Enlarged areolas & scars - what's is the best technique to avoid the same outcome? (Photos)

Dear Phenomenal295059,
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 surgery, I would suggest you 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

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Your breasts are still very low on the chest wall. 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 if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Based on your preop photo, periareolar mastopexy was not the best form of breast lift for you. Revision should include lollipop type of lift, which will create better lift, better scars and symmetric areolas. Good luck.

When I see your preoperative photo, it's hard for me to imagine that you were not told you needed a formal mastopexy, not a donut lift. Assuming I'm correct, this means you did not 'want the scars' from a lift like that. Now you see that a donut lift in someone like you gives you the worst of both worlds: prominent scars and persistent sagging (and persistently large areola). So, the fact that you're asking about fat grafting tells me that you haven't gotten the big picture yet. You need a formal mastopexy, which will impart an anchor shaped scar pattern. The obvious benefits include better breast mound shape, better lift, and smaller areola. However, what you don't realize is that although the scars will be longer, they will likely be much finer and less visible, especially with time.

Your result is a very common in that a periaerola mastopexy leads to flat breasts, large aerola and thick scars. Your revision in my opinion needs to be a vertical [lollipop] mastopexy which will give you a more conical shape, smaller aerola that stay that way, and much better scars. You could have some fat grafting at the same time, just don't go crazy with too much volume. Good luck.

You actually need the vertical lift to raise and reshape your breasts, If only the peri-areolar incision is used, the lift will not be sufficient, and your areolae may stretch. Fat will not correct sagging breasts.

I agree that your areolas are too large, too high and the breast have bottomed out. I would consider a lollipop mastopexy to both reduce the size of your strokes and considerably lift your breasts.

Best wishes
Dr. Taranow

Hi and welcome to our forum!
There is significant improvement in appearance following your previous mastopexy. However, I do note the presence of large areolae, the distance from the top of the breast bone to the nipples is increased, there is loss of superior breast pole volume, and there is minimal sag.
A periareolar mastopexy places tension upon the areola, as one sutures a larger circle to a smaller one, sometimes resulting in pleating of the incisions, pancaking of the breasts, adverse scarring, and late permanent suture disruption which may lead to areolar enlargement.
You may wish to consider a vertical mastopexy to elevate the nipple areolar complexes into anatomic position and decrease areolar diameter (without tension), conify breast shape, and increase superior pole breast volume.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...