recommend the “donut” lift. Even when surgeons publish papers about it and include pictures of their best results, the nipples often stretch back out and the scars become very wide. You can’t rely on the nipple to hold tension when lifting the breast. This is why the lollipop and anchor scars are used.
That being said, the issue with the anchor or lollipop breast lifts are the blood supply to the nipple right after surgery. The blood supply is decreased and you wouldn’t want to add further stress to the breast by performing fat grafting at the same time. So that should be performed after the breast is healed.
Hope this helps!