Small lift (crescent) in office vs lollipop lift? (Photo)

I had assymetry issues to start with. Implant placed in both with a donut lift on the one side. Feel like the donut lift didn't do anything besides allow my nipple to stretch. The suggestion now is to do a small lift in office but I'm concerned that will only increase my stretching. I think I may need the lollipop lift.

Doctor Answers 10

Preference of Type of Breast Lift

Candidates for Breast Lift (#Mastopexy) surgery are women who have #saggingbreasts due to past pregnancies, genetics, or aging. Often times the sagging is too great to be treated by implants alone. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume.  One side can be tightened more or less than another.

A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. I prefer to  use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.


Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

What works best for you?

The key to success lies in letting you surgeon know specifically what you would like to look like following the surgery. For example, how perky do you want to be, what shape do you want to have, etc.? 

 Here is a rule of thumb that works for most patients. If you nipple is above your lower breast crease then often a periareolar lift will be sufficient for most patients. If your nipple is at or below your crease then a vertical lift (lollipop lift), inverted T or anchor pattern may be required. The Lollipop incision for Grade 3 or 4 ptosis (areolar near or below your breast crease) works best in my hands and the use of a Lollipop technique can lift your breast to the perkiness you desire. However, other plastic surgeons are more comfortable with an inverted T or Anchor Pattern technique.The donut lift does tend to both flatten and have scars widened as you are removing skin around the areola which causes tension in that single area causing it to "spring' apart over time. With the Lollipop incision the tension is spread out over a greater distance of the lower vertical scar (where the areola once was) causing less tension on the areola and entire closure. The vertical lift tends to cone the breast making it more shapely (conical) and less flat. For a visual take a paper circle, cut out a small wedge on the bottom and bring the edges together to see this effect. In general I would pick the best Surgeon and explain fully what you want to achieve rather than the technique. Always choose a board certified Plastic Surgeon.

Crescent vs lollipop

Thank you for your question. I am sorry you are disappointed with your results. A donut or crescentic lift will not correct the asymmetry that you now have. A circumvertical approach will best address the issues at hand, that is matching the nipple size to the left and elevating the position of the nipple areolar complex. The use of a Goretex suture around the areola will help prevent widening of the areola due to tension on the closure.

Consult with several, experienced Board Certified Plastic Surgeon and have realistic expectations. This is a difficult problem.

Best wishes,

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Lollipop lift

Thank you for your question.  The lollipop lift will have a more predictable result for this degree of correction.  Good luck.

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Lift

It would be nice to see your preops.  It looks like the nipple areola complex has to be lifted some more.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast lift

This is why I do not use the donut lift. It has very limited lifting use and often ends with stretched areola and flattened breasts. I would probably use a lollipop lift to correct your breast. Good luck.

Classic failure of periareolar lift

The donut lift or periareolar lift is really not much of a lift and IMHO way overused. It often results in pleats and an overly large areola which you have. Now that skin has already been removed it is unlikely have the laxity to convert to a vertical lift. Sorry but at this point be very careful as more surgery may cause you to have significant complications. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 55 reviews

Breast lift

Hello and thank you for your question. A "donut" lift in the office will cause worsening stretching, flattening of your breast, and a wide scar around your areola.  This has a high probability of not working in you, particularly if done under local anesthesia in the office.  The quick fix may be tempting for both surgeon and patient but can often lead to unsatisfactory results.  I recommend a formal breast lift in the operating room under general anesthesia.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

Lollipop lift ?

Thanks for your pictures and the photos. 

Yes, The donut lift (Periolar lift) has limited nipple elevating ability and is prone to either the areola stretching , or sometimes the scar. Based on your photos, I don't think a crescent will bring you high enough.  Repeating the prei lift  may not get you high enough on the right and would likely stretch again.  The Lollipop allows more areolar elevation. because the lollipop "stick" pulls the tissues in from the side there tends to be less areolar stretching.

Hope this helps.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

Nipple lift question

Hello and thank you for the question and the photo. As you have experienced, breast implants can sometimes MAGNIFY asymmetry. I would agree that most of the time, doughnut lifts do nothing other than stretch out the nipple. This is a common issue with binelli type nipple lifts. Some doctors will use a permanent suture to prevent the stretch, but that sometimes leaves a palpable string that you can feel around the nipple. 

In this case, I would suggest having the full lollipop type lift. Most women don't want the vertical scar, and I understand that, but it is really the best / only way to correct this issue.

You should seek several consultations with board-certified plastic surgeons in your area before making any decisions. As always it is best to be healthy, no smoking, and to make sure any health concerns you have are managed by your primary care physician.

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 16 reviews

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.