Considering Areola Reduction (Benelli) - Opinion? (photo)

I'm 21 years old, and have always been extremely bothered by my areolas. Throughout my teenage years, my weight varied between 140-195 pounds. I feel these fluctuations led to stretched areolas, and now that my weight has stabilized I would like to have my areolas corrected to a more proportionate size for my 34B breasts. Am I a good candidate for areola reduction using a Benelli lift? Could the nipple be moved higher on the breast during the procedure? Would this create an illusion of lift?

Doctor Answers 18

A bennelli would not give you the result you desire

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Breast lift with simultaneous implant surgery can solve the problem that many women develop after having children or losing a significant amount of weight which is loss of upper pole fullness, combined with ptosis, or “sagginess”, of the breast.  The main difficulty with this operation has been achieving long term results – in other words, helping to prevent “bottoming out” of the implants and loss of the upper pole fullness that placement of the implants was designed to achieve.  This can be accomplished with development of a proper submuscular pocket to support the implant and is actually much more important than the size of the implant chosen.  The size of the implant you choose should be one that gives you the roundness and cleavage in the upper pole that you desire.

Benelli lift

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Your nipples are not excessively large in my opinion.  The Benelli lift may reduce the size of your areolae slightly, but in my opinion would not be worth the scars involved.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Areolar reduction with Benelli lift

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A Benelli lift does reduce the sie of the areolas and creates a scar around each areola.  Although this procedure will give you a small amount of lift, it will also create a flattened appearance to your breasts which may very well be less desireable.  Best of luck,

Christopher Davidson, M.D.

Best Breast Surgery for Me (Tuberous/Constricted Breasts)?

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Thank you for the question and pictures. I think your breasts  demonstrate some of the qualities seen with tuberous (constricted) breasts.

Some of the characteristics seen with tuberous breasts include a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy" and areola and some degree of ptosis (drooping).  
Generally,  correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

In the most severe cases of tuberous breast, a more complete breast lift may also be necessary.  In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.

In your case, if the appearance/shape/size of the breasts are a concern,  you may be an excellent candidate for corrective surgery.  
When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant experience with this type of surgery.
I hope this (and the attached link) help.

Benelli lift for areola reduction

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People do all sorts of measurements to determine the average or ideal dimensions of various body parts.  The average diameter of the areola is approximately 4.0 centimeters.  If your areolae are larger than this then a Benelli lift will not only help to reduce them in size but it can also be used to elevate them slightly on your breasts.  Keep in mind that the trade-off would be a scar that goes all the way around your areolae.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Considering Areola Reduction (Benelli) - Opinion? (photo)

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A circum-areolar reduction would decrease the size of your areolae and elevate the breast as well

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Considering Areola Reduction (Benelli) - Opinion?

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You may need more than just a lifting operation. ONLY in person evaluations from boarded PSs in your city will guide you toward a better decision. 

Areola Reduction

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A youthful, aesthetically ideal breast has an areolar diameter of about 38-42mm (about one and a half inches). Some breasts have large areolas from the time that they develop during puberty, and some enlarge later in life with pregnancy and lactation. A large areola tends to make a breast look 'matronly' even if it is not droopy. Areolar diameter can definitely be reduced, and this can be performed as a stand-alone procedure or as part of larger cosmetic breast procedure such as a lift, reduction or augmentation.

The surgical technique involves removing the excess areolar skin, in the form of a donut-shaped skin excision. A circular incision is made around the areola at the desired diameter of about 40mm, then a second circular incision is made at the outer border of the large areola. The epidermis is shaved off between the two incisions, leaving the dermis behind. A 'purse-string' suture is then placed in the dermis at the outer incision that allows the surgeon to reduce the outer diameter to 42-44mm by cinching together the two ends of the suture. The suture acts as a drawstring to reduce the outer diameter, and allows closure of the areola with reduced tension on the healing incision.

The purse-string suture is critical for maintaining areolar shape and size. Without the purse-string suture, areolas will almost always enlarge over time. When that suture is tied, the skin of the outer portion of the areola is gathered somewhat, as the circumference of the outer incision is much larger than that of the inner incision. The gathered or 'pleated' appearance of the outer margin of the areola gradually flattens out over time; this generally take a few months.

Occasionally I see a patient purely for areolar reduction, but the majority of patients I see have their areolas reduced as part of a mastopexy (breast lift), augmentation mastopexy (breast lift plus implant placement), or breast reduction procedure. The circumareolar scar (scar all the way around the areola) usually heals very well and is camouflaged by the color difference between areolar skin and breast skin, but if you are going to have a scar around the areola you might as well do something to improve breast shape and/or size at the same time. Keep in mind however that most breast lift and reduction procedures require a vertical scar from the bottom of the areola to the inframammary fold (crease below the breast), and in some cases a scar in the inframammary fold as well.

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.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Considering Areola Reduction (Benelli) - Opinion? (photo)

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The answer is YES, a Benelli type purse string procedure to tighten the breast skin envelope a bit and diminish areola diameter/area would be helpful for you, but will not be enough to create the beautiful breasts you probably really would like to have.  From the photo, you appear to have a mild variant of tuberous morphology. Expansion of base width by internal release, increased volume and expansion of skin envelope with an implant, lowering the inframammary crease, along with a carefully designed peri-areolar lift would produce, in my opinion, a nice outcome for you. 

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Areola Reduction with Peri-Areolar or Benelli Lift Technique

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Since you would like smaller areolas, and the reduction would be relatively small, a peri-areolar purse-string technique or Benelli would be appropriate and give you a nice result.  If the areolas were lower and there was more stretched out skin above the areola, the peri-areolar technique tends to flatten the breast.

To counteract this, Dr. Benelli described an internal lift as well, in which the lower breast tissue is divided into flaps. These flaps are criss-crossed to narrow, lift and project the breast shape. Criss-cross sutures were also placed beneath the areola to help support it and decrease the tendency of the purse-string to flatten the front of the breast.

In your case, a simple purse-string would be sufficient to lift and reduce the areola.

Most peri-areolar lifts are done in conjunction with a breast implant. The implant provides a firm platform under the breast tissue which counteracts the flattening of the purse-string suture.  The implant also provides roundness and fullness, particularly in the upper breast. The upper breast is the area that is least well corrected with mastopexy alone, of whatever technique. 

You would be an excellent candidate for a peri-areolar lift with an implant.

For ladies who do not want an implant, then the original Benelli technique is available. There will be no size increase, but the shape can be made more projecting and the areola reduced and elevated. Dr. Benelli who is from France, said that he developed his technique because many European women, particularly in the 90's, wanted a lift, but did not want implants.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 54 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.