Lollipop vs. Benelli lift for sagging breasts?

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 the best  for most patients in my experience. 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.

If you have substantial sagging, neither a vertical lollipop nor a Benelli lift will work.  The only method that treats substantial sagging is the anchor pattern lift.  You definitely need to get a number of opinions before rushing into something.  It is very difficult to fix a substandard lift than to do it right in the first place!

To elevate a nipple 5.5 cm with only the periareolar (Benelli) incision is "wishful thinking." There are many factors involved with a lift/augmentation.
If your volume is good and you just want the lift and tightening, then the mastopexy alone. There are limitations of each lift: periareolar, vertical, or anchor. So, your surgeon needs to explain each in detail. 
If you need more volume, then a submuscular implant and mastopexy is ideal. As above, many options and combinations are available. 

The truth is that the Benelli is not really a good lift.  It actually flattens the breast rather than lifts it.  You need what you need and if the docs are telling you a vertical/lollipop then thats what you need.  50% of the revisions I see are people who tried to get away with not doing something they needed and now are unhappy.  Ironically they end up doing what they should have originally except now they have wasted time, and moneyGood luck

Thank you for your question.  Congratulations on your decision to have surgery.  Photos would be helpful to best answer your question. A breast lift to bring the breasts up and reduce the size of the areola.  The type of incision needed is best determined by physical exam.I perform a liposuction breast lift/reduction known as Breast LipoLift®. This specialized technique spares more nerves and blood supply as well as removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast, I then remove the excess skin to tighten the breast and create a more proportional silhouette with better cleavage. This procedure is also more accurate than traditional breast lifts or reductions since I use 3D measurements to uncover size asymmetries. During the procedure I remove exactly whatever is more from the larger side to get as close to symmetry as possible. Since I perform this less invasively the recovery time is faster and drains are not necessary. Over 90% of my patients are out to dinner the next evening taking only Advil and Tylenol if even needed. The size would depend on the proportion with your body versus going for a cup size.  It has been proven to have less complications than traditional breast reduction (please see my Breast LipoLift® page web page) and should not affect nipple sensation, mammograms, cancer risk or breast-feeding. The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in breast plastic surgery.  Best of luck!    Dr. Schwartz Board Certified Plastic Surgeon#RealSelf100Surgeon #RealSelfCORESurgeon#RealSelfTopContributor

The Benelli lift as performed by most surgeons is just the #donut lift, removing a donut shaped piece of areola and skin then using a #Pursestring or double purse-string suture to tighten the skin. A true Benelli actually will expose much of the breast through this incision and then the breast itself is shaped and lifted with sutures. With the “lollipop” technique, an incision is made around the areola and another between the areola and breast crease. This technique avoids a long #scar in the crease under the breast , which was an older technique known as the “anchor” or “inverted T.” Hence, Dr. Nichter or Dr. Horowitz prefer the “lollipop” technique or “donut lift” to avoid more significant scarring, rather than the majority of surgeons in the United States that use an anchor pattern lift.

Thank you for your question.  While I can sympathize with and share your desire to minimize or limit the amount of incisions as to prevent the amount of visible scarring after your procedure, I would stress to you the importance of making whatever your anatomy dictates are the appropriate incisions, in order to provide you with the best cosmetic result.  Because of the amount of breast ptosis or sag that you are experiencing, the limited amount of lift that a Benelli lift or a circumferential areolar incision can afford, and without the ability to conduct my own physical exam I would caution you from opting for the Benelli lift.  The biggest issues will be boosting your breasts up to the appropriate height, repositioning your breast tissue, and taking enough tension off of your closures to prevent poor scarring and a poor cosmetic result.  With a Benelli Lift, I would worry that you would end up with misshapen breasts and wide scars.  

Dear Bel,Thank you for your question.It seems that from your statement that you are concerned over the possible scars necessary, and would prefer to choose a procedure that minimizes the amount of scars.In order to reshape a breast that has lost volume and has become flattened with droop onto the upper abdomen a Benelli, or (nipple only lift) will not deliver.  It is simply an inadequately designed procedure when compared to the alternative procedures you have mentioned.If used in the inappropriate setting, over time the sag will likely return, but now with elongated looking areolas, or you are still ptosis ("sagging" below the fold) at the completion of the procedure.Depending on your measurements, and other possible considerations, a lollipop (vertical), or inverted T lift may be necessary.I hope this helps,Sergio Pasquale Maggi, MD, FACSAustin Plastic Surgery Centerdrmaggi.com

It is difficult to answer this question without a consultation including a physical exam, but hopefully this will offer another perspective on the two operations.   I find that I can achieve better reshaping of the breasts with a lollipop or anchor scar breast lift rather than a Benelli lift, but there are more scars.   There is no wrong or right operation; some patients will opt for a less-scarring operation even if this means they will have less dramatic reshaping of their breasts.   Others will choose the operation with more scars because they want their breast mound to be tighter and higher.  I try to match the operation to the patient's expectation of the results.

We all like the concept of “scarless
surgery” making the Benelli (periareolar) breast lift very appealing. There are no guarantees of no puckering,
though pleating tends to improve with time.
Also with breast lifts of significant distance, repositioning the skin
only may not be sufficient and a vertical (lollipop) lift helps reposition the
breast tissue too. Additionally, greater
tension can lead to wide scars with the periareolar that could be more obvious
than the vertical lift in certain patients.

Realistic expectations are
exceedingly important!