Large D Wanting Breast Lift and Implants or Just Lift? Full Lift or Benelli Lift?

I have large d-dd breasts that are heavy, saggy and ptotis. Reason being I lost 30kg. I have some loose skin, mainly lying down. I am only 22 and would prefer not to have massive scars.I would love high, firm, round breasts. I have attached a pic of what I would love them to look like. It has been suggested to me that I have a Benelli lift plus approx 325cc implants behind muscle, but I was also told I still may have some sag, which I don't want. I'm generally a size 10 to 12 & active/curvy.

Doctor Answers (6)

Breast augmentation only for this problem.

+1

A doughnut mastopexy is almost never indicated is certainly not in your case. You do not have ptosis and a breast implant should nicely fill out the volume.


Atlanta Plastic Surgeon
4.5 out of 5 stars 9 reviews

Lift or not

+1

I would stick with what you know. If you are conviced you need more volume, start with an implant. If you are not sure what type of lift you need or that you do not want scars, I would wait. See where you breast settles after an implant. You may answer your own question. Good luck.

Timothy Fee, MD
Jacksonville Plastic Surgeon
4.5 out of 5 stars 25 reviews

Avoid benelli's

+1

or get it in writing that it will achieve the result you post... because I have never seen a benelli produce that look.  In fact, benelli's flatten projection.  If you desire that look, you need to have a vertical scar.  But also realize that lifts do not maintain the result forever choose what will work best for you and be able to accept the risks that come with the procedure.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

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Breast Lift

+1

Thanks for your picture.  It is going to be difficult to achieve the look you want due to your current breast size and shape.  This does not mean you can not achieve a very nice breast size and shape.  I would not go with the recommendation of a 325 cc implant and a benelli lift.   You have good breast volume. You do not need additional volume.  You must accept breast incisions because a lift/reduction is your best option.

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast Lift

+1

I would suggest you consider a breast lift to help reshape your breasts.  If you have enough tissue volume, you may not need an implant.  I've included a link to an abc news video on my breast lift technique.  

Best wishes,

Dr. Basu

Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 123 reviews

Large D Wanting Breast Lift and Implants or Just Lift? Full Lift or Benelli Lift?

+1

Thank you for the question and pictures. Your situation is not uncommon and hopefully this response will be helpful to you and other young ladies with the same concerns.

 Many patients who are starting out with a significant amount of breast tissue and/or some “sagging”, will benefit from removal of some breast skin/tissue prior to undergoing breast augmentation surgery. Otherwise, if they were to have a breast augmentation and/or breast lift at this point, they will likely not be pleased with the outcome of the procedure performed.

One analogy I used to describe the issues at hand is called the sheet versus comforter analogy. Young ladies who present with very little breast and/or  adipose tissue “coverage” (analogous to "sheets")  are more likely to achieve the “full, round” look with breast augmentation surgery since the breast implants will show themselves through the relative thin coverage present.

On the other hand, patients who present with more breast and/or adipose tissue coverage (“comforters”),  are less likely to achieve the full round look after breast augmentation surgery, because  the “roundness” of the breast implants does not show themselves through the relatively thick overlying coverage.

 For these patients, who present with a significant amount of soft tissue coverage, traditional breast augmentation/lifting surgery may leave the patient dissatisfied, given that the “full, round” look is not achieved. One option for these patients is to remove breast tissue as well as breast skin during a breast reduction/lifting operation. By doing so, the plastic surgeon is essentially converting the patient from a “comforter” to a “sheet” situation. In my practice, I use a second stage breast augmentation procedure to achieve the “full, round” look that the patient is  hoping for. During this stage, selection of breast implant type, profile, size etc. becomes important.   Careful preoperative communication is one of the keys to success.

I  suggest that patients not base communication of goals  or satisfaction with the results of surgery on achieving a specific cup size. As you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
In my practice I use goal pictures to communicate with patients.  With this technique patients are able to demonstrate what they are trying to achieve and what type of looks they do not like as well. In office use of sizers under bras are helpful during the communication process.  Computer imaging technology may also be a helpful communication tool.


I also use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. 
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

 All types of breast lifting involved removal of some breast skin;  the lower the position of the breasts on the chest wall, the more skin that needs to be removed, in order to tighten the breast skin envelope.  In these situations, the more native breast tissue present, the more tissue that will need to be removed to help achieve the final outcome desired.

For some patients the necessity of additional scars  associated with breast lifting surgery is a “dealbreaker” ; for these patients it is better to avoid breast surgery altogether.
 

On the other hand, many patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.

 

 Generally, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.

Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time.  This revisionary rate may be as high (or higher) than 20%. Patients should be aware of this higher revisionary rate;  obviously, the need for additional surgery, time off work/life  considerations,  and additional expenses are “factors” that should be considered before undergoing the initial operation.

 It is also not unusual for patients to present after previous breast augmentation/lifting surgery, dissatisfied with the shape and/or amount of superior pole fullness/volume. These patients  may benefit from revisionary surgery. 

An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness).  It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation.  The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery,  Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia,  lateral displacement etc).


I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 759 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.