What is the best course of action for breast augmentation with a very short areola to inframammary crease distance?

I am 5'3'', 120 lbs with an A cup and have very tight areola to inframammary crease distance - around 2.5-3 cm. Two doctors have told if they put an implant in, my nipples would be pointed down. One recommended a Bellini to move the areolae up and to put in a small implant. Another said the Bellini procedure is actually just an areolae reduction and doesn't really move them up and can flatten the breast. Should I choose a small implant and go with a Bellini or can pocket creation solve my issue?

Doctor Answers 16

Constricted breast

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You are describing a constricted breast deformity.  The treatment plan would be individualized to your situation.  It may involve lowering the lower breast fold, or placing a teardrop shaped implant, or a breast lift (a periareolar type breast lift is often an inadequate compromise).  You should seek multiple consultations with board certified plastic surgeons.

Beverly Hills Plastic Surgeon
4.8 out of 5 stars 174 reviews

Breast Augmentation With Short Areola to Infra-Mammary Fold Length

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Thank you for your questions. With an A cup size I doubt very much that any type of breast lift would be helpful. My impression is that to put in a reasonable sized breast implant the infra-mammary folds would need to be lowered. A detailed exam is necessary to come up with the best plan to suit your anatomy and your goals. Please see an experienced board certified plastic surgeon to learn about your options and I hope you get the results you desire!

What is the best course of action for breast augmentation with a very short areola to inframammary crease distance

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The only way to solve that problem is to expand the skin between your nipple and the crease. None of the suggestions made to you will accomplish that. It can be done with a tissue expander with an eventual exchange for a larger implant or placing a suitable size implant within the limitation and allow the skin to stretch out over time and then increase the size of the implant in  a series of operations.

Implant selection

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You likely will not benefit from a breast lift. You may require an anatomic breast implant to create a nicer breast shape and help stretch out the skin of your lower breast. Without photos it's difficult to know, so you should consult with a few plastic surgeons in person for a detailed exam.

Best wishes,


Short nipple to IMF

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Like my colleagues have mentioned - it is difficult to give you a thorough consultation without seeing you in person. The biggest concern I have with mention of the Benelli lift is that this would not stretch out your nipple to inframmary distance and may actually make your nipple TOO high (MUCH more difficult to correct than a droopy nipple!). Also, you said you were an A cup but this does not tell me the distance from your sternal notch to nipple which is really what would determine the need for any sort of "lift". Ideal distance is 21cm. Your surgeon should be able to lower your pre-existing inframammary crease to accommodate an implant that will allow your lower breast pole to stretch and become longer than the 3cm you have now. In my practice we put implants in many girls with little to no breast tissue. I use the transaxillary technique (through the armpit) and lower the inframammary fold to fit the implant I have chosen. The choice of implant too I base on measurements to determine the best option for your body. In the hands of a board-certified Plastic Surgeon with years of experience, you will be happy with your results. I hope this helps. -Dr. Mills.

Dan Mills, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 33 reviews

What is the best course of action for breast augmentation with a very short areola to inframammary crease distance?

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Based on your description, it does not sound like you need a lift. A Benelli lift will not increase your nipple to inframammary fold distance, and it does tend to flatten the breast. Your best option may be to lower the fold conservatively, to improve the size and shape of your breasts. Photos or a in person consultation would be the helpful in providing you with a more accurate assessment and recommendation. Thank you for sharing your question. Best wishes. Dr. Gregory Park, San Diego Plastic Surgeon.

Really hard to say without seeing you...

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Assuming that you are a young woman with a small breast, then absolutely go with a smaller implant! Only submit to a lift if you are droopy.  I agree that a Benelli tends to flatten the breast and I would not subject you to that additional surgery if you don't need it.  Good luck!

Breast Augmentation of a Small Breast

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Any surgeon that thinks someone like you would benefit from a Benelli should be kept at a safe distance from your body. You would need to be examined by a surgeon adept at biodimensional analysis to determine maximum capacity of your tissue. It is likely small, but it will be safe. 

Please only visit a few ABPS certified/ASAPS member surgeons that specialize in cosmetic breast surgery.

Best of luck!

Breast Augmentation With a Short Areola to Inframammary Crease Distance

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Hello and thank-you for your question.

Photos would be helpful in giving you any meaningful advice.  The choice is to lower the infra-mammary fold or to raise the areola.  I would recommend an in person consultation with a Board Certified Plastic Surgeon in your area.

Best regards,

Andrew Lyos MD, FACS

Lift and augmentation

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The Bellini is not a good idea.  I have had a few patients like you and sometimes lowering the fold is appropriate, and sometimes a lift-type scar is appropriate to raise the areola. 

Feel free to look on my website.

My best, 

Dr. N

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.