I am wanting to get a breast lift but do not want the vertical scarring from it. I was looking into benelli or crescent lift but I'm not sure it would be enough. My question is, why can't the surgeon just remove a little more skin around the areola to pull the breast up more?
More skin with Benelli or Crescent lift?
Doctor Answers 8
Benelli lift can be powerful but Doctor's experience determines the outcomes
The Benelli periareolar lift can be a powerful technique but it is often misunderstood and applied to the wrong breast shape. In the hands of someone comfortable with this technique, the results can be very pleasing but they are very dependent on the Doctor's experience with the procedure.
- Very poor outcomes are seen with the Benelli lift if the skin around the areola is placed under tension without appropriate breast molding.
- It is never a good idea to decide which incision to use regardless of the starting breast shape.
- Patients should clarify the desired final breast shape. The decision of what technique will be used to obtain it will depend on starting anatomy and individual Doctor's experience.
It is a good idea to review the Doctor's outcomes with any technique, and then decide if your Doctor recommendation also meets the common sense test: if it does not sound right, it usually isn't.
Pushing the limits of a Periareolar and Crescent Lift can lead to problems
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.
Candidate for a Benelli breast lift?
With proper implant selection and quality of your breast tissue you may be a candidate for a Benelli type doughnut mastopexy. This type of lift works best if you are only removing areolar skin. Also know that this type of breast lift has the highest rate of patient dissatisfaction if it is pushed too far. I think you are a better candidate for a vertical type breast lift.
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Benelli Breast Lift or Crescent Lift
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.
Breast Lift Type?
Thank you for the question and pictures.
Careful physical examination and discussion of your goals will be necessary to determine the type of breast lifting that will be most successful and least complication prone.
Generally speaking, neither one of the procedures you mentioned offer a significant lift. I am not fond of the “crescent” lift at all; it provides minimal breast lifting and carries significant risk of elongation/distortion of the areola. In your case, you will likely benefit from a “vertical” mastopexy procedure.
Keep in mind, that most patients undergoing breast lifting procedures will accept scarring as long as their overall goals in regards to size, shape, contour and symmetry are met.
Short scar mastopexy: Benelli style lift (circumareolar or periareolar)
You should really serach the patient: "Peri-areolar breast lift with augmentation- Not Happy" on realself to see why a lift wtih the "Least amount of scarring possible" (in your own words) is not always a good idea. Sometimes a longer scar can achieve a better result.
Excising more skin increase the tendency for more pleating as well as a larger areola.
If you have to remove a lot of skin to try to lift the breast, then probably a Benelli or circumareola lift will not look right. You probably will have too much pursing and the wounds will not heal well.
A vertical lift will give a better result
Based on your photos, you would likely benefit most from a lift that has a vertical component added to the circular (areolar) incision. A crescent type lift will not be sufficient in your case and can leave you with thickened scars due to the tension under which the skin will need to be closed. A vertical lift will give you the nicest shape and nipple position. I realize that patients do not want any more scars than they need, however, this vertical type of lift is best in this case. The question comes down to you being able to tolerate a vertical scar (which actually heals quite well) in exchange for a great contour vs. a minimal circular(crescent/benelli scar with a suboptimal contour.
Please consult with one or more board certified plastic surgeons before making your decision.