Minimizing skin removal during mastopexy surgery can be a big mistake. The choice of technique for breast lift surgery is based on how much of a lift you need. It’s generally better to air on a more definitive lifting technique. A doughnut lift is probably going to be insufficient and will leave you with secondary undesirable side effects, and a high need for revision surgery. I generally do not recommend people travel long distances for elective surgical procedures. There are generally three variables that determine breast augmentation outcomes. The first is the patient candidacy for the procedure. The second is the choice of implants in regards to size shape, and type. The third is the surgeons ability to place the implant in the anatomic correct position, and in your case to do the breast lift correctly using the ideal technique. There’s a lot of information to review, and the importance of properly vetting providers cannot be overstated. The process of implant selection by itself is a lengthy discussion and different providers do this differently. Some do it better than others. to maximize high-quality long-term outcomes I recommend patients have multiple in person consultations, while in advance of choosing a provider and scheduling surgery. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients, who had similar body characteristics to your own. And experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing only the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results are likely to look like or how many of these procedures they’ve actually done. Highly experienced surgeons should in fact have access to hundreds or preferably thousands of before and after pictures. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. Ask each provider what the most common reason for revision surgery is, what their revision rate is. And what their revision policy is. People often do not appreciate how many patients have real concerns after surgery, the importance of in person, follow-up care, the number of patients end up needing revision surgery or that complications actually do happen. The biggest mistake patients make is having only one consultation which basically eliminates the ability to choose the better provider. Personally, I don’t think you can select providers well without meeting them in person. Being bored, certified in plastic surgery with years of experience in an overall good reputation does not mean that somebody has mastered any single procedure. Finally, using excessively large implants, increases the rate of having undesirable secondary side effects, complication rates, and the need for revision surgery. Implant selection is a very important part of the process, and each provider has a different way of doing this. Best, Mats Hagstrom, MD