Can I avoid Benelli lift and have Breast Augmentation only? (photos)

I am perplexed! I had five consultation with board certified plastic surgeons and only one told me I need Benelli lift. I am 5', 120lb 43 years old female. I would like to avoid any scars of the breast tissues and wanted to have breast augmentation via transaxillary incision, I also wanted to have small implants in 200cc range to get more natural look for my height. The surgeon who suggested Benelli lift told me I cannot do small implants without a lift. Your input will be highly appreciated!

Doctor Answers 29

Can I Avoid a Lift?

So what I find quite perplexing, and curious, is that you saw five surgeons and only one of them recommended a lift, while almost every single surgeon who has answered your question on this forum has stated that you need a lift and more than just a Benelli type of lift. You also stated that you wanted your implant to be placed through a transaxillary incision with an implant in the 200 cc range. I am agreement with the others on this forum, that based on what we can see from photos, you will not achieve a pleasing breast appearance with an augmentation alone, and that you definitely need a lift and not just a Benelli lift.

So why is there such a huge discrepancy of opinion? It is apparent from your question that you are very adamant about not having any scars on your breast ( transaxillary incision) and likely you have firmly made that point with every surgeon you have seen. So these surgeons are responding to your demands by offering you just what you are asking for, despite the fact that it really is not the best choice for you. The one surgeon that did recommend a lift also compromised with a Benelli lift which is not a good option for most patients because it only minimally raises your nipple position while at the same it causes flattening of your breast. You do not need your breast to be flattened and you need to have your nipple position raised a good amount. I think a vertical or lollipop type of lift would be more appropriate.

I can only think two reasons why the surgeons you have seen have not recommended doing a lift. The first is that you have not consulted with Real Plastic Surgeons, i.e. surgeons who are actually certified by the American Board of Plastic Surgery. There is a big difference, but it can be very confusing to patients when they see someone who claims to be "board certified", and has a bunch of certificates on the wall. It seems as though they might be qualified, but if your training was really as an OB-Gyn, and then you decided to re-invent yourself as a "cosmetic surgeon", you simply cannot become a qualified expert in breast surgery by going to a weekend course and purchasing a new plaque for your wall. The second reason is that in highly competitive markets surgeons may feel compelled to do whatever it takes to meet a patients demands in order to get the case, despite whether what the patient wants is really what they need. Interestingly, the only surgeon on this forum who suggested you could do just an implant alone was also from Scottsdale.

Can I avoid Benelli lift and have Breast Augmentation only

an augmentation will leave you with nipple/ areola complexes that are pointing down. If you can live with that the the implant alone is an option.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Can I avoid Benelli lift and have Breast Augmentation only? (photos)

Hi-  Unfortunately for the best breast shape you would need a lift, especially if considering a 200cc implant because it would not fill your deflated breast envelope. I also would not recommend a trans-axillary augmentation since you would need the lift. If you did not have the lift your breast would fall off the implant giving an unaesthetic result. Good Luck

Jordan P. Farkas, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast lift vs no lift

A breast lift will give you a significantly better outcome compared to just doing implants alone. If your surgeons can show before and after photos of women with the same degree of breast ptosis with a desireable outcome this may be different but I doubt this is the case. I understand the concern about visible scars but unfortunately you will not have a good breast shape without the scars. Please keep in mind these scars do fade with time. Best of luck

Josh Olson MD

Avoid Lift

Look I completely understand why patients do not want scars on their breasts. The simple fact remains that in order to create a youthful breast with good round shape often times borderline patients are better off with a lift. For you some kind of discussion needs to take place about a skin tightening procedure. I feel from what you show there that you will just have bigger breasts that look like they do now. Certainly we do have some techniques such as a dual plane technique that in borderline patients can be done to avoid the lift, but I really caution you that you should be giving consent to allow your surgeon to proceed with a full lift (Vertical or Anchor Incision) so that if during the case they realize that in no way will an implant give you what they want, then they have permission to proceed. If you are totally against scars on your breast, I often tell patients in your shoes, you are better off without surgery at all. IF YOU NEED A LIFT, YOU NEED A LIFT! I am not a huge fan of the Benelli either. I feel it short cuts the real issue. There are some patients who are perfect for that, moving the nipple about 1cm maybe a little more. But, most patients need a more aggressive move of the nipple an that requires a full lift. But, also you get better skin tightening in the proper areas with full lifts. Just make sure you are educated. Sometimes I just can't tell a patient until get the implant in place in the operating room. Good luck



Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 45 reviews

Breast augmentation and a breast lift (mastopexy)

It sounds like you have done your homework but sometimes getting so many opinions muddies the water. It is really difficult to tell on photos because a surgeon cannot assess skin quality by just viewing a photo.  Some gals have really stretchy skin and stretchmarks, so even if the nipple position is only a little low, the skin might cascade over the implant.

For my patients, if they are adamant that they don't want further scarring on the breast, then I tell them that we can do the augmentation but we will have to re-evaluate in 6 months. At that time, the implant will be in good position and we can see what type of mastopexy needs to be done or if no further surgery is necessary. Every patient also has different goals and realistic expectations. I think a conservative approach is better.

Make sure to go to a board certified plastic surgeon with experience in augmentation and breast lifts.

Best to you on your decision.  Go with your gut feeling and feeling comfortable with the surgeon.

Breast lift with implant

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a wise pattern breast lift. Your nipple sits below the inframammary fold and without a lift in addition to the implant, this will not have a natural shape.  A wise pattern lift with an implant can result in a very nice shape if good technique is used.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 92 reviews

Augmentation Mastopexy


There are 'board certified surgeons', and then there are surgeons certified by the American Board of Plastic Surgery (ABPS). Frequently the former and the latter are not the same. Further, just being certified by the ABPS does not make you an expert in complex problems like yours. Those that are also members of the American Society for Aesthetic Plastic Surgery (ASAPS) are more likely capable, especially if they specialize in breast surgery. Your breasts droop significantly, even with your arms back or elevated. You will not look good with implants alone. You will also not look good with a Benelli lift.  Your nipple-areolar complex needs to move much further than a Benelli lift can possible do, and trying leads to sometimes uncorrectable problems like flattening of the breast mound, persistent sagging, widened or irregularly shaped areola, thickened periareolar scars, and pleating around the areola. You need a formal mastopexy. Done properly, your scar will be inconspicuous and your results will be infinitely prettier. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 83 reviews

Benelli Lift vs. Implants alone

After reviewing your photos, I would definitely recommend a lifting procedure.  Your photos show your nipple-areola complex to be at the lowest portion of your breasts.  Additionally both yours nipples are pointing downward.  A lifting procedure will re-position your nipple-areola to a more pleasing position, and this may be combined with an implant of any size.  If you elect to have only an augmentation and no lift, you will probably be disappointed.

Steven H. Wiener, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

Benelli lift vs implants alone

Your nipples are quite low to begin with, and even a Benelli lift may not be sufficient.  However, it is likely that an implant alone will give you larger breasts that appear saggy due to the nipple position.  

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 138 reviews

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.