How much excess skin can be removed with a benelli/donut incision?

Question

I'd like to know how much excess skin can be removed using a donut incision. Im not interested in a lift (am fine with where my areola lay) but I do have excess skin I would like trimmed when I have my areola scars revised. How much can safely be removed this way?

Gary M. Horndeski, MD · Answer

The Benelli incision can be done with the circumference of the outer incision, twice the incision of the inner incision which corresponds to approximately 3 times the area of your new areola. The Benelli discards the skin and a new technique called the mini lift uses the skin to reposition the breasts higher and more medial.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear easycoast,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

Areolae reduction with the benelli techniques has its limits as well as its down sides. Your areolae may stretch out and have wide or thick scars. Might not be worth it

Michele A. Shermak, MD · Answer

Hello!
Donut mastopexy is limited in skin removal. You can certainly tighten up the breast to a point, and best to have the incision around the areola closed with permanent suture that will prevent spreading and widening of the areolar diameter. With greater needs for nipple lift and skin tightening, either lollipop mastopexy or full anchor incision best achieve the more gold standard lift outcome.
I would recommend you see a board certified plastic surgeon. You can find one at plasticsurgery.org.
Best of luck to you!

Andrea Martin, MD · Answer

Traditionally, the peri-areolar mastopexy, or breast lift, is meant for breasts which have minimal ptosis (aka droop), and the diameter of the areola is less that 5cm. Another limitation is the planned amount of skin resection, which should be a ratio of 2:1 outside diameter (being removed) : new areolar diameter. The main risks of this procedure are widening of the scar around the new areola and flattening of the breast shape when viewed from the side.

Connie Hiers, MD, FACS · Answer

This lift is limited in how much skin can be removed. Usually one half to one inch of excess skin around the areolae can be removed with this type of incision. Occasionally, a little more can be taken, but often the vertical scar is needed.

Douglas Taranow, DO, FACOS · Answer

It’s not a safety issue, it’s an aesthetic issue. If you take too much skin then there will be significant wrinkling around the areola.   If a lollipop lift is required, then do it.  The periareolar will make you tighter, just maybe not tight enough. 
Best wishes 
Dr. Taranow

Gregory Sexton, MD · Answer

I would discourage you from considering a donut mastopexy. When you remove skin around the nipple it tends to flatten the breast so you’ll have a normal breast shape until it gets the nipple and then it will flatten. If you truly need a lift do the standard anchor scar lift. You will be much happier.

Good luck,

Greg Sexton, MD

Good luck,

Greg Sexton, MD

Ali Gaber, MD - Account Suspended · Answer

it is around 1/4 the diameter of the areola so the part around the areola with disfigured scar could be removed safely .

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
The periareolar lift involves removal of a donut shaped skin segment around the areolar margin. In most cases, a continuous running permanent suture is placed to maintain a smaller areolar diameter and the incisions are closed. 
One can remove up to 1.5-2 cm of tissue. Attempting more may lead to pleating of the incision (when suturing a larger circle to a smaller circle) and pancaking (flattening) of the breast.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

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