Doughnut lift versus Full lift – wanting to achieve full upper pole, fake look? (Photos)

Question

42-year-old female. 5'11", 138lbs. Breast-fed 1 child. Trying to decide a donut left versus a full lift. Want to achieve full projection. Thinking silicone round ultra high profile implants. Previous lumpectomy on right breast. Also trying to think long term, do not want bottoming out! Thank you in advance for your answers.

Wayne I. Yamahata, MD · Answer

There are many types of breast lifts available. It is not possible to determine the most appropriate lift in your case without an actual physical examination. It is, if fact, quite possible that you could achieve your goals with augmentation alone.

S. Larry Schlesinger, MD, FACS · Answer

Life is nothing but a series of trade offs.  To get a really perky look, you need the standard full lift, however that decreases the size of the envelope leading to smaller breasts.  At 5'11", a "D" will look like a "C" on you.  If you get a donut or Benelli mastopexy, you will have minimal scarring but the entire surgery will rest on sutures around the areola, and if you put in too large an implant, it can stretch out the envelope and give you some level of droop (ptosis), and may go all the way to bottoming out.Your wish picture looks to me like the implant is on top of the muscle, which is definitely the fake look, but there is a greater chance of getting a capsular contracture.  There are so many variables to be considered in a breast lift/augmentation that at this point, I think it is better to choose the surgeon and not the surgery.  Both types of lifts you describe have their pluses and minuses.  Your thinking about using the ultra high profile implants will definitely increase the projection, but to get upper pole fullness that you commented on, you might want to consider the Inspira cohesive (gummy bear).  All in all, I think it is great that you are considering enhancing your anatomy by doing something for yourself after breast feeding your child.  This is a healthy thing for your entire family.  My recommendation at this point is to consult with at least three Board Certified plastic surgeons in your region who through their websites, and their answering questions and reviews on RealSelf have demonstrated knowledge about breast lift/augmentations.  Nothing beats an in person exam and open communication between yourself and your plastic surgeon.  This will help you both to understand what you want and what the limitations of plastic surgery are.

Daniel Barrett, MD · Answer

Dear 1974CaAAA,
based on your photos you should be fine with breast implants. They can help you achieve the fullness of your breasts. If you are considering surgery, you should visit a board-certified plastic surgeon for a detailed examination. Only after that you will get all the needed information. 
Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

Curtis Wong, MD · Answer

as more often then not, it fails miserably and causes more problems.  It works best with small breasts and small lifts.  What you want isn't small so would discuss in detail with your surgeon.  If your surgeon can guarantee the 'wish outcome' with the Benelli, then sign up and get your guarantee.  But if cannot, think you would be much better off with some variant of the vertical lift, especially if you want a fake look and excessively elevated implants/mounds.

R. Laurence Berkowitz, MD · Answer

Every woman has a different vision for her result.  To achieve what you are projecting in your "wish" you will need to be more lean to get the breast tissue to shrink and have the implants dominate the bodyscape. Doughnut lifts elevate the nipple, do not lift or redistribution breast tissue very well and tend to dilate over time.  The vertical lift is more versatile and allows for tissue redistribution and the areola will remain closer to the intended size.  I reserve the circumareolar procedure for tuberous breasts or very small lifts in rare circumstances.

Donald W. Hause, MD · Answer

The short answer is that Doughnut lifts are procedures with less scar but less overall improvement of ultimate shape. In reality, Doughnut mastopexy really only works for those patients with a small amount of sagginess of the nipple-areolar complex and is relying on the shape of the breast to be achieved by the implant itself (Patients with minimal breast tissue). Standard Lifts offer the best possible control of breast position and shape but have the trade-off/ compromise of an anchor scar. The best recommendation is for you to be seen by a Board Certified Plastic Surgeon in your area who is experienced in all techniques of breast lifting so you can weigh the options and get the best results possible.

Jean Paul Giudicelli Saba, MD · Answer

Hi, thanks for sharing your concern and photos with us!
  
First I want to congratulate you for making this important decision. Deciding to get an aesthetic procedure to change your body and get a new life style is a big step!
  
Looking at your photos I might say that you´ll be a great candidate to get a breast augmentation with implants. The size of the implant will depend of what you want and what your body support; the results of this procedure are beautiful, giving you and excellent shape of the inner and outer pole of the breast.  
  
Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine. For us your safety, always, is going to be first.
  
Have a great day! 
  
Dr. JPG

Lawrence Scott Ennis, MD, FACS · Answer

implant size
The best way to pick implant size is based on your breast and chest width and not the volume. As the implants get bigger, they get wider. When the width of the implant fits the width of your chest, it will look nice and fit your frame. If the implants are too small, you will have a gap between them and they may look too far apart. If they are too wide, they will make you look top heavy as they may be too wide and stick well out past the sides of your chest. There are ways to get a bigger or smaller look.This can be done by picking a different implant profile. The higher the profile, the narrower the base width of the implant. If someone has a very narrow chest and wants to be big, they should consider a higher profile implant. If someone has a broad chest and they do not want to be too big but want to avoid the gap and still have cleavage without projection, they should consider a lower profile implant such as a moderate. There are options in between these such as the moderate plus. I prefer the underarm approach so there is no scar on your breast. The new silicone is the only way to go as far a rippling as the new silicone ripples much less than saline, especially in the larger implants. I personally prefer the smooth round implants under the muscle placed through the under arm to give you the most natural look and feel. This also leaves you no scar on your breast. I personally think you would be fine just doing the implants alone.  Dr Scott Ennis - Plastic Surgeon – Destin and Miami , Fl

Nina S. Naidu, MD, FACS · Answer

Hi, thank you for your question.  Based on your photos, implants alone through either a peri-areolar or infra-mammary incision should be able to give you your desired shape with fullness at the top of the breast.  A full breast lift should not be necessary.  With fuller and larger implants, the skin does have a tendency to stretch out more with time, but if the surgery is done correctly bottoming out below the existing breast fold should not occur.  I suggest seeing a board-certified plastic surgeon in your area for an evaluation who can discuss your options further with you.

Jon A. Perlman, MD (retired) · Answer

I must start out by saying I don't find your goal photograph to be very appealing since the patient has suprapectoral implants and they may even be encapsulated. In your particular case however I find you to be a good candidate for augmentation with an appropriate and not overly large implant that matches your body and enhances and optimizes your fullness and contour. Your right nipple position appears to be reasonably satisfactory but your left nipple seems to be slightly lower, so I would be discussing with you the option of an elective Benelli lift either planned before surgery or a consideration during surgery based on how the implants settle and your appearance with your new implants in place. I would definitely not recommend a full uplift and find this to be unnecessary for you.

My best advice for you is to find a board-certified ABPS plastic surgeon in whom you have confidence and follow his/her recommendations. In my practice I would be recommending smooth surfaced mid-plus profile implant placed in a partial subpectoral position and possibly performing a Benelli lift depending upon your appearance during a face-to-face consultation and your willingness to accept an incision in a minimmaly visible but not invisible place. Please enjoy the video attached above. Best wishes,
Jon A Perlman M.D., FACS
Certified, American Board of Plastic Surgery
ABC-TV/Extreme Makeover Plastic Surgeon
Beverly Hills, California

Doughnut lift versus Full lift – wanting to achieve full upper pole, fake look? (Photos)

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