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

Question

Hi: Getting explant with capsulectomy, lift & moderate lipo to sides. I can get anchor but surgeon said because nipples are so big the vertical scar would contain some and be darker. He suggested another option to lift with only moving nipple up, making it smaller & vertical scar w/ permanent suture. Would this be a good option if I'm concerned about scar? What happens if I don't get internal suture? I want something smaller & very natural looking that will last. Thanks!

Kenneth Hughes, MD · Answer

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.

Daniel Barrett, MD · Answer

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

Donovan Rosas, MD · Answer

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
RealSelf Top 100
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Camille Cash, MD · Answer

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.

Gary M. Horndeski, MD · Answer

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.

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

Answers (9)

Answer: Which lift?

Answer: Which lift?

Answer: Avoid anchor incision

Answer: Avoid anchor incision

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

Answers (9)

Answer: Which lift?

Answer: Which lift?

Answer: Avoid anchor incision

Answer: Avoid anchor incision

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Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.