5'8", 190lbs. Donut lift (Benelli) and 600cc implant. Good choice?

My surgery is scheduled for the 26th of this month and I am set for a periauriolar lift with implants. My surgeon recommended a 550cc but said I could go up to 650cc. Would this give me a good look? I want full large breasts that match my wide hips and full figure. I have issues with scars keloiding so the least amount of scars possible is a big plus.

Doctor Answers 9

Donut Lift and 600cc Implant?

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Good Choice?......................almost assuredly not a good choice, but it is really impossible to give you definitive guidance without photos because we have no idea where you are starting from. But here is what can be inferred from the information you have provided.

Given your height and weight it sounds like you have a larger frame, so a larger implant may well be appropriate for you. The problem is that the combination of a Benelli or donut lift in combination with a large implant is often recommended in situations where patients are trying to avoid the more extensive scars seen with other types of lifts. This almost always a bad choice and here are the reasons why.

- Implants do not lift your breast. If you need a lift and are trying to avoid one by putting in a larger implant you will only end up with a larger sagging breast over time.

- The Benelli or donut lift has only limited potential to elevate your nipple position and does nothing to elevate sagging breast tissue if needed. It also flattens the breast which is not something most women need. There are certain situations where it is an appropriate lift but they are relatively uncommon.

- Combining a Benelli lift with a large implant results in large amount of radial tension being placed on your areola and the surrounding the scar. Over time this results in flattening and enlargement of the areola and widening, irregularity, and thinning of the scar which looks terrible.

It is in fact relatively uncommon for patients to have a true inherited predisposition to forming keloids and this tends to primarily be in African American and Asian populations. Patients will sometimes assume that they have a predisposition to forming "keloids" because they developed a poor scar in the past, but the problem was really that the scar was in a bad location or the closure of the wound was not done well. So the previous poor scar in one area is not predictive of a poor scar on your breast which is generally a relatively forgiving area for scars, except when they are under a lot of tension. So one way to guarantee a poor scar is to create excessive tension by trying to accomplish a great deal of lift with a procedure that is not appropriate and further increase that tension with a large implant.

You should really research this further and in particular look at a lot of photos of Benelli lifts with large implants. You may decide that your results are not what you imagined.

I would be concerned

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Using large implant puts considerable tension on the wound. The circumareolar mastopexy flattens the breast. Flattening and then putting tension on the wound could lead to unattractive scarring.

Good luck

Benelli lifts

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have very limited applications in my opinion.   A 600 cc implant is large and may not allow for a traditional lollipop lift and if the Benelli was the only way to achieve the lift, then fine.  But the doughnut lift is the last resort in my practice.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

5'8", 190lbs scheduled for donut lift with 600cc implant augmentation . Good choice?

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Thank you for your question . Photos would've helped to give you more specific answer. First of all, 600cc implants are large, but might be OK based on frame and measurements. Donut or Benelli lift is not Ok. This will flatten the areola or most projecting part of the breast mound and you most likely will end up with wide, sun burst type of scars. Very difficult to fix. BTW, a Benelli lift will not lift your saggy breasts, just repositions your nipple areolar complex to a slightly higher position. I would advise you revisit the plan with your plastic surgeon prior to surgery and ask him/ her to show you several Benelli lift results with large implants long term. Good luck.

Donut lift (Benelli) and 600cc implant. Good choice?

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Without photos there is no way of telling what kind of result that would give you. However, be aware of some issues with those choices. A 600cc implant is quite large, but if your tissues are thicker perhaps you can handle that size with less long term issues of skin and tissue stretching and thinning and potential drop out than someone with thinner tissues. As to the Benelli lift, be aware of its limitations. It is a very weak lift that can lead to significant problems with poor scarring (wide scars, starburst scars, hypertrophic scars), large stretched-out areolae, a flattened breast shape in the areolar area of the breast, and little-to-no real lifting if performed in someone who has significant breast overhang and a very low nipple position. On the other hand, it is a good operation in someone who just needs some mild nipple elevation (3 cm or less, though 2 cm or less is better) and some areolar reduction and maybe has not much more than a couple of centimeters or so of breast overhang. If the Benelli lift is used in someone who really needs a stronger or more extensive lift, be prepared for a bad result. Many patients want to avoid that vertical scar and thus request the Benelli lift, but if the breast shape and scars are bad, the areola has stretched out significantly, and the breast is still hanging off of the implant, they will understand why the vertical scar is needed in their case and they will need a revision to achieve a satisfactory result.

Big implants and a Benelli lift.

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Without photos it is impossible to give you a meaningful answer, but here are my thoughts.

If you truly keloid, that means the keloids would extend beyond the scar margins and I would be hesitant to operate on you.  If you just scar badly (hypertrophic scarring) I would make sure you either tape your incisions after surgery or used silicone pads to help with the scarring.

In general, I think big implants and a Benelli can result in a really weird looking breast.  If you are opting for a Benelli because you don't want the other breast lift scars, you may be in for a disappointment.  With a big implant like you are considering and a Benelli, there will be a lot of tension and that can set you up for excessive scarring. 

It would be most helpful for you to post photos!

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

5'8", 190lbs. Donut lift (Benelli) and 600cc implant.

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600 cc implants are considered quite large and may pose long term problems for some but not all patients. Without an exam or even photos it is not possible to make any comments specific to what might help you. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Best Breast Implants for Me?

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  • Thank you for the question.
    As you can imagine, despite your good description of body type and goals, it is not possible to give you precise advice online.
  • The best online advice I can give to ladies who are considering breast augmentation surgery is:
  • 1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.
  • 2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
    In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “good look” etc means different things to different people and therefore prove unhelpful.
    Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate.
  • 3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.
  • I hope this (and the attached link) help.

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

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I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

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 aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute

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.