Benelli Breast Lift for Large Breast with Mild Sagging?

I have 34dd-34ddd breasts (natural), I have do not have children and have always slept with a bra. However, at 34 they are not as perky as I would like. Perhaps it is less of an issue of sagging and more of an issue of shape and the areola getting lower and on its way down. My question is does the Benelli lift work for large breast that still have volume with mild to moderate sagging and can a lift now ward off a more serious lift or sagging later?

Doctor Answers 13

Benelli Lift for large breasts

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The Benelli lift is of very limited use in breast lifting by itself, in my experience, and the larger the breast, the worse the result. I would recommend you stay away from it and consider a standard breast lift if you want a significant result. Of course one can only make such a recommendation after a real consultation and examination, so I recommend you get some more opinions, best of luck.

Large Breast Lift

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The key to success lies in letting you surgeon know specifically what you would like to look like following the surgery. For example, how perky do you want to be, what shape do you want to have, etc.? However from your description it would appear that a lollipop type lift would be best for you rather than a periareolar lift like the Benelli procedure. Here is a rule of thumb that works for most patients. If you nipple is above your lower breast crease then often a periareolar lift will be sufficient for most patients. If your nipple is at or below your crease then a vertical lift (lollipop lift), inverted T or anchor pattern may be required.

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.

Problems with the Benelli or doughnut mastopexy

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The Benelli or doughnut mastopexy has the highest level of patient dissatisfaction.   The force vectors are all in the wrong direction and it tends to flatten out the breast loosing the conical shape to the end of the breast. It raises the nipple but does nothing to support the inferior breast.  In many cases the areolar widens out in an abnormal fashion.  If you are only removing areolar skin then I think that it works otherwise a vertical mastopexy is the correct decision.

Breast Lift or Reverse Tummy Tuck

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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.

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

Type of Mastopexy?

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Thank you for the question.

The Benelli ( circumareolar)   breast lift provides for only a minimal breast lift;  few patients are good candidates for this procedure. Based on your description it does not seem like you would be a good candidate. You may benefit  from in-person consultation with well experienced board-certified plastic surgeons.

Best wishes.

Benelli Lift

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Dr. Benellito conceaved of a breast lift that involved removing a ring of skin around the areola and sewing the remaining breast skin to the edge of the remaining areola.  It has been modified in a few ways through the years, but still remains to be a procedure for SMALL breasts, and almost always in conjunction with implants.

Misapplied to larger breasts, which forces the surgeon to remove an ever larger ring of skin, and the results are usually ugly, and sometimes disasterous: irregular shaped areola, pleating of the skin around the areola, thickened scars, and abnormaly flattened breast mound shape.  The number one reason for malpractice lawsuits against plastic surgeons in the state of California involves this surgery.

My expertise is in breast surgery, and having performed countless breast lifts, I've come to the conclusion that in the larger breast, a truly good result is only gotten with a combination of lift and reduction.   That is because a large breast will always 'bottom out' no matter how tight the skin is made after a lift alone procedure.  If your desire is to maintain volume, than an implant can be utilized with this lift/reduction procedure.  Although seemingly contradictory, the breast implant  provides volume and shape that is more reliable for a long term good result, at the expense of removing the more natural feeling breast tissue.

Althought this more formal or extensive type of lift means there will be more incisions, when done well the resulting scars are usually inconspicuous. 

Visit a few well trained, American Board of Plastic Surgery certified doctors who perform A LOT of breast surgery.  Look at their photos and talk to them about what's right for you.  If you don't think you can tolerate the incisions, or if you don't want to be smaller and don't want breast implants, than you are better off doing nothing than getting a benelli lift!

Best of luck to you.

Benelli lift for large sized breasts

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I am cautious in recommending the Benelli Lift in individuals with large breasts.  It tends to work better in smaller breasts with glandular ptosis requesting modest augmentation

Benelli lift for larger breasts

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It is certainly possible to perform a Benelli lift for large breasts but it is hard to say without an exam or photos to review.

Benelli lift is NOT good for large breasts

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Sagging of the breasts is caused by:

  • weight of the breast tissue (the more gland you have,the heavier = more sagging)
  • quality of the skin (less elasticity = more sagging)

Benelli is a skin only procedure, so it works well with firm skin, and relatively small lifts.

We all age and loose elasticity, gravity works on our body, so you cannot prevent sagging with time especially with larger breasts. The firmer your skin is the slower this happens. So supporting your breasts as you do is the most important preventive measure, otherwise reducing the weight, which you dont want, is the only alternative.

If you have loose glandular tissue, a procedure now that modifies the gland could help inpreventing procedures later, but that  is a serious prosedure allready.

The rest has been mentioned by my colleagues,

good luck

Ivar van Heijningen, MD
Belgium Plastic Surgeon

Benelli lift candidates

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In the wrong patient a Benelli lift will leave you with a flat fronted breast with a baggy lower pole - not a nice shape or look.  At your size, you probably have enough extra skin that the Benelli won't work.  A full lift will give you much better shape and in the right surgeon's hands the shape for scar trade-off will be worth it.  Don't try to apply the wrong procedure to your personal starting point.

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.