I Want Fuller Breasts and a Flatter Tummy, but Not the Huge Scars, What Are my Options? (photo)

I am 5'6", 138lbs, I am VERY ACTIVE and strong. I like my shape, weight and body in general. I am not looking for perfection, just a little better. I would like a slight lift on my breasts do to loss of fullness on top and stretchmarks. I want to donut lift. I also would like a mini tummy tuck, no muscle repair. I just want some skin and stretch marks removed. I don't have a lot of extra flab on my hips or sides, no muffin top. Just icky skin.

Doctor Answers 26

Options for Mommy Makeover

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Thank you so much for sharing your photos.  It allows us to give you more accurate recommendations.   

I understand your concern for minimizing scarring.   We as plastic surgeons are always looking for ways to minimize or conceal scarring.    However, the key principal of body contouring is that in order to achieve ideal shape and contour, we must sacrifice scars.


Although you are interested in a donut lift and mini tummy tuck, based on your pictures you would obtain a very unsatisfactory result and be unhappy with the minimal amount of skin that would be removed with this procedure in your case.  


Your pictures indicate that you need a full tummy tuck and circumvertical breast lift +/- implants based on your desired size.


I hope this helps.


Dr. Gill

Houston Plastic Surgeon

A Mommy Makeover Will Reshape Breasts and Flatten Tummy

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Although there is some scarring is involved with a breast lift with implants and tummy tuck this is your best overall option.  Here are the reasons:

  1. Only a breast lift with implants will return some of the upper breast fullness you have lost.
  2. Only the full abdominoplasty with flatten your tummy and get rid of most of the damaged skin
  3. You are an excellent candidate for both of these procedures and will get an outstanding result whereas more conservative procedures with smaller scars will most likely not make the changes you describe.

In general, the scars are well hidden and well healed and fall beneath even a 2 piece bathing suit.  Be certain you consult with a plastic surgeon certified by the American Board of Plastic Surgery and look at several examples of his results and the healed scars.  Patients are generally so excited about the improvements after surgery the last thing they are concerned about is the scarring.  I find patient have a greatly improve body image and can wear a much greater array of clothing choices.  

It is almost always best to perform the correct procedure or no procedure at all.  Saving a few centimeters of scar length is usually not worth having an inferior result.

Finally, the stretch marks which cannot be removed would probably benefit from Fraxel laser.  This will make them thinner an less noticeable.

Mommy makover: reducing scars with surgery

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Mommy makover: reducing scars with surgery
From your photos, limited incisions will  not provide the correction that you want.
I would suggest a standard abdominoplasty and vertical breast lift

Options for mommy makeover

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I commend you on your physical health. It's great to know that you're taking care of yourself.

The stretch marks and the extra skin you have above your belly button will not be all removed by a mini- tummy tuck. In general, anything below can be removed but little improvement may be done to those above the belly button. 

For your breasts, a donut lift will not be sufficient in achieving the perkiness you'd like, and the stretch marks may not be improved significantly. You can get a nice change with a small breast implant to replace the fullness you have lost in the upper pole.

Scarring is inevitable from surgery but they can be minimized with proper incision care and scarring treatments. You may want to think about which is more important to you: more scarring but better reshaping and stretch mark removal, or less scarring and less results.

Mommy Makeover Surgery May Be Your Best Option: Combination of Fully Tummy Tuck & Breast Augmentation/Lift

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         Review of your pictures demonstrates excess abdominal skin, weakened abdominal muscles and severe abdominal stretch marks. In addition, there’s severe breast sag with stretch marks and loss of upper breast fullness. Under these circumstances, neither a donut breast lift or a mini abdominoplasty would be able to accomplish your aesthetic goals.


         Although it’s difficult to make a recommendation without performing a physical examination, it appears that you would benefit from a full abdominoplasty with tightening of the underlying rectus muscles. In addition a keyhole mastopexy with implants would be necessary to meet your aesthetic goals.


         Unfortunately, what we want and what we need aren’t always the same. In your case, avoiding excess scarring is a priority, but there’s no way to address your contour problems without skin removal and resultant scarring. It’s important that you consult a board certified plastic surgeon. This surgeon will be able to formulate a treatment plan that will address your concerns. 

If someone had a "Magic Wand" your wish could be granted.

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Other than my own headline, I like Dr. Soto's the best. Your requests are certainly understandable (best result with the least scarring), but as well-trained, ABPS-certified, and experienced plastic surgeons, the best among us will not pander to your lack of knowing what most of us have learned the hard way, and will try to explain that what you ask is just not possible.

Thanks for including photos; they are instrumental (but not as good as a personal examination) in helping to see that you are slim and fit-appearing, but with loose skin of your breasts and tummy areas.

A mini-tummy tuck will NOT give you a good result, only dog ears, and the need for a second operation to try to "fix" the inadequate result that you got, rather than what you "saw" in your mind's eye and no plastic surgeon can achieve (research on this site about mini tummy tucks, and you will see what we mean).

Since implants cannot lift your breasts, this is not an option to help the ptosis (sagging) your breasts exhibit even with your arms up, and a periareolar "lift" provides minimal lift, scars that are often puckered, pleated,  and irregular (because of the discrepancy between the outer cut circumference and the areola's circumference), and breasts that are still saggy and now flattened with visible scars. A carefully tailored full breast lift (plus implants if you do wish more fullness) will give you immeasurably better results, and if you heal like most patients, the scars are actually superior to donut lift scars. For examples click on the web reference link below. Good luck and best wishes! Dr. Tholen

A breast lift and full tummy tuck are likely your best options.

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Thank you for your question and the photos.

A breast lift and full tummy tuck are likely your best options.

To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.

What you want is "mini", but you need more to adequately deal with breast sagging and loose abdominal skin

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You are not the only one who starts by saying they don't want big scars.  I don't like big scars either.  Here is the issue.  First of all, the donut lift is useless.  It does virtually nothing to correct the breast sagging and usually distorts the areola.  So you get scars with little or no benefit.  You have more than borderline sagging and would be best treated with a vertical (lollipop) lift.  Although there is a vertical scar, the breast shape is much better and even the scar around the areola tends to look better because there is little tension on it (unlike the donut procedure).


With regard to your tummy, you have lots of extra skin, stretch marks and a large fold over your belly button.  You would be best served with a regular tummy tuck (it's not even a close call).  Keep in mind that a mini still has a pretty long scar and just won't get the job done nearly as well.  Best to get the results you want (one operation is better than two), but keep the scar nice and low, within your bikini line where you won't have a problem with it.  My patients worry about the scar before surgery, but not after.


It is not unusual for a patient to come it to see me wanting one thing and I know that is not going to do the job for her, so I have to show her what will.  I've attached a link to the tummy tuck section of my website.  You can also check out the breast section if you like.

Mommy Makeover - options

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Of course a periareolar lift and mini-tummy tuck may help a little however don't expect a home run from either.  To get optimal results, I recommend a full tummy tuck and a full mastopexy.  The scars from both can be minimized and really do heal exceptionally well.  A full tummy tuck can still be performed without muscle repair.  A periareolar lift will flatten the breasts a little so be prepared to discuss with your surgeon all your options and make sure you have realistic expectations of outcome with smaller surgery. 

Options for tummy and breasts

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Your photos are very helpful. I don't think a donut mast openly will give you the upper breast fullness you are looking for. I think you would do best with a formal breast lift but the trade of would be the additional scars.  Likewise it looks like you have a good amount of extra skin above your belly button. In order to get that better you might need a full length scar. It doesn't mean that you have to have the muscle tightened though. Ultimately you will need to choose between the scars you are willing to accept and the results you really want. In general the tighter you want it, the more scars which you are left with. Good luck.

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