I am trying to avoid a vertical scar (previous scars tend to pigment although don't spread) so I'm hoping a Benelli lift with augmentation (Naturelle midrange 304cc silicone) will be adequate. I am currently a 34C/D and I don't mind a little sag but am more concerned with shape, nipple placement and overall aesthetics. My PS is fine with this option although would perform a lollipop if given the choice. Am I making the right decision?
Is a Benelli Lift with Augmentation Right for Me? (photo)
Doctor Answers 17
Binnelli Vs. Vertical Lift with Breast Augmentation
Although most of your respondents were glib about a Benelli lift for you, I would heed the advice of Drs. Gottlieb and Pousti. The Benelli lift is a great technique for a small, minimally sagging breast, and it can lead to a beautifully shaped breast. Your breasts however, are not small or minimally sagging (your nipples appear to be below your infra-mammary fold).
Choosing a Benelli lift when you need a more appropriate lift could result in a multitude of problems including but not limited to: a flattened, persistently sagging breast mound, persistently low lying areolae, irregularly shaped and enlarged areolae, thickened scars, and pleating of the skin around the areolae like rays around the sun. In the state of California, the Benelli lift is the number one named procedure in cosmetic breast surgery malpractice lawsuits.
You would do yourself a disservice to have breast surgery that did not include the proper lift, which for you would include a vertical scar component. Most women (and their spouses) don't even notice the scar due to fading and/or acclimation with it's usually subtle appearance. However, if you cannot come to terms with it, you should not have any surgery at all.
Best of luck!
When to use a circumareolar ( Benelli) lift.
Thank you for your question and for your photographs. You have a mild degree of sagging of the breasts and are considering a moderate size implant. In this situation a Benelli lift is reasonable to consider because an implant alone may not be enough to elevate the excess skin.
Even with Benelli lift because you have a generous amout of natural breast tissue your natural breast will still have some droop, but a little droop looks more natural.
A lollipop lift can allow more elevation of the nipple, but leaves a vertical scar. Benelli gives a more limited degree of elevation.
In my own practice many of my patients allow me the option to choose which type of lift to use at the time of surgery. Once the implants are inserted the picture changes as skin is elevated by the implant. You might discuss this, and your goals with your surgeon. Even so, if you choose to allow Benelli lift only you are not burning bridges, it could later be converted to a lollipop or full lift.
If you truely don't want more than a Benelli lift you may want to consider a high profile implant. A 375 high profile has a similiar diameter to the 304, but has more projection. Implants that project more elevate more skin from the get go and can sometimes diminish the degree of lift needed. Of course you chould only consider this if you are comfortable with the added volume.
I hope these options help.
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Binelli lift and Augmentation
You appear to be a good candidate for a moderate size implant and lift. The Binelli lift will help, but might reduce projection a bit. The Binelli with a vertical component will give excellent shape and projection.
Your concerns seem to be the scars. The vertical scar is almost always the best one on the breast and heals beautifully. I would also recommend post operative taping of the scars for 4-6 weeks and the addition of SkinMedica Scar Recovery Gel. This is the Best scar treatment to date. I give each of my cosmetic patients a tube one this (free) one week after surgery as I have seen the results and want the best for my patients. It works!
Keep the discussions open with your Plastic Surgeon so you are both on the same page for expected outcomes. Good Luck.
May not get the result you want with a doughnut (Benelli) breast lift
The biggest problem with the Benelli breast lift is that you get minimal lift with the risk loosing breast projection. On the right candidate the procedure works very well. I generally reserve this operation to women who have enlarged areola along with a mild degree of sagging. In your particular situation you definitely are at risk for not achieving the result you desire. You are at risk for developing widened peri-areolar scars and a widening of the diameter of the areola. The addition of the vertical or lollipop scar takes the pressure off of the areola, gives you improved breast projection and the correct proportion of the nipple to the crease under the breast. I would follow your plastic surgeons advice in your situation.
Dr Minetti is absolutely correct. Benelli lift is path to a poor result for your breasts. Why not just wait til you're ready to accept a vertical scar and trade a scar for a great shape.
If your not concerned about the sag, a modest implant with a periareolar lift will give you good enough results. If after its all said and done and your not 100% happy you can always redo the lift to vertical lift.
Type of Breast Lift Decision
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.
In general, I think I would follow your surgeon's advice, go with a lollipop type incision and prophalactically use a lightening cream like hydroquinone afterwards to prevent hyperpigmentation.
Benelli lift and implants
It is very difficult to tell if you would be a candidate for a Benelli and an implant. Your arms are elevated in the photos and this can make your breasts look lifted. An exam is key.
Benelli vs.. Vertical breast lift
The vertical lift offers the most stable and significant improvement in breast shape and overall aesthetics in women who have moderate to significant drooping as compared with the Benelli(doughnut) lift. Of course you are the best judge of your desired outcome and your tolerance for the trade-off in scarring. In my experience the verttical scar is well worth the results in most patients and tends to heal well.
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.