Breast (lift) augmentation options - would I be a good candidate for a donut lift? (Photos)

This is a very common question, and you’re right to pause before choosing a lift type. Based on your description and photos, a donut (periareolar) lift would not be sufficient to achieve your goals.Why a donut lift isn’t the right tool hereA donut lift is best suited for very mild nipple elevation only. It does not:Correct true breast saggingReposition descended breast tissueReliably improve upper-pole fullnessHold up well long term when an implant is addedIn breasts with mitotic / low-seated anatomy (where the breast mound sits low on the chest and the lower pole is elongated), a donut lift often leads to:Areolar stretching over timeFlattening of the breast shapePersistent lower-pole heavinessDisappointment despite “avoiding scars”What your anatomy actually needsYour concerns — lack of upper-pole volume, enlarged areola, and low-seated breast tissue — point to a structural problem, not just a skin problem.The most predictable and stable solution is:A Push-Up Lift (supportive mastopexy)Using an anchor (Wise-pattern) scarCombined with an implant to restore volume and shapeThis approach allows:True repositioning and reshaping of your own breast tissueReduction and stabilization of the areolaCreation of lasting upper-pole fullnessA breast that sits higher and looks balanced, not just “bigger”About the scarsIt’s completely normal to want to avoid a vertical scar. However, in cases like yours:Choosing a smaller scar often means accepting an inferior resultA Push-Up Lift uses low-tension closure, which allows scars to fade significantly over timeMost patients find the improved shape far outweighs the scar trade-off

Thanks for your question! You actually have a really nice size and shape to your areola but you are very bottom heavy. The word to describe your breasts is "psuedoptotic". I would suggest a reverse mastopexy and we may not even need to touch the areola. If you definitely want them smaller, you would need to consider a true breast lift. A donut lift would not work for you. Good luck!

Your nipples are located below your breast fold therefore a donut lit would not be sufficient to achieve your desired outcome.

The scar burden of a breast lift varies directly with the degree of ptosis/sagging. The more significant the correction needed...the greater the scars.

Slight ptosis can be corrected by a "donut" or circumareolar mastopexy/lift. Moderate ptosis may be addressed via a "lollipop" lift or vertical mastopexy. The most significant degree of ptosis will necessitate an "anchor" or Wise pattern scar.

Based on your photos, you would likely need a Wise pattern/anchor lift. There is always a surgical trade off-scars for results.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Donovan Rosas MD

Board Certified by the American Board of Plastic Surgery

Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons

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Thank you for sharing visuals, it’s completely understandable to want more upper fullness and a smaller areola while keeping scars minimal.
In general, a donut (periareolar) lift can be a good option for women with mild sagging, since it allows for areolar reduction and a subtle lift through an incision that blends naturally around the areola.
That said, if there’s more noticeable droop or stretched skin, a vertical (lollipop) lift is often recommended to achieve a smoother, more youthful contour and longer-lasting shape, even though it does include a short vertical scar.
Without an in-person exam, it’s not possible to determine candidacy precisely, but a consultation with a board-certified plastic surgeon would give you clear insight into which technique would help you reach your goals most naturally.
Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon

Many women do not want a breast lift because of the vertical scars associated with the traditional techniques. For that reason, an alternative was developed called 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Based on these photos it is very likely that you will need breast lift with lollypop scar. The other option, to avoid breast lift scar, would be augmentation only and breast lift as a secondary procedure as needed. Good luck.

Thank you for your question and photos. You do have low lying asymmetrical breasts and to correct the asymmetry and give you similar results as your wish picture, you will need a vertical breast lift/augmentation. A donut lift is not a lift, repositions the nipple areolar complex slightly higher, but the scars often stretch beyond the original diameter of the areola if not done appropriately. You have sagging of your lower poles of the breasts, and if you want upper pole fullness, this sagging tissue needs to be removed with the augmentation. Otherwise, you can end up with a waterfall deformity, full upper poles with empty sagging lower poles. See a board certified plastic surgeon experienced in all aspects of breast surgery for an in person consultation/evaluation. Good luck.

Thank you for your question. I have been in practice over 30 years, and revision breast surgery is a large portion of my practice. No one comes to my office asking for a vertical incision, however their anatomy generally dictates the type of incision needed. The biggest mistake I have seen other surgeons make are performing a doughnut lift when they really needed a vertical incision. In your case, there is no question that you need at least a lollipop and at least a short scar in the horizontal crease mastopexy. You should be I will have a beautiful result. The vertical scars heal as good as scars can when performed correctly. Best wishes to you.

Dear Genuine701779,

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.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery