What kind of Lift do I need? (photos)

What kind of lift do I need? I am looking to have a breast augmentation done after nursing 2 babies. Do you think I can get away with a donut lift? Thank you!

Doctor Answers 17

Kind of Lift Needed?

Ultimately an in person exam would be needed to make a specific recommendation bacause there are too many variables, such as skin quality, amount of breast tissue, patient goals, that go into the decision regarding what type of lift is best suited to your situation. All that said, it is important to understand that the various lift procedures accomplish different things and they are not fully interchangeable. Also, the different breast lifts are about much more than just the location of the incisions.


The so called donut lift (also known as a Benelli lift) is a very limited type of lift and is only well suited to a relative small number of situations. The donut lift can only accomplish a very limited lift of your nipple position, it does almost nothing to lift sagging breast tissue, and it tends to flatten the breast, so if it used in situations where a more effective lift is needed, the results are not attractive. Very often patients are attracted to what appears to be a more limited scar, but when the donut lift is misapplied, particularly in combination with a large implant, not only is the breast shape unappealing, but the areola can be distorted along with a widened and irregular scar. Most patients would consider these negative outcomes a poor tradeoff for the limited scar configuration. 


Your photos show that you have a significant degree of asymmetry, both in terms of breast size and degree of sagging (ptosis). While a somewhat satisfactory result might be achievable with a donut lift on your left side, this type of lift would most likely not be sufficient to achieve the greater changes that are needed on your right breast. If you push hard enough for a certain type lift you will find a surgeon who will tell you that yes you can "get away" with a donut type lift. But that does not mean that the results will be pleasing.


Lipo-lift

I appreciate your question.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size.

It takes 6 weeks to heal and I wait 12 months before any scar revision.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.

 

Best of luck!

   

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Getting away with a donut lift.

Thanks for the photos.  Answering you question would really require an in person exam.  In general, I reserve donut lift for really, really mild cases of sagging when the nipple needs only a centimeter or two of lifting.  The problem with the donut lift is it can really blunt the breast and leave a weird shape and also the pressure of the implant can result in stretching the areola.  It is super important to focus on the shape of the breasts rather than on the location or length of incisions.  The incisions will heal and they almost always fade a lot with time.  A weird shape will be a weird shape forever.  Please see my blog about this topic. 

Also, I would ask you to consider just having a vertical lift.  Breast implants are great for ladies who are flat chested but you actually have quite a bit to work with.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 67 reviews

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Choose Your Breast Lift Procedure

The procedure is done on an outpatient basis under intravenous sedation and local or general anesthesia. As mentioned above there are a variety of techniques for these operations.  Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, anchor lift  (inverted T ). Most commonly, we prefer the lollipop or donut lift because of the shape, small scars and easier healing. Although the “anchor-shape” or inverted “T” incision is still more popular in the United States, it represents an older technique with extensive scarring and a less optimal result in many cases. These newer techniques are utilized in the vast majority of cases, the rare exception being extremely large breasts. The nipple-areola complex is repositioned higher, the excess skin is removed, and the breast is reshaped in a pleasing contour and in a more normal position.

The crescent lift removes a small amount of skin at the top of the areola. We find that there is very little  lift and the areola becomes oval in shape and distorted with this method.

The Benelli lift as performed by most surgeons is just the donut lift, removing a donut shaped piece of areola and skin then using a #Pursestring or double purse-string suture to tighten the skin.  A true Benelli actually will expose much of the breast through this incision and then the breast itself is shaped and lifted with sutures.  This is a more complex procedure and is often not done as describe by Dr. Benelli.

 The insertion of an implant as well, may be advisable to restore superior fullness, which is lost with aging and after pregnancy despite the rest of the breast being overly large.  Fat grafting can be used instead of implants to improve the contours of the breast. This is the #NaturalBreastLIft or #CaliforniaBreastLift

In the end it will be best to discuss all options based on your desired final results with your plastic surgeon in consultation. Then, the decision as to the procedure that will be best for you is up to you in the end. Good luck.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

No donut lift

I am not a big fan of the donut lift.  It leaves poor scars in the long term due to stretching and gravity.  I would do a Wise pattern lift with implants (if you want more volume).

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 51 reviews

If you can accept less than the perkiest results

I would not recommend a lift at this point and only suggest it later after you've had your implants in a satisfactory position.  Be cautious about excessively lowering your implant as it would create a very long distance between your clavicle and the upper pole.  Let your surgeon inform you of your options.  I personally would do the donut lift only if other options were non-existent as the scarring is unpredictable and it flattens projection.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

What kind of lift do you need?

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. 
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a  Breast Augmentation

What kind of Lift do I need

patients tend to lose projection with the donut lift so I would suggest a lollipop incision in your case.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

To lift or not to lift

Thank you for your question.  Your nipples appear to sit at or above your inframammary fold so a lift may not be required.  However, an in-person examination would be required to be sure.  If a lift is required, it may be limitied to a circumareolar lift but no more than a vertical or lollipop lift.  Consult with one or more board certified plastic surgeons to discuss your options.  Best wishes!

What kind of Lift do I need?

Thank your for your pictures and questions. This is a very difficult question to answer based only on a picture. The amount of scar you have for a lift and what lift you need depends on your soft tissue characteristics, the implant/volume you choose, and your overall goals. Often the exact lift needed is not determined until the operating room. I think that based on your picture, you might be able to have a donut lift depending on the implant you choose but an in-person exam and a detailed discussion is needed.

Hope this helps!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.