What Kind of Breast Augmentation Revision Procedure Would You Recommend in my Situation? (photo)

Saline,'05. Rt B deflated & Silicone gel replacements, '08. Doc went larger (DD-ugh!), w/ circumareolar lift. Said my Lft B had scarring that he had to remove= ugly, big "areola" (scar) and dent on the bottom of my Lft B. R better, but small dent (bottoming out?). My breasts are way too big, espec given my thin skin. I want a "C" (?) cup, w/ NO sagging & no risk of sag in future. What would you rec w/re: breast aug/revision/lift? Could I get gummy bear w/belinni lift, or is that dreaming? THX!

Doctor Answers 3

What Kind of Breast Augmentation Revision Procedure Would You Recommend in my Situation?

Multiple surgeries can cause many issues. Best to just correct the areolar asymmetry under local and leave the rest alone in my opinion. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Areola and Breast Shape Changes After Circumareolar Lift

The circumareolar lift/donut mastopexy seems appealing because the scar is limited to the edge of the areola. However:

  • The removal of a "donut" of skin around the areola creates tension between the areola and the surrounding breast skin.
    • The areola loses this "tug-of-war" and the breast skin evenyually stretches the areola to a wider diameter.
    • This also stretches the scar.
  • The direction of skin tension flattens the nipple and the shape of the breast becomes flattened, more boxy.
    • the Belinni technique does not change these considerations

Mastopexy (breast lift) may accomplish several goals:

  • lift the droopy breast
  • reposition the  nipple and areola
  • reshape the breast
  • reshape/resize the nipple-areola complex
  • reduce extra skin of the breast

An important part of a mastopexy is shaping the breast and restoring projection, the degree to which the breast slopes forward in profile with the nipple at the apex of a pleasing and natural tear-drop shape.


Based upon these principles, your inquiry and photos, it is worth considering:

  • replacing your implants with smaller silicone gel implants
    • "gummy bear" or other type of gel should be discussed with your surgeon
  • a mastopexy that will reduce the areola, scar and reshape the breast, as well as reduce the extra skin and lift the breast.
    • this will most likely  require an anchor-shaped scar
  • there is no procedure that eliminates risk of developing sagging again in the future
  • implants can contribute size and shape, but do not support the breast or prevent drooping
  • your surgeon's examination may reveal the cause of the "dent" below the right areola.


Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.6 out of 5 stars 39 reviews

Breast Augmentation Revision

A breast lift is usually done for one of these reasons:
•elevate the nipple and areola
•remove excess skin from the breast (after weight loss, pregnancy, aging, large implants)
•create or restore symmetry

RIght now you have all three indications for a lift, and with smaller implants I feel there will be enough skin excess that a full anchor pattern lift will be needed. 

No sagging is a reasonable expectation, no chance of sagging in the future is not. Sagging will be less likely with a smaller implant than you currently have. 

You need to discuss at length with your surgeon your expectations and make sure your surgeon feels these are realistic.

Thanks and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.