I'm unsure if I should get a donut or lollipop areola reduction to correct overstretched areolas from a donut mastoplexy (Photo)

Question

It's been about a year since I had my donut mastoplexy augmentation surgery above the muscle. My surgeon and I decided this was the best route though he preferred the lollipop procedure. As I did not and still do not like the vertical scar left from that, I opted for the donut procedure and post op, it looked great...however a year later the aeraolas have thick scars where skin seemed to react to sutures.My surgeon still Prefers the lollipop procedure & I the Donut but worry about what's best

Sean Kelishadi, MD · Answer

Hello and thank you for your question.  This is a very common concern to many patients who need a breast lift. Although the scars are greater for the "lollipop" incision, the extra vertical scar is within the shadow of the breast and is not horribly visible except under bright light at close range in most people.  Breast lift techniques do result in more noticeable scarring than with simple breast augmentations, but for most people, what is achieved in shape and cleavage is worth the disadvantage.Just so you know, both techniques that you mentioned are very good ones in the right patient and in general, I choose one or the other based on the following:1) if it is mainly the nipple position that needs lifting, I like the circumareolar approachvs2)
 if a large portion of the breast tissue/weight needs to be lifted, a 
circumvertical and sometimes a full anchor incision is needed as the 
circumareolar approach in my mind is not strong enough to hold the 
weight of the breast and results in stretching of the areola and 
drooping over time.In your particular case, your doctor recommended the circumvertical approach, but you chose the circumareolar due to your fear of scar.  The reality is that there are no shortcuts and the nipple areola complex could not lift and carry the weight of your breasts and thus, they are now stretched out and have sagged again.  The lesson learned is that if Plan A failed, performing Plan A again to treat the same problem will result in the same outcome as before.  To correct the problem that you mentioned, it is time to move to Plan B, the lollipop incision to achieve the outcome you desire.You can click on the referenced link and scroll down to see pictures of two patient examples where mastopexy and augmentation were performed in one patient needing the lollipop incision and in another where the circumareolar technique was sufficient.  I hope this helps answer your question.

Karol A. Gutowski, MD, FACS · Answer

Repeating the donut incision will not make it better. The lollipop is the only option. The scar will get better over time.

Kamran Khoobehi, MD · Answer

Your breast tissue has failed donut lift and trying the similar procedure and expecting different result is not the best. You would get better result from full lift.

Peter E. Johnson, MD · Answer

What your photo shows is the limitation of an around the nipple lift, especially with the pressure of a breast implant behind. We call this relapse, and it can be controlled with a blocking suture to try to prevent the areola from stretching again. The vertical or lollipop is probably the better solution for you.

I'm unsure if I should get a donut or lollipop areola reduction to correct overstretched areolas from a donut mastoplexy (Photo)

Answers (4)

Answer: Overstretched areola from a do-nut mastopexy.

Answer: Overstretched areola from a do-nut mastopexy.

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Everything you need to know about Breast Lift with Implants

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I'm unsure if I should get a donut or lollipop areola reduction to correct overstretched areolas from a donut mastoplexy (Photo)

Answers (4)

Answer: Overstretched areola from a do-nut mastopexy.

Answer: Overstretched areola from a do-nut mastopexy.

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Recommended reading

Everything you need to know about Breast Lift with Implants

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