Donut lift with implants or wait till after implants and get a full lift if needed? (Photo)

My PS recommended a doughnut lift with 350-400 HP silicone implants. I'm 32 135lbs 5'7 and the goal is to get back the full chest I had 4 bre kids ago and look as natural as possible. My breasts/nipples have always been lower on my breast and had never considered an augmentation till they deflated. I Am not opposed to getting a lift if required but I have seen bad press about the doughnut lift not really being a lift. What are your thoughts?

Doctor Answers 12

Lift with or without implants

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift with augmentation such as silicone implants, you will get very nice results, contact a board certified plastic surgeon, I recommend you soft cohesive silicone implants about 350 cc's you will look pretty and they will be perky.

Patients who goes to a consultation for drooping breasts (ptosis) or volume loss after pregnancy (pseudoptosis) almost always have one very important question. "Can my drooping be corrected with just implants or do I need a lift".

Implants alone will correct drooping when:
  1. Breast drooping is mild
  2. The nipple is still near the center breast and does not point downward
  3. There is some visible skin beneath the nipple/areola when looking at the breasts straight on.
  4. The patient is okay with being at least a cup size larger
A breast lift (with or without an implant) is better when:
  1. Breast drooping is moderate or severe
  2. The nipple is at the bottom of the breast or points downward
  3. There is no visible skin under the nipple/areola when looking at the breasts straight on.
  4. The patient is already a C or D cup breast size and doesn't want to be larger
  5. The areola is too large and the patient wants it reduced
I also show the patient photographs of a spectrum of breast scar present after a breast lift in order to check their tolerance for this scar. Most patients are surprised how little the scar shows and are okay with proceeding. If the patient really needs a breast lift, but is concerned about the scars, I will suggest they wait on surgery. In time the breast appearance problems will usually outweigh their concern about the scars.

I use implants in combination with a lift when:
  1. The patient wants to be larger in addition to being less droopy
  2. The patient desires to maintain projection and roundness of the breast mound
  3. The drooping is severe..... I recommend to see a board certified plastic surgeon for a personal evaluation and also to talk about your goals. Good luck :)

Dominican Republic Plastic Surgeon
4.5 out of 5 stars 397 reviews

Donut lift with implants or wait till after implants and get a full lift if needed

Thank you for your question and photo. You are a good candidate for breast augmentation, which will restore volume.  A breast lift will give you a more youthful breast.  Consult with a board certified Plastic Surgeon and view photos of patients who look similar to you,  who only had  implants versus a breast lift and implants.  Best Wishes.

Jeff Angobaldo, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 104 reviews

Breast lift

Thank you for your question and photos.  It appears that, based on your photos, that you are a borderline case for a breast lift.  If you are content with having implants alone, you could most likely get away with them.  Keep in mind though that your breasts will still sag without the breast lift.  If you want your breasts to appear more youthful and perky, I would then recommend a full lift with at least small implants.

All the best,

Dr. Results
Miami, FL

Jose M. Soler-Baillo, MD
Miami Plastic Surgeon
4.7 out of 5 stars 92 reviews

Full lift with implants

A breast lift would give a more youthful shape to the breast. A breast augmentation alone would only address the volume. You would get the best result with a full breast lift with augmentation. I wouldn't suggest having the donut lift done. Please seek an in person consultation with a board certified plastic surgeon in your area. Good luck. Dean Vistnes.

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 47 reviews

Breast Augmentation and Lift

It appears that you are on the border of needing a lift.  In these situations, I discuss the pros and cons of each approach with the patient.  Many women looking for a natural look choose to do the breast augmentation first and see how they like the results.  Some women will be happy with them, while others may feel the nipples sit a little low still and proceed with the lift.  You do not burn any bridges that way, and it is nice not to have the scar around the nipple if you may not need it.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.8 out of 5 stars 73 reviews

Donut lift with implants or wait till after implants and get a full lift if needed?

Thank you for your question.

As long as you are prepared for a secondary lift procedure if needed, having implants alone and waiting is reasonable. In fact, that is the way it was done for many many years.

The benefit is that if you are happy with implants alone you can avoid the scars of the lift.

In addition, once implants are in and settle, if you do need a lift your surgeon can more accurately decide if a donut lift will adequately lift the breast or whether a vertical component is needed (lollipop lift.)

For more information please read below:

Donut lift with implants or wait till after implants and get a full lift if needed? (Photo)

Without examination in person, it may be hard to give you an accurate opinion. 
Regardless of the type of lift you need, I prefer to combine the augmentation and lift in one setting, in the right patient.
I may recommend that you seek more than one consult from great specialists in your city to be better informed..

Maan Kattash, MD, FRCS, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 53 reviews

Doughnut lift, or wait till after augmentation and get a full lift if needed?

Your pictures are very helpful, but do still not tell the full story of how elastic and stretchy the tissues are.  With that size implant you are borderline as to whether a lift is needed. The doughnut mastopexy has been a useful procedure in selective situations, but only a modest repositioning of the nipple.  A vertical mastopexy with lollipop situation will allow full control the of the shape. If you are determined to avoid a lift, and would accept a secondary procedure, I would avoid the doughnut mastopexy as well...that is very easy to do as a secondary procedure.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 95 reviews

Donut lift not enough for you

I agree that a dual plane augment alone may give you the breasts that you desire. The high profile may be a bit round and have too much projection for you if you want natural. You are correct that  an augment first and lift later can be done. The donut lift is a small lift technique and unfortunately is used when other lifts really needed. Good Luck

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Donut lift with implants or wait till after implants and get a full lift if needed?

In my experience, "donut" lifts rarely make a significant improvement but do cause wider and unnatural scars. Depending on the implant size you are considering, I would recommend a dual plane augmentation if you are trying to avoid a lift. 

See case #950 in the link below for an example.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 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.