The following pictures are examples of patients at the Center for Cosmetic Surgery who were good candidates for the circumareolar or "doughnut" breast procedure.
In Denver, Colorado, breast lift surgery is chosen by women from Colorado Springs, Fort Collins, and the Denver area to elevate and reshape sagging breasts and to give a perkier, more youthful appearance. Sometimes, breast implants are placed during the same surgery to create more fullness than would result from a lift alone.
The need for a breast lift is usually the result of an inflation and deflation of breast volume due to pregnancy or significant weight loss. Sometimes, merely gravity and time can cause the need for a mastopexy. And in some cases, women develop with lower, relaxed breasts and can benefit from a lifting procedure.
A breast lift entails removal of the extra skin that is allowing the breasts to drop to a less attractive position. The breast tissue (parenchyma) with the arealae and nipples attached, are moved upward, and the lower pole tissues are tightened to hold the breasts up. Underlying breast parenchyma is sewn together in the lower pole to reinforce the lift prior to closure of the skin. Occasionally, women are candidates for the areolar lift that does not require the vertical scar down the front of the breasts. Ultimately, the best shape must be achieved using the minimal scarring to do so. Most women feel the scar is a small price to pay for a perkier breast position.
41 year-old female who desired a modest breast reduction but mostly a lift; underwent removal of approximately 500gm on the larger right side, 390 gm on the left. Results shown at approximately 2 months post-op. View Case
42 year-old female who had lost over 100lb (naturally), was left with significant abdominal tissue skin and soft tissue excess, as well as fairly ptotic breasts. She therefore came to me seeking post-weight loss cosmetic surgery here in Denver, Colorado, and I advised her she was an e... View Case
This is a 29-year-old woman who wished to improve the shape of her breasts. She was a D cup, and wanted a perkier C cup. In addition, her right breast waqs larger and lower than her left. She underwent a mastopexy, or breast lift, which gave her a more youthful, perky shape, and helped e... View Case
This is a 41 year old, 5'6", 149 pound woman who didn't like her breasts after having children. They had "deflated", losing their upper fullness and sagging over her rib cage. She wanted to be filled out and perky again. She underwent a Denver, Colorado breast augmentation and ma... View Case
This 42 year-old woman actually underwent a concomitant mastopexy during a right upper pole lumpectomy; the same can be done secondarily for post-op defects - even after radiation - in appropriate candidates. View Case
This 37-year-old woman underwent a breast reduction utilizing a short-scar technique. 200 cc of tissue were removed from each side, decreasing her breast size from a DD to a full C. She also underwent an abdominoplasty at the same time. The patient is 5'3" and 136 lbs. P... View Case
This is a 33 year old, 5'5", 153 pound woman who previously underwent breast implant surgery. She did not undergo a lift (mastopexy) and, as can be seen in these pictures, her breast implants did not achieve an attractive shape to her breasts. Breast implants do not lift breast. Therefo... View Case
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 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 2 intersecting ellipses with an area above for areoalar elevation and in-setting. 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 inconspicuous. 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 tissue together in the lower pole beneath the skin. The skin is "tailor tacked" with surgical clips while the patient is in the upright position during 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 candidates for this procedure have tight lower pole breast skin with a short distance between their areolae and breast creases. This procedure is often used 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 a frequent reason for breast revision surgery. This common problem is somewhat attributable to patient demand for avoidance of the vertical scar.
Even though the circumareolar procedure avoids vertical scars, the disadvantages can be significant:
A beautiful breast shape with a faded scar is still attractive and even sexy. But an unattractive breast shape without scars is still unattractive. Achieving a beautiful breast contour is the primary objective of a breast lift, followed closely by limiting scarring to achieve the goals.
All too often, however, Dr. Vath, Dr. Wolfe, and Dr. Steinwald meet patients with sagging breasts who hope to avoid the vertical lift scar and still achieve a beautiful shape. Even though this is understandable, it usually is not possible. Once a breast truly sags below the breast crease, removal of lower pole skin is unavoidable. But all hope should not be lost. When the proper techniques are used to tighten the lower pole breast tissue to keep tension off of the skin, scars usually stay thin and fade wonderfully over time.
This is a 40-year-old, 5'9" woman who previously underwent a breast augmentation at another center with 390cc saline breast implants in Denver. She did not undergo a breast lifting procedure at that time. She presented complaining of an unattractive breast shape. Dr. Vath performed an implant exchange placing 350 cc silicone gel implants and then a breast lift. Postoperative pictures were taken 2 months, 1 year, and 3 years after surgery. Notice the appreciable fading of the scars by 3 years from surgery. A beautiful breast shape with a faded scar is much more attractive than the alternative without the scar.