Wanting Breast Lift with Implants - Least Amount of Scarring Possible
Doctor Answers (16)
Bennelli Lift has minimal scarring for breast aug with lift
The Bennelli Lift is a periareolar scar, which will soon fade such that you will not even notice it. I use the technique often when I am performing a breast aug with a lift. With the Bennelli technique you will not be compromising any of the 'lift' . You will get perky breasts with a youthfully positioned nipple. Yes, you can have it all!
Please read my blog post below which is explains the procedure in greater detail.
Breast augmentation and mastopexy
Thank you for the question and picture.
Based on experience, I would suggest that your 1st concern should be obtaining the best results possible (scarring concerns should be secondary). Most patients undergoing this procedure will accept scarring as long as their overall goals in regards to size, shape, contour and symmetry are met.
In other words, if you select your surgeon based on the offer of a “limited scar” procedure you may be disappointed with the results.
Also, be careful about communicating your goals with specific cup size references. You may find this to be inaccurate and again a source of dissatisfaction postoperatively. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. I 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. By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.
Breast Lift with Implants
Based on your profile picture, my recommendation would be a circumvertical lift and submuscular augmentation. I find the perioareolar lift to do a nice job of lifting the nipple position a few centimeters, but not great for breast reshaping. In addition, similar to a facelift or tummy tuck, it is how you reshape the deeper tissues that leads to a long lasting result. I believe a circumvertical (lollipop) incision will allow for this parenchymal/breast tissue reshaping.
In addition, the additional weight of a 500 cc implant will cause the breast skin to stretch regardless of technique used (rock in a sock), therefore this must be taken into account.
I recommend that you consider slightly more scar (lollipop) such that you can obtain the best and longest lasting shape.
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Short scar mastopexy breast lift: not always the best option or choice
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.
Lifts and augmentation with overly large implants
Granted it is not possible to be certain from the photo but it looks as if your nipple position is high enough relative to the inframammary crease that you don't have enough ptosis (sag) to need a lift and can be filled out with a lift effect using an implant alone. This could limit the scar to 2 cm in the inframammary crease with a saline implant or 3 1/2 to 4 cm for a gel implant. Again, an implant does not truly lift the breast but gives the effect of a lift by filling out the breast, particularly the lower pole. A periareolar incision type lift doesn't actually lift the breast either and only appears to be beneficial in breasts like yours that don't really need a lift. I also disagree that the size of the implant will make the breast sag in the future. If you're going to sag in the future you're going to sag. If the implant is too big for the breast then it may also cause distortions including malposition of the implant or bottoming.
It is exceedingly difficult to control and predict outcomes with both a lift and an implant, particularly with large implants. Breasts that are lifted without implants look bigger and therefore the effect is magnified with a lift and an implant. Also implants with a lot of forward projection work against the successful lift and can stretch the scars required for the lift among other problems.
I would recommend a properly sized implant (based on the width of your breast) without the lift and use a high profile for maximum forward volume that your tissues will tolerate without causing problems. Down the road if your breast sags and you need a lift then consider it with or without doing anything about the implant.
Less scar breast lift and augmentation
You would be a great candidate for a periareolar breast lift and augmentation. You may not be as perky as you would be if you did a full "anchor" type incision, but the benefit of less scar sounds like it would be better for you. The larger implant will also enhance the ability to use this approach.
ALthough it is difficult to say from one photo and certainly hard without an exam, you may be an excellent candidate for a circumareola lift with an implant. This will lift the areola and limit the incision to the border of the areola.
Breast lift + large (400-500cc) augmentation with minimal scaring
The answers by both Dr. Rand and Dr. Baxter are right on the money. Some times doing less over the long term actually ends up looking worse and needing more. Since the majority of your problem is glandular ptosis, the ideal solution would entail a submuscular augmentation where you could utilize a somewhat larger prosthesis and maintain long term stability combined with a vertical lift which allows the surgeon to excise the ptotic inferior breast tissue. This results in a tighter more youthful appearing breast and over time the vertical incision does heal quite well. A subglandular augmentation would not hold up at all over time and a periareolar mastopexy unfortunately would not adequately address the glandular ptosis’ redundant skin in the lower pole, and again would not hold up well over time.
Breast lift with implants
A vertical breast lift or a lift with a lollipop scar is the best for you. It will raise your breast tissue and enlarge the breast. No need for a horizontal scar. If you do a round incision around the areola only with the implant, it will raise your areola, but you will be unhappy with the breast shape and scar. It tends to spread the areola and only raises the areola, not the breast. Looking at your picture, the first option would be best for you.
Lift with large implants
it would be best to have a frontal view of your torso and your breast measurements to better assess your question. but according your height and weight, using up to 500 cc submuscular implants will definitely bring you to a DD. This size will be quite big for your torso, which puts you at a higher risks for future problems, such as bottoming out. you could maybe get away with just a crescent lift = half-moon scar on top of the nipples, versus having full periareolar incisions. the advantage are less scarring, less risk of loosing nipple sensation but the lift is not optimal. you could always have a full periareolar lift in the future though.
For Downtown Chicago, the cost is 8 500 $ including OR, Anesthesia, implants and 1 night at the W Lakeshore hotel.
Florence Mussat, MD
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