How much skin can a donut lift safely remove without adding to scarring issues?

Question

I am looking to revise my areola scars and fix the contour deformity caused by my periareola implants (removed for 3yrs). I am not interested in adding scars with a traditional lift & will be very happy with a 2cm lift from a revised donut. How much skin can be removed safely during a donut without increasing the risk of stretching the scar? Will a donut lift also be able to fix my deformity? The deformity happens when my arms are raised and my implants were placed over the muscle. Thank you.

Wayne I. Yamahata, MD · Answer

Depending on your goals, it is very unlikely that a donut lift will provide your desired outcome. There are inherent limits to the amount of skin that can be removed with this procedure. When this is exceeded, the scars will tend to be less favorable and wrinkling or gathering may develop along the areolar margin.

Daniel Barrett, MD · Answer

Dear easycoast,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Vasileios Vasilakis, MD, FACS · Answer

Thank you for the question. A full lift would provide a more powerful result. Since you do not desire additional scars, a donut lift would revise the scars and should lift the nipple by 2 cm. Adding fat to improve the contour can be done at the same time. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Gary M. Horndeski, MD · Answer

A general rule of thumb is the circumference of the old areola multiplied by 2 is the circumference of the largest excision you can perform. This will easily take care of the scarring around the areola but this may not completely resolve your problem with descending breasts. If your implants were retro-pectoral then an alternative to consider is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Michele A. Shermak, MD · Answer

Hello!
The donut lift is extremely limited in its impact. I think the best result you would see is limited tightening with improvement of your periareolar scar. A permanent suture like Gortex would be necessary to allow for scar optimization - it limits spread and results in a long term predictable shape and diameter.
Your best aesthetic option would be a formal breastlift, as your nipple position is low and you have visible deflation. Fat transfer would provide a nice adjunct to breastlift to add some volume and freshness to the result.
Best of luck to you!

Donald R. Revis Jr, MD · Answer

Good morning,
The revision may not completely resolve the deformity, but it should be able to raise your nipples a good 2cm and clean up those scars!

Mark Eberbach, MD · Answer

Sorry you have developed this issue. I find that the worry about more scarring in cases like yours will lead you to a less than ideal result. Try to give up on that worry.

A wise pattern will add to the length of scar but the trade off for better shape will be worth it in the long run, in my opinion.

How much skin can a donut lift safely remove without adding to scarring issues?

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