Many women would like to see their breasts look more youthful, higher, and more ‘perky’, and many have considered a procedure called the breast lift, also known as mastopexy. Most women, to a greater or lesser extent, are concerned about scarring from the procedure, which affects their decision about whether to move forward with the procedure, and if so, which type of breast lift to have performed.
There has always been an interest among plastic surgeons to improve the way we perform breast lifts and breast reductions to get the best results in terms of breast shape and appearance of the incisions. Although most women find the vertical incision most undesirable (the incision that runs from the areolar to the bottom of the breast), plastic surgeons have been more interested in reducing or eliminating the inframammary incision. This is because plastic surgeons know that a vertical incision usually heals so well and inconspicuously, unlike the inframammary incision, which has a tendency of being thickened, discolored, or raised.
Surgeons in Europe and South America have popularized the ‘lollypop’ or vertical breast lift that eliminates the inframammary scar completely. However, American surgeons have great difficulty getting the same great results as the traditional inverted T/ anchor lift. Worse, there are more problems that are difficult to correct associated with this purely vertical breast lift. Refinements that include utilizing short inframammary incisions have now made the vertical breast lift an excellent option for most women, with much less problems associated with a purely vertical breast lift. For many women though, these limited incision lifts are not small enough or limited enough.
Dr. Benellito conceived of a breast lift that involved removing a ring of skin around the areola and sewing the remaining breast skin to the edge of the remaining areola. It has been modified in a few ways through the years, but still remains to be a GREAT PROCEDURE FOR SMALL BREASTS, and almost always in conjunction with implants. When this procedure is misapplied to larger or more droopy breasts, it forces the surgeon to remove an ever larger ring of skin, creating results that are usually ugly, and sometimes disastrous: irregularly shaped areola, abnormally wide areola, pleating of the skin around the areola, thickened scars, abnormally flattened breast mound shape, and persistent breast sagging. The number one reason for malpractice lawsuits against plastic surgeons in the state of California involves this surgery – the Benelli or donut lift.
The crescent lift is also a minor lifting procedure that some doctors offer women. Once again, it can be misapplied to larger more droopy breasts. The effects of this are also not pleasing: expanded, off-round areola, thickened scar, flattened breast mound, and persistent sagging. In my practice, any small, minimally sagging breast will get a circumareolar lift because the results of a crescent lift are inferior to those of a circumareolar lift.
My expertise is in breast surgery, and having performed countless breast lifts, I’ve come to the conclusion that in the larger or more sagging breast, a truly good result is only gotten with a combination of a full or formal lift and reduction. That is because a large breast will always ‘bottom out’ no matter how tight the skin is made after a lift alone procedure. If the aesthetic goal is to maintain volume, than an implant can be utilized with this lift/reduction procedure. Although seemingly contradictory, the breast implant provides volume and shape that is more reliable for a long term good result, at the expense of removing the more natural feeling breast tissue.
Although this more formal or extensive type of lift means there will be more incisions, when done well the resulting scars are usually inconspicuous.
Visit a few well trained, American Board of Plastic Surgery certified doctors who perform A LOT of breast surgery. Look at their photos and talk to them about what’s right for you.