The following pictures are examples of patients at the Center for Cosmetic Surgery who were good candidates for the circumareolar or "doughnut" breast procedure.
The amount of skin removal and resulting scar is precisely determined based upon the needs of each breast. The wise pattern skin excision that results in an "anchor" scar is necessary in many Denver, Colorado, breast lift cases due to the large amount of extra skin that needs removal in order to create the best breast shape. There is no magic here. The wise pattern is two intersecting ellipses with an area above for areoalar elevation and insetting. These two elliptical excisions reduce the vertical and horizontal dimensions of the breast skin to achieve a tight, round lower pole- the hallmark of an attractive, perky breast. The breast tissue (parenchyma) is tightened beneath the skin to support the breast and keep tension off of the skin. The final scars are surprisingly well tolerated. The scar around the areola is hidden between the darker and lighter skin tones. The horizontal scar is hidden in the breast crease and the vertical scar fades and flattens most nicely to become barely perceptible over time.
The vertical mastopexy is the same operation as the Wise pattern except the horizontal ellipse of skin and resulting scar in the breast crease is omitted. This is feasible for smaller breast sizes, especially when breast implants are added to restore some volume. Again, there is no magic to these procedures. The breasts are supported from within by suturing the breast parenchyma together in the lower pole beneath the skin. The skin is "tailor tacked" with surgical clips while the patient is sat up in surgery. This method delineates the precise amount of skin removal necessary to achieve the best breast shape. This step determines if the horizontal elliptical excision can be avoided resulting in the "lollipop" scar. At the Center for Cosmetic Surgery, Dr. Vath, Dr. Wolfe, and Dr. Steinwald often perform a modified vertical mastopexy where most of the excision is performed with the vertical ellipse and only a small, additional horizontal elliptical excision is added, rather than the full length "anchor". This small, additional horizontal scar is usually of no concern to patients because of its inconspicuous nature in the breast crease; however, it can be a critical element in completing the perfect, uncompromised breast shape.
The circumareolar lift is primarily an areolar lift rather than a true breast lift. Although it does slightly tighten the skin envelope of the breast, this procedure does not elevate breasts that sag below the breast creases. Primarily, a circumareolar mastopexy is for patients that have low areolar positioning on the breast, but not true sagging below the crease. Generally, good candidate for this procedure have tight lower pole breast skin with a short distance between their areolae and breast creases. Not infrequently, this procedure is utilized to even out asymmetrical areolar position or to achieve areolar reduction. This operation absolutely does NOT replace a vertical or wise pattern mastopexy, and when used in the wrong situations, leaves patients with a deformed, unattractive breast shape. Misuse of this operation is one of the most common mistakes made in cosmetic breast surgery and frequent reasons for breast revision surgery. This common problem is somewhat attributable to patient demand for avoidance of the vertical scar.
Although the advantage of this procedure for good candidates is the avoidance of the vertical scar, disadvantages can be significant.
The Center for Cosmetic Surgery has two offices conveniently located in the Denver metropolitan area. One is located just outside of Denver in lovely Golden, Colorado immediately off 6th Ave West and the other is located downtown in Cherry Creek, Denver. Please schedule a personal consultation to learn what plastic surgery can do for you. Simply call (720) 279-1926 or request your complimentary consultationcomplimentary consultation online.