Will I need a lollypop incision after explant to reduce areola size and breast lift? (photos)

Can I get away with just areola reduction? I got implants and a lift (doughnut incision) nearly 6 years ago - going from a small B to a large C. I am 39 years old, have two children and I nursed. The implants and lift came after the children. I weigh 123 lbs. and am very physically active. In addition to this information, I have been experiencing a suction noise under my right breast after hiking which is concerning. Is it possible to reduce areola size after explant without a lift and avoid lollipop incision? Or do I need a lift?

Doctor Answers 13

Areola Reduction Alone After Implant Removal

I gather from the question that you do not plan on having the implants replaced but simply to have them removed. If that is the case then I would suggest simply having the implants removed at one session and then at a later date (4-6 months or so) re-assessing the situation and make a determination as to what you would like to have done. After you remove the implants there will be a significant amount of loose breast tissue. With the volume of the implant gone, there will nothing filling out the breast tissue that was surrounding the implant. As time passes there will be some shrinkage/contracture of this tissue. Exactly how much is unpredictable. After about 6 months most of any contracture that is going to take place will be all but complete and at that time you can assess the situation and see what (if anything) you'd like to have done. The breast form, fullness and nipple position will determine the best procedure to accomplish your goals.All of this should be thoroughly discussed and performed by a board certified plastic surgeon - preferably someone who has a significant amount of breast surgery experience.
For the best results seek the consultation of a plastic surgeon certified by the American Board of Plastic Surgery. They have a website listing all the certified plastic surgeons. Members of the American Society of Aesthetic Plastic Surgery will all be board certified in plastic surgery and have demonstrated an interest and special skill in cosmetic plastic surgery as well.

Nashville Plastic Surgeon
4.4 out of 5 stars 25 reviews

Donut mastopexy or lollpop?

The suction noise that you describe is likely related to the fact that the implants are under the muscle.  As the muscle contracts when you are exercising (hiking) it displaces the implant inferior and laterally which causes the suction noise/sensation.  It is not harmful to you.  With regard to reduction of your nipple size, I think you would be best served with a breast lift that does have a vertical component (lollipop or anchor).  These tend to give a smaller more predictable size and shape of the areola.  The scars look quite good over time.  The advantage of a donut mastopexy is that there is only the scar around the areola but the limitations are that you can only get a small or moderate amount of lift and the scars tend to stretch out over time which often leaves the patient with asymmetrical, large, irregular, oval shaped areolas.  I would recommend discussing your situation with a plastic surgeon that is certified by the American Board of Plastic Surgery (abplasticsurgery.org).  I hope this helps.


I honestly think you need a breast lift, in addition to the explanation.
A donut lift is not powerful enough to treat the shape you have.  The areolar size can be reduced at the time of the lift.
I commonly do this as a one stage procedure.

Will I need a lollypop incision after explant to reduce areola size and breast lift?

Thank you for your question.

I would recommend removing your implants first then perform a lift at a second procedure after the tissue had completely healed.   This may be 2-3 months after the removal of the implants.

Delay the lift


As others have said, I would likely opt to remove the implants and capsules and wait a few months to let the tissues heal. Some patients do not ultimately want any more work done when staged like this...almost half actually don't desire the lift or areola reduction later. :)

Best Regards,

John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 25 reviews

Lollypop Lift

For the best result I would want to remove the implants and do the lift a few weeks later to allow time for you to heal.  This will give you a better result.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 reviews

#Explant #BreastImplantRemoval - Will I need a lollypop incision?

Probably, in order to get the best aesthetic result - depending on what your criteria are.

For some people, the goal is the least amount of scarring, even at the expense of the shape.  For others, the best shape is the goal, even if that means more scarring.  What you choose will depend on what you want, and the guidance of your plastic surgeon, so it is worthwhile to visit a few different surgeons until you find one you're comfortable working with.

Often, the best ultimate result is achieved by staging the procedure - removing the implants at the first surgery and then waiting several months (some would say 6-12) to allow your breasts to contract on their own.  At that point, you (and your surgeon) would be in a better position to decide what procedure, if any, would be best for you.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf500

Lollipop lift and explantation

I like to remove the implants first and then delay the lift for some individuals especially those without a lot of breast tissue.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Do I REALLY need a Lollipop Scar?

You ask a commonly asked question.

To get the results we want, we often need to do things which we would rather not do. Such as practice scales on the piano, so extra swimming laps, push away certain foods, read boring articles etc. Moreover, great results depend on doing what NEEDS to be done rather than shying away from it.

When you see a Plastic surgeon, it is important to know what would produce the BEST result - the one he/she would be proud to show at one of our meetings to thousands of fellow Plastic surgeons, NOT the one he/she could "get away with". It is then up to you to decide which outcome you prefer.

In your case, you demonstrate a so-called "Waterfall effect" the breast tissue is sagging and falling off very high implants. The doughnut incision suggests that you would have done much better with a lollipop incision at that time since it was unable to correct the sag AND seriously distorted the shape of your areolas. (BTW it frequently does it when used to overcome more than minor sagging of the nipple complex).

Once the sagging skin along the bottom of the breast is removed and tightened, thereby moving the breasts up and making them filler, you will have a vertical scar. The round shape of the lollipop is the result of an upward shifting of the breasts and restoring a circular appearance to the areolas.

I would encourage you to seek the best solution for you.

Dr. Peter A. Aldea
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 101 reviews

Explantation with lift

Your implants are very high and are pushing down the NA complex so it is very likely that you will not need the complex repostitioned.  If you incisions are around your areola and there is extra skin after the explant, the donut skin excision is advisable to prevent the indentation of the scar in this location.  If you do not have extra skin or if your incision is under the breast, then an internal lift would be sufficient.  There are over 6 different types of lifts, so which one you need depends on many factors including where the excess skin is located.  A lollipop lift is usually not needed when an internal lift is done and hardly ever when there is not much tissue at the lower pole as in your case.  Doctors that do not perform many explantations, do not appreciate these variations.  Please see the information on the internet that I have shared re explantation as it is very important to go to a doctor with experience. 

Susan Kolb, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 22 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.