I have decided to get a mastopexy with 225cc silicone implant under. Question is whether to do the lollipop or donut. What I know is the lollipop will get you more lift with less stress on the nipple (although you're stuck with an extra scar). However, the donut will leave the nipple more stretched out and flatter, due to the tension. I'd love to hear pros/cons of the different styles so I can make a more informed decision. Thank you. Age 29 5'4" 115lbs pre-op 32B
I Am Getting a Mastopexy with Augment. What is 'Better', Lollipop or Donut? (photo)
Doctor Answers 24
Lollipo or Donut
Hi, there. I think you have been doing some research into augmentation and lift. You are right in that lollipop (circumvertical) lift will be able to give your more lift. Because tension is distributed to larger area, incisions tend to heal well. As long as you do not have tendency to form hypertrophic scar, your scar should heal well. (You do want to massage your scars and avoid Sun). Overall, lollipop lift will be able to give a better shape. In terms of donut lift, the amount that we can lift is limited. The areolas will be flattened from the surgery. Your plastic surgeon should be able to recommend which lift will be better for you. Best wishes.
Given your anatomy I would probably just go with the implant and see how you do. I think you may get away with a lift from the implant and be happy without any extra scars
Donut Lift- Less scar, same result
The main objective of a Breast lift with implant is to have a larger breast higher up on the chest wall.
Most of the time, the sum of your own breast tissue plus the volume of the implant are more than enough to fill the skin envelope. Therefore the only problem remaining is repositioning the nipple-areolar complex.
As in your case, this can be done most efficiently and the least amount of scar with a donut mastopexy. A lollipop mastopexy/augmentation is only needed in rare cases where there is a lot of excess skin.
You can read more about the different types of scars in the link below.
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Lift with Implant
If you opt for a fuller implant, you will need less of a lift (perhaps just a periareolar lift). However, give your stated choice of implant, you may need a lollipop lift to help shape the breast and lift up the nipple position. The type of lift will depend on your current nipple position, the quality of your breast skin, and to some degree, the volume of your implant. Please see a board certified PS to learn more about your options.
Donuts, lollipops, and Bismarks (implants)
Considering the relatively small size of the implant you mentioned, you may wind up being satisfied with a vertical lift without an implant, as long as you have internal suspension sutures. I have had many over the years take this option and feel they were large enough without an implant once the shape and repositioning of their tissue was accomplished. They wound up glad they held off getting an implant in a single stage with the lift. Obviously you need to see some results done by the consultant to see if they are experienced with these techniques and are able to give you the result you hope to have. I have been amazed at how well that vertical scar does; it's been about 20 years since one needed revision.
Avoid Lollipop and Donut
I would recommend you avoid the lollipop or donut mastopexy. There is a new technique called The Mini Ultimate Breast Lift. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be placed retro-pectoral. At size 32 B 200 cc implants would take you up to a size D. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant. This technique avoids the ugly vertical scars of the lollipop. Donut mastopexy does not lift the breast mound but just changes the position of the areola on the mound.
Gary Horndeski, M.D.
Lollipop or Donut
From your photo, it looks like you are borderline needing a lift. I can't tell if your nipples are below your fold or above it, so an in-office exam would be the best way to know if a lift is even necessary. Also your expectations that you discussed with your surgeon will help determine if you need a lift or not. If your nipples are above your fold, you can most likely just have a breast augmentation and be happy. If you are below the fold and need a lift, that is really a personal decision that only you can make. You've done your research and are still conflicted, so sometimes taking baby steps is a good decision, example: breast augmentation first and if you are unhappy, you can do a lift later using the same implants. I realize that's another surgery and recovery to go through but it may be worth it in the long run saving you from a scar. Discuss all your options again with your surgeon and make a decision together. ac
What is better for me, a donut or a lollipop mastopexy?
Your picture show that your nipples are at or above the fold under your breast therefore you have what is called a pseudoptosis. That means they are not really droopy. You should get a good result with an implant, but it should be done with a dual plane technique. This means the upper part of the implant is under the muscle, but the lower part is under the breast tissue. This allows the lower breast area to drape better over the implant. You could even go a little bigger. The advantage is that you only need the scar of the breast augmentation which is a lot smaller. The donut mastopexy offers the advantage of a scar that is only around the areola, but it could flatten the breast a bit. If a permanent suture is placed around the areola there will be no stretching. The vertical lollipop technique will give you a stronger lift, but it will have the extra scar. Without examining you it is hard to tell you what would be a best technique. I have had similar patents who had a great result with the dual plane augmentation and did not need the mastopexy and avoided the extra cost and the scars. Look at the pictures on my website.
Lollipop or Benelli?
Are you needing the perkiest result possible? Where are your nipples in relation to your fold? Your photos do not show a lot of drooping so is possible an implant could be 'good enough', depending on your expectations and desires. If your implant fills out your tissue well, there may not really be enough tissue to do a lollipop lift. Communicate with your surgeon and really make it clear what you expect and if perky, then you have to have a lift and as for technique, would probably have to leave it in his/her hands with your preferences noted.
Donut Mastopexy Preferable If Possible?
Whether or not you can get away with BA with a Donut shaped skin excision depends largely on the size implant you choose relative to the volume of your breasts and the degree to which they sag. Every procedure has its limitations but I believe that every effort should be made to limit scarring on a young, attractive girl's breasts.
By using a High profile implant your surgeon can prevent flattening of the breasts and by placing several layers of sutures (one layer that is permanent) your surgeon can avoid spreading out of the areolar scars. From the limited information available, I would definitely opt for the Donut procedure...good luck!!