Implant removal with anchor or periareolar breast lift? (Photo)

The smaller the implant and the less the amount of time it has been
since placement, the greater the chance the breasts will return to their
preoperative state. It is very difficult to predict breast size
following explant b/c breast implants and weight fluctuations over time
tend to thin tissues, cause a decrease in size, and create more droop.  During a capsulectomy, the envelope which surrounds the implant is removed. The implants may be removed or reinserted during the procedure.
Usually removing them and performing the lift at the same time makes
the most sense as some patients clearly need a lift.  If you are
borderline, it is not unreasonable to remove the implants and then
observe a waiting period of six months before the determination for
breast lift or breast fat transfer is made. This will give your breasts
time to bounce back and your PS time to determine what type of lift, if
any, is needed. The Wise pattern lift, also referred to as the inverted T lift, the anchor, or the full breast lift, takes the vertical lift pattern and adds a horizontal incision under the breast and in the inframammary fold. Most likely this type of lift will be used to remove the most amount of skin and to tighten the skin and tissue envelope maximally. It is frequently necessary in vertically long breasts to remove enough skin to create the appearance of round and tight breasts that do not appear to be hanging.

Dear Naturalbound12,
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 thatsbeing brought together to support the breast and hence improves longevity.
If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

A circumareolar lift is a limited lift for selected patients. There is a choice of mastopexy incision patterns but this is not for the candidate to select but rather for the surgeon to deem which is most appropriate.
For very slight degrees of ptosis a periareolar lift can be used to address the limited sagging while resizing the areola. There is only limited skin exicision and limited movement of the nipple areolar complex (1 or 2 cm at most). Inappropriate application of this technique usually leads to sub-par results including loss of projection and a longer flatter breast as well as spread or widened scar and areolar distortion/distension
With regards to your specific question, larger breasts often require a greater scar burden to achieve an adequate lift and coning effect of the breast mound.  Based upon your photos, you would be best suited for a anchor or Wise pattern lift.
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
RealSelf Verified Member
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The technique I recommend is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated 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.  Later, fat transfers can be performed if additional volume is desired.  Best Wishes,Gary Horndeski, M.D.

You would probably do well with the vertical lift and avoid the underneath scar. If your implants are not too large, then your tissue is less stretched and have less skin.

Thank you for your question.  I don't understand why your surgeon states the vertical scar would contain some darker skin (areola tissue).  That is concerning to me.  I would seek more in person consult appointments with board certified plastic surgeons who perform explantation surgeries with lifts often. Best of luck to you.

The options for the lift will depend on your tissue, amount of sagging and your expectations. There will be loss of projection post explanation and Periareolar lift will not work too well. 

An in person examination would give more accurate information, but it appears you would most benefit from a full lift.  The nipple/areola will be downsized during the procedure.  I'm not sure that a periareolar approach will provide you with enough lift.  I encourage you to discuss your concerns with a board certified plastic surgeon.  It is important that you feel comfortable and confident in your surgical plan.

Lift options are based on size of breast, degree of sagging, and quality of tissue.  Looking at your photos, you would benefit from a full lift.  Visit with a plastic surgeon in your area for measurements and to discuss all options.