Do I have to have an anchor scar? Would I be a candidate for a donut lift? (photo)

Question

Looking to have my breasts done ,I’ve been to a couple of doctors so far - both of whom have told me I will need a breast lift with implants as I’m already a D cup and have slight sagging. Both doctors recommended an anchor incision but I desperately want to avoid this. Would I be a candidate for a donut lift if I opt for a higher profile and a dual plane/under muscle with texture? I’m not looking for large implants as I already have a decent size (285-300cc max)

Finny George, MD · Answer

Hi, thank you for sharing your question. If you do in fact require a lift, a donut lift is feasible but keep in mind that the weight and tension from the implants may cause areola widening in the future.

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Hi, for more accurate information of course we have to examine your skin quality and evaluate your breast texture but according to your pictures seems like implants and donut lift will be enough for you. Because you don’t have severe sagging you have pseudo ptozis which might be resolved with implants only in some cases.

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. It is difficult to provide a definitive answer without the benefit of examining you, but based on your photographs I am not convinced that you require a lift. If you do, there are pros and cons of different scar patterns - a dohnut (periareolar) scar enables a subtle lift and is at risk of scar stretching, whereas a vertical or anchor (wise pattern) scar enable manipulation of the underlying gland to provide a longer lasting result but does result in additional scarring. You may also be a candidate for a subglandular augmentation (rather than going under the muscle), which may give you a better chance of avoiding the need for a lift. Consult an expert in aesthetic breast surgery, Good luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gary M. Horndeski, MD · Answer

The technique I recommend is 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. The incisions are around the areola and in the inframammary fold. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

George Marosan, MD · Answer

Thank you for your question and photos. First of all, a donut lift is not a lift. It repositions the nipple/areolar complex higher, using a circular incision/scar. If not done correctly, this often spreads into a sunburst pattern. Your main issue, based on these photos only, is that you have breast tissue sagging in the lower poles of the breast. Very large implants might avoid a lift in the short term, but then you will need an anchor lift. A breast lift/augmentation is a plus/minus operation, the sagging tissue is removed and an implant is placed to give fullness more superiorly. With a smaller implant (250-300cc volume) you will need only a vertical breast lift. This will shape the breast nicely and also prevents your areola from overstretching. See a board certified plastic surgeon experienced in all aspects of breast surgery for an in person consultation/evaluation. Good luck.

Miguel Mota, MD · Answer

Excellent question. so the bigger the implants the more they will fill you out. This means that bigger implants may translate to less skin excision which could actually mean a smaller scars like the donut lift. But this comes at an expense…… Much larger breasts. If your not looking for large implants or larger breasts, if you want to fill out and lift your breast there is really no better option then the anchor lift. Ty donut lift will not lift as much and it will leave you with bigger breasts then you want. I don’t think it’s worth it.

Best of luck,
Dr. Miguel Mota

Best of luck,
Dr. Miguel Mota

Harry T. Haramis, MD, FACS · Answer

You may avoid a formal breast lift by placing implants dual plane.  They will still look natural and remain slightly low.

If you want very high, perky breasts, then an anchor lift can be added to implants.

Further discussion with your/a plastic surgeon is recommended.

Oliver Harley, FRCSEd(Plast) · Answer

Hi, thanks for your question.  Combining breast implants with an uplift, whether anchor or donut style, is something which is commonly done but which has a high likelihood of failed expectations or unwanted issues because you are doing 2 operations which fight against each other - so you get more scar stretch than you might expect and this can be especially bad with the donut style.  My advice to you would be to work out which you want most - bigger breasts or more uplifted breasts......do that first and then, if you still feel you want more, to do the other op separately.  Looking at you, i wouldn't see any immediate or absolute need to do breast uplift and, especially if you wish to avoid visible scars, go with the implants and see how you like these.  If you want a lift this can be done subseqently....but i expect you will be happy just with the implants and thereby save risk, money and scars.  best wishes and good luck oliver harley plastic surgeon

Camille Cash, MD · Answer

From the submitted photos you would not be a good candidate for a donut lift with implants.  The donut lift is only able to give a minimal lift.  When also adding implants there will be additional tension on the sutures which could result in the areola stretching.

Do I have to have an anchor scar? Would I be a candidate for a donut lift? (photo)

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