Glandular ptosis can sometimes be treated with breast augmention without mastopexy
There are numerous types of breast lifts available and all have advantages and disadvantages. Based on your description and photographs, I would expect that a Benelli type lift would be adequate. Be informed of potential problems associated with this procedure such as occasional reduced projection and “flattening” of the breasts. Also, the scars may not always be ideal with scattered cases of gathering of tissue along the incision.
If you goal is to avoid scarring, it is conceivable that you could receive an acceptable result with breast augmentation alone. If you tried this option and decided you still needed some type of lift, this could be performed later as a secondary procedure.
I hope this information is of some benefit to you. Good luck on your future surgery.
Biplanar breast augmentation without breast lift should work for you
Thank you for your question. I agree with others that I do not think a breast lift is necessary based on your photographs. A biplanar breast augmentation alone should give you a nice result. If a breast lift is needed it would be better to wait and do it as a second procedure.
I think it may be possible to achieve good results from the right implants alone. Choose something with a narrower base and firmer texture.
Breast lift with donut mastopexy
A short vertical scar breast lift may provide you with better longterm results with your mastopexy. An areolar mastopexy may not provide you with longterm results.
Breast Implant May be All that is Required
Thank you for your pictures. Depending on how large a size you chose for a breast augmentation, an implant may be all that is required. Your breasts are deflated from breast feeding. Most of the time, placing an implant to re-inflate the tissue may be all that is needed to restore youthful volume. Its possible your surgeon could perform the augmentation through a small incision below the nipple at the bottom of the areola. If the augmentation fixes the nipple position...then that's it. If you need a small lift, then a circular lift could be performed by converting that incision into a small oval. Even if this is the case, you probably wont require a very large lift. A board-certified plastic surgeon can assist you with this decision. Best of luck to you! Dr. Pacella
Sometimes A lift is needed, Sometimes Not
Although you have loss of volume in your superior pole you may be a candidated for just a breast augmentation.
The key to success lies in letting you surgeon know
specifically what you would like to look like following the surgery. For
example, how perky do you want to be, what shape do you want to have,
etc.? However from your description it would appear that a lollipop
type lift would be best for you rather than a periareolar lift like the Benelli
procedure. Here is a rule of thumb that works for most patients. If you nipple
is above your lower breast crease then often a periareolar lift will be
sufficient for most patients. If your nipple is at or below your crease then a
vertical lift (lollipop lift), inverted T or anchor pattern may be required.
A Benelli lift is quite limiting in its ability
to do much of an up lift. Even with a
340 high profile implant I think the result will leave the increased size and
fullness too low a level. I do not feel
you will be satisfied with the result.
Benelli Mastopexy with Implants Enough for Breasts with Pseudo Ptosis
A Benelli type of breast lift is sometimes indicated in pseudo-ptosis. It can be used to reposition the nipples if desired if one has some asymmetry or sometimes it can be used to decrease the diameter of the areolas. However, a 19 cm distance from the collarbones to the nipples is not that low. An augmentation without a lifting procedure may be indicated. One could use a dual plane type of augmentation. Be sure to discuss with your surgeon the pros and cons of adding a lift to your augmentation.
any surgeons perform what they call a 'circumareolar' (or 'donut' or 'Benelli' ) mastopexy. In my opinion there is absolutely no such thing as a 'circumareolar mastopexy'. Removing skin around the areola may enable a surgeon to elevate the position of the nipple/areola complex perhaps 1-2 cm on the breast mound, but it DOES NOT lift the breast itself. In most cases, unfortunately, it serves to distort the shape of the breasts, making them appear flattened at the top. If the breast needs to be lifted, it absolutely requires some internal rearrangement of breast tissue to create a projecting, aesthetically ideal and lasting result - which in turn requires that vertical incision and vertical surgical scar below the areola (and sometimes in the inframammary fold as well.
Benelli vs. Lollipop
The Benelli may be adequate, but I believe that a lift using the lollipop incisions will likely look better and last longer.