Two Operations to Avoid the Ugly Vertical Scarring?

The goals of a breast lift are twofold:  1. to elevate the nipple/areola and 2. to tighten the skin underneath the breast.  Breast lifts using the donut or crescent technique limit the amount of scarring but are VERY limited in their usefulness.  They are ONLY good for elevating the nipple/areola and do nothing to address excess skin.  Sometimes a small amount of excess skin can be addressed using a small breast implant to fill it out, however, beyond a certain point even this does not help.  Patients with more significant sagging will require a more aggressive breast lift such as the "lollipop" (vertical scar) lift or the traditional anchor- type lift.  While these may produce more scarring, they will produce a perkier look to the breast.  Simply doing a donut or crescent lift over more than once will not lift the breast if a more aggressive approach is indicated.  Your doctor will discuss the various breast lift approaches and help you determine which lift is most appropriate for you.  Ultimately, the decision is whether you would prefer the sagging or the scars necessary for a perky appearance to your breasts.

      There is only so much a Benelli lift can do, no matter how many times it is performed.  The Benelli is something similar to closing something with a drawstring - the tighter the closure the more the bunching.  This bunching will only smooth out if relatively modest.  The Benelli will flatten the breast as well.  Finally, the Benelli places the tension at the areolar perimeter and causes areolar widening.   Kenneth Hughes, MD Los Angeles, CA

There are some techniques in which a wedge can be taken from under the breast fold( transversely) and lifitng the nipple as well. It really depends on the individual breast.

Thank you for the thoughtful question.  Given that you are asking a general type question, my response can only be of a general type as well.

 

The type of breast lift a patient would benefit from depends mainly on the degree of breast ptosis (sagging).  If a patient would benefit from a vertical mastopexy with the resulting vertical scar, it is unlikely that any other type of breast lift ( no matter how many times performed) would provide the same type of results. In other words, for the these  patients, the “loose” skin must be excised to achieve a satisfactory breast lift.  The Benelli breast lift is very limited in what it can achieve,  again no matter how many times performed.  Occasionally,a patient in a somewhat “borderline” situation may benefit from the Benelli breast lift followed by additional “tightening” subsequently.

This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery. Many patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.

For other patients, the presence of scarring is a “dealbreaker”;  obviously, these patients should avoid surgery.

I hope this helps.

The question to which you have referred came from a patient whose photo demonstrated marked ptosis (sagging), and a full pattern lift would be needed to correct her problem.  Implants may fill out loose skin, but will not correct the sagging. 

The minimal scar  lift that can be achieved with incision only around the areola also achieves only a minimal amount of lifting--about 2 cm maximum. 

Without photos it is not possible to offer specific advice. There are some hybrid procedures with a periareolar incision and an incision in the fold that can work for some patients, thereby avoiding the vertical incision. 

All the best.