Skin incision patterns for a breast lift depend on the amount of excess skin, elasticity, and degree of lift needed. Variations can include:
1) A half-circle incision at the upper half of the nipple-areola complex. This is known as the “Crescent Mastopexy” and is performed in combination with a breast augmentation. See Breast Augmentation and Lift page for more information.
2) A full circle around the nipple-areola complex. This is known as Benelli Donut or peri-areolar mastopexy and is best performed in combination with a breast augmentation.
3) A full circle around the nipple-areola complex with a vertical line extending down from the lowest aspect of the areola to the infra-mammary crease under the breast.
4) A full circle around the nipple-areola complex with a vertical line extending down from the lowest aspect of the areola to the infra-mammary crease under the breast, and along the crease under the breast.
Benelli Donut or Peri-areolar Mastopexy
Orange County plastic surgeon Dr. Agha performs a Benelli Donut Mastopexy when there is only minimal breast ptosis. Even in those with a smaller degree of breast ptosis, the nipples and areola can migrated to the lower pole of the breast, losing a youthful appearance.
The Benelli Donut Mastopexy involves an incision around the nipple-areola complex. The excess breast skin is excised as a “doughnut” around the areola. The breast tissue with the nipple-areola complex is then lifted to a higher position. The incision is then closed by approximating the outer skin incision to that of the nipple-areola complex. The scar ends up around the areola.
Short Scar (Lollipop) Breast Lift
As the breast-sagging becomes more appreciable, the nipple-areola complex drops and the breast tissue loses its perkiness and becomes flatter and more pointed. For patients experiencing these effects, Dr. Agha performs a more complex breast lift that remodels the breast tissue into a rounder shape with upper breast fullness. For these moderate cases of breast ptosis, Dr. Agha pursues a short scar breast lift. Among the many short scar methods, the vertical mastopexy results in a scar around the nipple-areola complex, descending down to the breast crease (infra-mammary fold), and culminating in a short horizontal component at the crease. The actual configuration depends on the breast shape and degree of ptosis. This breast lift scar is much smaller than the anchor incision.
Wise-Pattern (Anchor) Breast Lift
In severe cases of breast ptosis, the suspension ligaments and breast tissue are sagging, the nipple-areola complexes drift down towards the lower pole of the breast, and the skin envelope is too large. To correct the breast to a more natural appearance, the nipple and areola need to be moved significantly higher to their normal anatomical position. For these cases, Dr. Agha performs the anchor-type incision that extends from the nipple-areola complex, vertically down to the breast crease and along the crease under the breasts. This pattern of skin excision permits a more significant skin removal and surface tailoring. Through these incisions, Dr. Agha elevates the breast tissue and remodels it into a rounder and fuller shape.
He reestablishes the breast shape with internal sutures. Internal support tends to hold the breasts up longer and results in a more “perky” youthful breast. The skin is then re-draped over the suspended breast tissues.
The Wise-pattern incision is also the chosen technique that is most often used for those patients with significant weight loss or bariatric surgery. Most of these patients will have extreme breast tissue laxity and skin excess. For these cases, Dr. Agha performs a Dermal Suspension Mastopexy (pioneered by Drs. Rubin and Agha) or Spiral Flap Breast Reshaping (pioneered by Drs. Hurwitz and Agha).