Round block breast uplift techniques

The Benelli breast uplift (concentric, or peri-areolar or doughnut lift)
This technique is considered less invasive and was designed with the scars being around the areolae. With the Benelli, a donut shaped piece of tissue around the areola border is removed and the surrounding tissue sutured to the areola. The incisions are normally closed with purse string sutures. Sometimes a little more tissue is removed above the areola (like the crescent) to compensate for a lifting effect when it is sutured. The Benelli lift results in a flatter, rounder breast shape post-operatively as opposed to a sloped breast. The flatter aspect after the uplift is, however, temporary, and given time to settle a pleasant effect does ususally occur quickly.

The Benelli breast uplift can be combined with breast augmentation in cases of moderate ptosis(saginess) of the breast and a very empty skin envelope.

Areola Reduction Surgery
Some women may be displeased with the size of their areolae which may be enlarged due to genetic predisposition, previously having had large breasts then undergoing tissue loss, stretching of the areola due to implants or other reasons. The areola reduction surgery is designed to remove the redundant areola tissue to improve the overall cosmetic appearance of enlarged areolae. The reduction may result in a slight lift and may also produce slight irregularities at the incision line if the reduction was significant.

Again the approach can be combined with  breast augmentation via implants

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Scar sparing breast uplifts ?

Scar sparing breast uplifts are currently receiving a lot of attention in scientific Plastic surgical literature.

Generally, uplift procedures are advised once a certain degree of btreast ptosis (sagginess) has developed. Once the level of the nipple is located below the level of the submammary crease , literature reviews generally recommend some kind of uplifting procedure, with or without use of breast implants. Whether a breast augmentation is to be advised together with the breast uplift, will depend on the amount of available breast tissue and patient desires.

Whether or not to stage breast augmentation and breast uplift into two proedures remains a matter of controversial topic, and surgeons opinions about this vary.

Whilst it is true that rates of revisional surgery for breast uplifts is significantly higher than for both procedures individually, it is also true that a staged procedure naturally bears a 100%revision rate.

Case 1

Patient with significant volume loss following multiple pregnancies

Progressive ptosis(sagginess) with nipples below the inframammary fold

Patient asked for uplift and volume fill

Operation performed was subglandular lift

Combination with vertical scar mastopexy

Result 10 months post op

Good projection

Sufficient size

In spite of the undoubtedly significant percentage of revisional surgeries for breast augmentation with uplift, patient satisfaction is still very high. Most touch up surgeries will aim to correct nipple position and/or scars.

Opinions among surgeons regarding which technique to use generally vary considerably, but the technique with the least scarring is not necessarily the one that makes the patients most happy.

Especially among Caucasian patients much is to be said for rather considering more scarring to trade in for a favourable shape, since fair skinned patients tend to scar favourably and the scars tend  to fade over time to a degree that they are of much less concern to patients.

Bear in mind that this is a long term observatzion, scars after breast uplift may be quite red initially before gradually fading. The process of scar fading after breast uplift is not entirely in the surgeons hands, lots wil depend on personal factors also.

Within reason, one can also explain if the patient is willing to accept more scarring there is less chance of recurrence of ptosis (sagginess). Nevertheless, very shortly after a breast uplift, and regardless of the technique used, it is not unusual for the scars to be quite red and swollen, especially when absorbable suture material, which I personally recommend, is being used. Given time, these scars, nearly without exception, tend to fade significantly and do not normally concern patients then.

To promote softening and fading of these scars after breast uplift (mastomexy) we tend to use silicone stripes, which promote softening of the scars more rapidly. But as alway, time is the best healer.

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