I am considering a peri-areolar breast lift w/ breast implants and have read various pros (less invasive, less visible scarring) and cons (scar stretching, breast/areola flattening). I'm a small B/large A (different sizes), with mild grade 2 ptosis, hoping to get to a full C. I've seen 3 surgeons so far, 2 that recommended Benelli Lift, and 1 that suggested the regular anchor as he never seen a periareolar lift without the above mentioned cons. Also, I have not had children yet but plan to within the next 8 years. What sort of effect will that have? Thanks!
Pros and Cons of Benelli Lift?
Doctor Answers (10)
Benelli Lift vs Vertical Lift
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.
Proper use of the periareolar mastopexy
I have many pictures of the periareolar mastopexy on my web site for you to review. In patients whose nipples have drifted down to just above the lowest point of the inframammary crease or when the nipple is exactly at the crease level, it is possible to get a good result with a periareolar augmentation mastopexy. I have discovered some new ways to keep the areola from spreading out so the old problems with this procedure I do not see in my practice. The flat breast with the baggy skin envelope at the bottom is the result we don't want to see and this comes from doing a periareolar in someone who needed the full lift with the vertical scar..
If you have substantial lower pole skin laxity or if the nipple is lower than the crease or is pointing down, the full lift is clearly better.
The Benelli Lift
The Benelli breast lift is indicated for mild cases of breast sag and therefore has limited application. The procedure is often referred to as a periareolar mastopexy or a donut mastopexy.
In cases of mild breast sag, the excess skin and sag can be treated with a Benelli mastopexy. This procedure removes and tightens the excess skin around the areola. This leaves a scar at the junction between the areola and surrounding tissue. This procedure can be done in combination with breast augmentation when patients want larger breasts as well.
The success of the Benelli lift is dependent upon appropriate patient selection. When sag is minimal, the procedure is less invasive and wounds heal nicely with minimal scarring. Unfortunately, the procedure is often utilized when moderate amounts of breast sag are present. This results in tension on the wound closure which can cause spread of scars and flattening of the areola complex.
Without pictures or a physical exam, it’s hard to know what option is best for you. Under the right circumstances, the Benelli lift is associated with excellent results, but this is dependent upon appropriate patient selection. It’s important to thoroughly discuss this procedure with your surgeon before proceeding so you’re comfortable with your decision.
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Benelli lift with implants works well on the right women
You are definitely well-educated about the Benelli lift and seem to have a good understanding of the benefits and possible disadvantages of it. A photo would be very helpful, but your description sounds like you would be a good candidate for the benelli augmentation mastopexy. You really don't see much breast flattening when you use an implant and have only a small amount of skin to remove.
Periareolar breast lift is a great technique
There are many techniques today for breast lift surgery. The priorities for a breast lift should include creating a natural and full breast mound and to minimize the scars much as possible. A Benelli is an excellent technique to accomplish this. Be sure that your board-certified plastic surgeon has a great deal of experience with this technique. Also discuss with your plastic surgeon what the lower pole of the breast will look like a measly after the surgery. They will want to discuss with you if it is acceptable to have a longer scar in this area if you shuuld have excessive breast tissue.
Benelli lift and breast implants
A benelli lift and an implant to raise the areola is certainly a great combination. I do them all the time in the right patient.
Benelli breast lift and breast implants are good combination.
1) We usually do breast lifts together with breast augmentation using only a circular scar around the nipples (Benelli).
2) Benelli lift alone without implants is not a good operation except to correct tubular breasts.
3) For breast lifts without breast implants, we use lollipop scar (Lejour technique).
4) Anchor scar is almost never indicated for breast lifts.
5) Your goals sound reasonable.
Before and after photos help to see the difference between breast lift procedures
The better lift for you depends on how much lifting is needed. The benneli lift (around the nipple) usually works best for small amounts of lift. If you need more lifting, a lift with incision around the nipple and vertically to the bottom of the breast works. If you need the greatest amount of lifting, the anchor shaped incision (around the nipple, vertically to the bottom of the breast, and in the crease underneath) works. I find that patients are much happier having a breast that is properly shaped even if it takes more incision.
It will help you to look at before and after photos of women who have the same amount of breast sagging as you do, see which operation they had, and what it looks like. Then you can decide which works best for you.
It is a less powerful lift
Any time you operate around the areola there is a chance your ability to breast feed in the future can be diminished as well as a chance of decreased sensation. Both techniques suggested to you will have scars aound the areola but the addition of the vertical component of the lift will give you a stronger lift.
Peri-Areolar Lift is less invasive, but lifts less
Breast lift surgery before children can alter the ability to breast feed. If breast feeding is important to you, you might want to wait or have a less invasive lift to try to alter this as little as possible.
I would add to your Cons that these less invasive lifts lift the breast less. Much of my decision on offering a peri-areolar lift depends upon timing (breast feeding,) the amount of lift needed to fix the problem and the patient's willingness to accept scarring.