Is a Benelli Lift Without Permanent Suture Possible? (photo)

In many surgeon's hands including my own, the Benelli procedure has the least likely long term predictability compared to other techniques. Use of a non permanent suture such as PDS is possible, but may lead to even more unpredictability over the long term. If in doubt seek a second opinion. 

It is possible to do this lift without the Gore-tex, but the predictable usually happens--the areolas gradually increase back to an unacceptably large size. I would add that a Benelli approach will not allow for correction of the left breast in my opinion. 

Best wishes. 

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.

Hello,

There will be tension on your areola after the purse-sting mastopexy (Benelli lift) is performed.  If this tension is on the soft tissue itself the scar will widen and so will the size of the areola.  The suture is there to prevent this.  After the area has healed and the forces have balanced the suture can be removed if its desired.  As of today I have not had any permanent suture issue arise in any of my patients.  Although suture extrusion can happen this is very rare and can be corrected easily in the office under local anesthesia.

All the best,

Dr Remus Repta

Thank you for the question and pictures.

Although you may receive different responses from every plastic surgeon who may have his/her strong preferences/opinions, I think the message that you should come away with is that every procedure has its potential risks/complications and pros/cons associated with it. In regards to permanent versus absorbable sutures used during the Benelli lift, I have used both types  of sutures numerous times,  have had good results with both techniques many times,  and have had complications with each approach many times.

In other words, there is no perfect “ suture technique”;  much of the final result may depend on other factors such as degree of areola reduction and skin elasticity/collagen issues.

Sorry if this response does not not helped to clarify.

Thank you for the question. Doing Benelli lift without permanent suture runs the risk of areolar stretching and flattening. My advice for you is to communicate your questions with your plastic surgeon.

Although it is possible to perform Benelli (circumareola-only) mastopexy without a permanent purse-string suture, the results are almost always very abnormally widened areolae and poor scarring.  Therefore it is not at all recommended to eliminate the permanent purse-string suture in such cases. 

It is very rare to have any complications from the properly placed permanent Gortex purse-string suture. If, in such a rare event, there is a complication, it can be easily managed under local anesthesia in the office setting.

Judging from your photos you would best benefit from a more extensive mastopexy and implant revision to achieve optimal aesthetic improvement in breast shape.  Certainly this can only be determined with an examination.  Hope this helps and best wishes to you for a most beautiful final result!