Every surgeon says something different. I'd like to know if the areola stretch or become larger or not after a benelli lift/areola reduction. Some say yes others say no, so which one is it? Also, is the stitch from that surgery visible under clothes when not wearing a bra?? Thanks a lot.
What is the Truth About the Benelli Lift/areola Reduction? Does It Make Areola Stretch More?
Doctor Answers 17
Benelli Mastopexy Has Distinct Limitations
The problem is that in women who truly need a vertical or full mastopexy, but refuse to have the incisions that these operations require, we as surgeons tend to compromise and subsequently will push the limits of this operation. When we as surgeons try to push the limitations of an operation like the Benelli lift, a number of problems can occur, such as stretching or spreading of the areolar complex.
The reason for that there is no general consensus with respect to Benelli Mastopexy, is that there is commonly a misunderstanding between patients and their surgeons about what this particular operation can achieve. There are many types of breast lift operations available, however several of them require an incision be placed either on the front of the breast, in the inframammary fold, or both. Many patients that I see would prefer to avoid these incisions, choosing to have circumareolar (aka Benelli) lift incisions instead.
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Wonderful procedure when indicated for the right patient
Yes, scars can stretch after a Benilli Lift or Peri-areolar Mastopexy, however, I now use a permanent suture when performing this technique and my rate of revision has gone down dramatically for this procedure. Since switching to permanent sutures I have maybe one a year that needs to be revised due to the areola stretching. This is a wonderful technique if indicated for the right patient.
Benelli Breast 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.
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Periareolar Techniques are Great-Think about a Goes!
The circumareolar scar from the latest techniques using permanent sutures are excellent. The number of revisions per year in minimal and quite often the scars are better than from other types of reduction/lifts.
Benelli is only one of the earlier types of circumareolar lifts. In my practice, the Goes technique with and internal brassiere support is the best.
1- internal brassiere with mesh for added durability.
2-Can lift breasts that have a nipple to sternal notch distance of less than 25cm - so the amount of sag that can be corrected is limited.
3-Patients with dense breasts/less fatty - usually younger do better with this technique.
4- Nipple is never removed from breast tissue, sensation is better.
5-Lift is mostly achieved by lifting from above, makes for a natural, durable result.
6- permanent suture around areola makes scar minimal.
Periareolar breast lift
The goal of every breast lift should be to 1) minimize length of scars, while 2) maximizing quality of scars and 3) maximizing breast shape. For the ideal patient, a periareolar lift is a fabulous operation. However, trying to get too much lift out of a periareolar lift can leave a poor quality "purse-string" scar and a flattened breast shape.
In my hands, the ideal candidate for a periareolar scar approach has slightly "cone shaped" breasts that can be flattened a little without negative consequences and requires only a couple of centimeters of nipple elevation.
Benelli mastopexy issues
Intuitively and in practice, in my opinion, the Benelli approach is rarely prudent - sacrificing shape to minimize the total length of the scars. This is rarely a good trade off. The breast shape with this approach is more blunted and flat versus a more natural conical shape. Furthermore, there is either stretching of the areola with time and/or problems associated with the permanent sutures employed to prevent this from happening in the first place.
The Periareolar lift works great in the right patient but it can be overused
For an implant patient with a need for a very minor lift, the periareolar lift works great when done properly with areolar size stability provided by a permanent suture. The main problem with this procedure is that it can leave the breast flat in front and baggy at the bottom when it's utility is overextended into the patient who really needed a real full lift.
Benelli Breast Lift and Spreading of the Areola?
The “truth" about the Benelli breast lift, is that like any that other procedure, a variety of different outcomes are possible ( including spreading of the areola) depending on factors such as appropriate patient selection, technique used, suture material used, skin elasticity concerns etc.
In other words, if all of the above factors are “optimized", the procedure will work well; if not, it won't.
I hope this helps.
Risk Of Areolar/Scar Widening In Benelli Breast Lift
When the periareolar breast lift is done well and in the properly selected patient, it can give a good result without the areolas or the surrounding scars becoming wider. The problem is that it is often chosen enthusiastically by the patient to avoid any lower breast skin scarring when it may not be the best breast lift choice given their amount of breast sagging. In these cases when combined with an implant, both the areolas and scars can become wide and very visible. The problem is not the operation but in whom and why it is done.This issue aside, it is important to know that the RISK of areolar and scar widening is always present in any lift operation when the tension is primarily born by the areolar closure.