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Lollipop Vs Benelli Lift for Sagging Breasts?

I have been advised that I have substantial breast sagging, (26 cm). 3 doctors I saw only recommended Lollipop whereas one surgeon told me I can have 5.5 cm lift with the Benelli Lift and no puckering or implant.

Is this realistic? I don't want the vertical scar but don't want a dodgy job. Is puckering permanent and is it better than a vertical scar?

Doctor Answers (38)

Both procedures are good for sagging breasts

+4

Both procedures are good, and no one can tell you what to do in your particular situation without actually examining you themselves.

You understand the core issue of the debate: the Benelli lift has less scar, but it may not lift/tighten as much and the scar can be thicker or pucker. Without seeing you, it is impossible to know whether it would work for you.

I'd say this: 5.5 in general sounds like a lot to expect out of a Benelli. And, in general, if your SN:N is 26 as you say, 5.5 is probably more than you need to be lifted. The most common error with a breast lift, no matter the technique, is to raise the nipple too high. So I'd look into that again.

Be sure that your Benelli surgeon really understands what he/she is talking about and be convinced that they are highly experienced with that procedure before you select them.

And one more thing: most American surgeons call any breast lift with a scar just around the areola a Benelli. But Louis Benelli described much more than that: wide undermining with extensive reshaping of the breast. If your surgeon is calling it a Benelli, be sure he/she knows enough to know what a Benelli really is!


Los Angeles Plastic Surgeon
5.0 out of 5 stars 29 reviews

Benelli Breast Lift

+3

A word of caution: many 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.

For several years I have been using a 'vertical scar' technique for most breast reductions, which eliminates the long, horizontal incision in the inframammary fold below the breasts. I have also adapted this technique for breast lift surgery, and have been extremely pleased with the results. As with breast reduction patients, this new technique not only eliminates the horizontal incision, but also creates more impressive breast projection and maintains it better over time. The breast lift procedure I perform not only removes breast skin but also moves some lower pole breast tissue to a higher position, increasing the projection of the nipple/areola area.

Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'. However, in most breast lift Raleigh / Durham patients it is difficult to create sustainable fullness in the upper poles of the breasts by means of a mastopexy alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation. For patients who indicate that they wish to achieve a fair amount of fullness in the cleavage area as a result of their breast lift surgery, I recommend that they undergo augmentation mastopexy. This surgery combines a breast lift with the placement of a breast implant usually of modest size, which produces the most youthful breast profile possible.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 42 reviews

Lollipop Breast Lift Best for Sagging Breasts over 2 Centimeters

+3

Thank you for your question. I agree with most that a Lollipo Breast Lift is your best option since your sagging breasts have a Nipple Areola that requires 5.5 Centimeters of lift.

Trying to lift the breast this amount using a Peri Areolar Breast Lift will result in puckering and deformity that will be very visible and much worse that a well healed Lollipop Lift Scar.

Good luck.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 37 reviews

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3 to 1 odds

+3

Bel,

I'll take three to one odds anyday.  You already know the answer to your question.  A periareolar lift procedure is generally reserved for lifts of around 2cm.  It sounds like you will need the lollipop.  Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

The Best Lift for Breast Sagginess

+2

It’s not unusual for patients with breast sag to request procedures that limit the extent of scarring.  Unfortunately, these efforts often result in significant compromises regarding the quality of scars and ultimately the shape of the breasts.  Limited incisions can create tension on wound closures that result in spread of the scars and actual distortion of the breast shape.
It’s important to remember that breast sag is usually accompanied by excess skin and failure to address this problem can result in a less than optimal result.  Breast lift surgery often requires removal of excess skin in multiple dimensions to achieve the best possible result.
Patients with breast sag are always unique.  They have specific anatomic findings and personal aesthetic goals.  It’s virtually impossible to recommend one of these procedures in the absence of pictures or a physical examination.  It’s therefore important to discuss certain concepts that are relevant to the surgical procedure.  As a general rule the breast contour and the quality of the scars are more important than the length of the scars.
In some cases, the degree of sag may be greater than the capacity of a donut mastopexy to deal with the excess skin.  Performing this procedure under these circumstances can result in tension on the closure with severe spread of the scars.  In this situation a lollipop incision would be a far better option. 
It’s important that you consult with a board certified plastic surgeon who has extensive experience with this procedure.  You have already seen multiple surgeons who have recommended a more aggressive approach.  I suspect that this is probably the correct approach for your problem.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 89 reviews

Circumareolar Lift Vs. Lollipop Lift for Breast Sagging

+2

You raise an excellent concern regarding breast lift options.  Most patients would prefer to have minimal scarring (as would most plastic surgeons) with a breast lift.  However, with a significant amount of lift necessary as in your case, there are limitations to the Benelli (Circumareolar) approach.  While the Benelli approach can lift the nipple-areola, the larger the lift, the more likely that the circular scar wiill pucker, widen, stretch and flatten the breast (imagine you are pulling the drawstring up on a purse to close it...this is very similar to what is being done with a Benelli lift).  The Lollipop lift can accomplish a sgnificant degree of lift while also reducing the areolar size (if necessary) and minimizing tension on the scars which significantly help scar healing.  Additionally, the Lollipop lift does not flatten the breast and the scars themselves usually heal very nicely.  In your case, you and your plastic surgeon need to decide if the lift can be adequately performed without the additional scar and if so, what can you realistically expect as your final result.  Based on the information that you have provided, I would strongly favor a Lollipop lift.  Best of luck!

Louis DeLuca, MD
Palm Beach Plastic Surgeon
5.0 out of 5 stars 34 reviews

Vertical lift or benelli

+2

I have to agree with with most comments on this post.  Ironically your scar will probably look much better with a vertical lift than with the benelli.  A lift of 5.5 cm is asking a lot for a benelli.  It will not only flatten the breast but most likely stretch the areola back to or larger than it's original size because of the tension around it.  Furthermore, I find it difficult to shape the breast using that technique. There is more control with the vertical lift in that respect.  I tell my patients that a benelli is best for simply moving the areola up 1-2 cm max- usually to achieve symmetry with the other breast.  Hope this helps and good luck!

Tiffany McCormack, MD
Reno Plastic Surgeon
5.0 out of 5 stars 24 reviews

I find a lollipop lift or a anchor lift gives a better shaped breast with out puckering

+2

 In the end you want the best shaped breast with out puckering. In my hands this is best accomplished with a lollipop or anchor lift with or with out a sub mammary gel implant.  Benelli Lifts are some what variable in most surgeons hands. 

Carl W. 'Rick' Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 13 reviews

Benelli Periarolar Lift vs lollipop lift

+1
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 the best  for most patients in my experience. 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

The Lollipop incision for Grade 3 or 4 ptosis (areolar near or below your breast crease) works best in my hands and the use of a Lollipop technique can lift your breast to the perkiness you desire. However, other plastic surgeons are more comfortable with an inverted T or Anchor Pattern technique.The donut lift does tend to both flatten and have scars widened as you are removing skin around the areola which causes tension in that single area causing it to "spring' apart over time. With the Lollipop incision the tension is spread out over a greater distance of the lower vertical scar (where the areola once was) causing less tension on the areola and entire closure. The vertical lift tends to cone the breast making it more shapely (conical) and less flat. For a visual take a paper circle, cut out a small wedge on the bottom and bring the edges together to see this effect. In general I would pick the best Surgeon and explain fully what you want to achieve rather than the technique. Always insist on a board certified Plastic Surgeon.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 50 reviews

Best operation for sagging breasts.

+1
It is difficult to answer this question without a consultation including a physical exam, but hopefully this will offer another perspective on the two operations.   I find that I can achieve better reshaping of the breasts with a lollipop or anchor scar breast lift rather than a Benelli lift, but there are more scars.   There is no wrong or right operation; some patients will opt for a less-scarring operation even if this means they will have less dramatic reshaping of their breasts.   Others will choose the operation with more scars because they want their breast mound to be tighter and higher.  I try to match the operation to the patient's expectation of the results.

William Andrade, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 6 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.