Patient Details
This 29-year-old woman presented to Dr. Mihail Climov seeking breast rejuvenation after pregnancy. She had experienced loss of breast volume, mild breast sagging (ptosis), enlarged nipple-areolar complexes, and breast asymmetry.
Her left nipple-areolar complex was larger and positioned lower than the right. She wanted to restore breast volume and upper pole fullness while improving nipple position and areolar symmetry—but wanted to avoid the more extensive scars associated with a traditional Wise-pattern breast lift if her anatomy allowed.
Dr. Climov performed a bilateral circumareolar mastopexy, also known as a donut breast lift, combined with subfascial breast augmentation using 385 cc Allergan Natrelle INSPIRA™ SRF silicone implants.
These photographs show her results approximately 2 months after surgery.
Procedures Performed
- Bilateral Circumareolar (Donut) Mastopexy
- Bilateral Subfascial Breast Augmentation
- Allergan Natrelle INSPIRA™ Silicone Implants
- Style SRF
- 385 cc
What Is a Donut Breast Lift?
A donut breast lift, medically known as a circumareolar mastopexy or periareolar mastopexy, is a limited-scar breast lift performed through an incision around the circumference of the areola.
A controlled amount of skin is removed around the areola, allowing the nipple-areolar complex to be repositioned and the surrounding breast skin to be tightened.
Because the resulting scar is concentrated around the border of the areola, a donut lift can be an attractive option for carefully selected women who need mild lifting and areolar correction without the more extensive incisions of a full breast lift.
When combined with breast implants, the procedure can simultaneously restore volume while refining nipple position and breast shape.
Who Is a Good Candidate for a Donut Breast Lift with Implants?
The key to a beautiful circumareolar mastopexy result is proper patient selection. A donut lift is not intended to correct significant breast sagging.
It may be appropriate for women who have:
- Mild breast ptosis or nipple descent
- Mild skin laxity after pregnancy or weight changes
- Loss of breast volume or breast deflation
- Enlarged or stretched areolas
- Mild differences in nipple height
- Areolar asymmetry
- Nipples that require only a relatively small amount of elevation
- Adequate breast shape that does not require extensive reshaping
- A desire for additional volume from breast implants
- A preference for minimizing breast lift scars when anatomically appropriate
For these patients, combining a donut lift with breast augmentation can provide both the volume enhancement of an implant and the limited lifting effect of a mastopexy.
Why Combine a Donut Lift with Breast Augmentation?
An implant and a breast lift accomplish different things.
A breast implant primarily adds volume, projection, and upper pole fullness. It does not reliably correct a nipple that sits too low or remove significant excess skin.
A mastopexy reshapes the breast envelope and repositions the nipple-areolar complex but does not provide the same increase in breast volume as an implant.
Combining the two can therefore address both problems at the same time.
For this patient, the 385 cc implants restored volume and projection, while the circumareolar mastopexy allowed Dr. Climov to improve nipple position, reduce the enlarged areolas, and address pre-existing asymmetry.
Donut Breast Lift vs. Wise-Pattern Breast Lift
One of the most common questions patients ask is whether they can have a donut lift instead of a traditional breast lift.
The answer depends primarily on how much sagging, loose skin, and breast reshaping are required.
Donut / Circumareolar Mastopexy
A donut lift uses an incision that travels only around the areola.
It is generally best suited for patients who need:
- Mild nipple elevation
- Mild skin tightening
- Reduction of enlarged areolas
- Correction of mild nipple or areolar asymmetry
- Limited breast reshaping
The primary advantage is the shorter scar pattern. However, its lifting capacity is limited.
Trying to perform a circumareolar lift when substantially more correction is required can place excessive tension around the areola and may contribute to widening of the areola, flattening of the breast, or an unfavorable scar.
For that reason, Dr. Climov does not select the lift based on scar preference alone—the patient's anatomy determines how much lifting is safely achievable.
Wise-Pattern Mastopexy
A Wise-pattern breast lift, sometimes called an anchor breast lift, provides substantially greater ability to remove excess skin and reshape the breast.
The incision typically extends:
- Around the areola
- Vertically from the areola toward the breast crease
- Horizontally within the inframammary fold
This creates the familiar anchor-shaped scar.
Although the scar is longer, the Wise-pattern technique gives the surgeon significantly more control over the breast envelope and is often the better choice for women with:
- Moderate to severe breast sagging
- Significant excess breast skin
- Nipples positioned substantially below the breast fold
- Long or deflated breasts after pregnancy or major weight loss
- Significant breast asymmetry
- Breasts requiring substantial reshaping or reduction
In these situations, accepting a longer scar can allow for a considerably better breast shape.
Donut Lift vs. Wise Pattern: Which Is Better?
Neither technique is inherently better. They are designed to solve different degrees of breast ptosis and skin excess.
Donut Lift vs. Wise Pattern: Which Is Better?
Neither technique is inherently better. They are designed to solve different degrees of breast ptosis and skin excess.
The goal should not simply be to choose the procedure with the smallest scar. The goal is to use the least extensive scar pattern that can reliably create the breast shape the patient needs.
Can I Get a Donut Lift Because I Don't Want an Anchor Scar?
Possibly—but only if your anatomy makes you a good candidate.
Many women understandably prefer the idea of a scar limited to the areola. However, a donut mastopexy cannot provide the same degree of lifting and skin removal as a Wise-pattern mastopexy.
If significant sagging is present, attempting to avoid the necessary vertical or horizontal incision can compromise breast shape.
During consultation, Dr. Climov evaluates nipple position, breast fold position, skin excess, breast volume, tissue quality, asymmetry, and the distance the nipple needs to be elevated before recommending a scar pattern.
In breast lift surgery, the shortest scar is not always the best scar. The appropriate operation is the one that provides enough access and skin removal to create a stable, attractive breast shape.
Subfascial Breast Augmentation with Donut Mastopexy
This patient's breast augmentation was performed using a subfascial implant position, with the implant placed beneath the pectoral fascia rather than beneath the pectoralis muscle.
For appropriately selected patients, subfascial augmentation can provide excellent implant coverage while preserving normal pectoralis muscle function and avoiding the animation deformity that can occur with implants placed partially beneath the muscle.
Her 385 cc Allergan Natrelle INSPIRA SRF implants were selected to provide increased projection and upper pole fullness while maintaining proportions appropriate for her frame.
Results at 2 Months
At approximately 2 months after breast augmentation with circumareolar mastopexy, this patient demonstrates:
- Increased breast volume
- Improved upper pole fullness
- Greater breast projection
- Improved nipple position
- More proportionate areolar size
- Improved symmetry between the nipple-areolar complexes
- Fuller, more youthful breast contours
At two months, the breasts and scars are still healing. Implant position, breast shape, swelling, and scars can continue to evolve over the following months.
Schedule a Breast Augmentation and Lift Consultation
If your breasts have become deflated or mildly saggy after pregnancy, weight changes, or aging, you may not necessarily require a full anchor breast lift.
During your consultation, Dr. Mihail Climov will evaluate whether breast augmentation alone, augmentation with a circumareolar donut lift, or a more comprehensive mastopexy would provide the best result for your anatomy.
