Unilateral Doughnut Mastopexy with Sientra Gel Implants, Raleigh, North Carolina*

Many women present for breast augmentation and have asymmetry of the breasts. It is not infrequent to have small or even larger differences in nipple position , Breast shape and breast size.. Minor degrees of asymmetry may not require correction although persistent differences will occur. When the asymmetry is more noticeable, a unilateral mastopexy may be necessary. This patient desired increase of breast size up to a D cup. She had unilateral breast ptosis on the right side with a larger areola on the right which was lower. She also had a somewhat larger breast on this side. She underwent a periareolar or donut type mastopexy which reduces the size of the areola and elevates the nipple position somewhat. It does require a scar around the areola. Breast augmentation typically stretches large areola and without a mastopexy, this patient would have had a much larger areola on the right side and droopier. She had bilateral submuscuular placement of Sientra high profile implants with the right one being slightly smaller to compensate for volume discrepancy. She was very happy with the improvements made and although she had a faint scar around the right areola, it avoided significant postoperative asymmetry. Dr. Lyle uses a Keller funnel (Or insertion sleeve)to reduce potential contamination of the breast implant and eases insertion allowing for a smaller incision.