Breast Lift

The Benelli lift with breast implants basically accomplishes two things: create an “illusion” of a perkier appearance, and provide more breast volume.


The term “illusion” is an appropriate way to describe the effects of Benelli lift, which unlike the standard breast lift, does not manipulate and reshape the actual breast tissue. It simply relies on repositioning the areola higher on the breast.


benelli lift with breast implants


Meanwhile, a standard breast lift actually “lifts” and re-anchors the sagging breast tissue.


For this reason, the Benelli lift only suits patients with pseudo or fake breast ptosis or sagging—i.e., the upper breast pole appears “empty” but the areola has not yet sagged below the breast fold.


To demonstrate the effects of Benelli lift with breast implants, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos involving the technique.


The patient shown in the video had enlarged areolas, which were positioned lower than ideal, although they had not yet drooped beyond the breast crease. Moreover, her breast size was disproportionately small for her body and thus she requested for a simultaneous augmentation surgery.


Dr. Smiley started off the surgery with the creation of a smaller areola. He used a round cookie-cutter device to make an imprint of the new areolar complex. Then, he created an oblong-shaped incision outside of the same cut.


With the aforementioned incision pattern, Dr. Smiley was able to remove some of the dark pigmented skin of the areola, ultimately reducing its size. Of course, he lifted it a few centimeters from the breast crease to achieve a perkier, more youthful appearance.


According to studies, the ideal distance between the nipple and the sternal notch (visible dip between the neck and the collarbone) is between 17-21 cm. But if there is a larger gap, the breasts are perceived to be saggy.


After improving the shape, size, and placement of the areola, Dr. Smiley positioned the implants to give the patient more breast volume. These prostheses are propelled into their pockets through the previously created incision around the nipple area, thus avoiding additional scar.


The resulting scar from the Benelli lift, meanwhile, lies precisely at the dark-light skin junction and so it will blend into the background after six to 18 months, Dr. Smiley said in one of his Snapchat videos.

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Breast lift with tummy tuck is a common mommy makeover combo surgery. Because of the operation’s extent, this is only reserved for healthy patients who can handle the ensuing recovery, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


Dr. Smiley has recently posted on his Snapchat account a case study involving a female patient who requested breast lift with tummy tuck.


breast lift with tummy tuck

The patient flew from Hawaii to have her surgery conducted by the celebrity plastic surgeon who performs over a hundred mommy makeover surgeries every year. (In one Snapchat video post, he revealed that he has already operated on more than 7,000 tummy tuck patients.)


The patient had large areola that aggravated the appearance of her drooping breasts. For this reason, Dr. Smiley recommended reducing her areolar complex to achieve a more proportionate, youthful result.


Using a cookie-cutter device, he delineated the new smaller areola by removing some of the dark-pigmented skin from its border.


After reducing the areola—ensuring that the resulting scar lies precisely at the dark-light skin junction to make it undetectable—Dr. Smiley then used vertical incisions between the nipple area and the breast crease to elevate the tissue, leading to a perkier appearance.


To further achieve impressive breast contour, Dr. Smiley placed incisions parallel to the breast crease; hence, the resulting scar lies precisely at the natural skin fold for its optimal concealment.


(Note: The overall shape of the scar resembles a nautical anchor, thus most surgeons call this breast lift technique as anchor lift.)


While the vertical scar of the anchor lift is in a more obvious location, Dr. Smiley says it generally heals and blends nicely into the background after 6-12 months. However, this is only possible with proper wound closure technique in which there is no or very little tension on the skin surface.


Aside from closing the wound in several rows to eliminate superficial tension, Dr. Smiley says he prefers absorbable sutures, which are known to promote favorable scars and are less likely to cause the appearance of “railroad tracks.”


After breast lift, Dr. Smiley proceeded to tummy tuck in which he used a hip-to-hip incision to remove the sagging skin and repair the abdominal muscle that had become separated due to pregnancy. The resulting scar has been made very low that the patient can wear a scanty two-piece bikini without any problem.


Overtime, the hip-to-hip tummy tuck is expected to fade and shrink almost to the width of a human hair.


Once the incisions from mommy makeover surgery are fully healed, Dr. Smiley recommends the use of silicone sheet and gel; the goal is to hydrate the scar and allow it to fade into the background.

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The exact instructions as regards to breast lift wound care may differ from surgeon to surgeon; nonetheless, there are generally agreed upon guidelines such as preventing or treating infection immediately, avoiding over-exertion while healing is not yet complete, just to name a few.


Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that aside from the quality of breast lift wound care, the suturing technique will also play a critical role in the prevention of wound separations and healing problems.


breast lift wound care


The goal is to eliminate most of the tension on the skin surface by placing it on the deeper tissue, says Dr. Smiley.


Aside from meticulous wound closure technique, risk factors such as obesity, smoking, serious medical conditions, and use of aspirin and other drugs with blood thinning properties must be eliminated or at least controlled well ahead of the surgery.


In standard breast lift (i.e., anchor or T-shaped incision technique) wound separation is not uncommon in the T junction (or the area where the vertical incision meets the horizontal incision along the submamammary fold) because of the opposing tension. Hence, patients who only need mild to moderate tissue elevation is encouraged to choose the modified form in which the inframammary crease incision is eliminated, a technique referred to as lollipop lift.


Meanwhile, Dr. Smiley explains the postop care that can prevent or at least reduce risk of wound separations.


  • Prevent or treat immediately signs of infection


Persistent swelling, pus or foul discharge, fever, and increasing pain are common signs of infection. To prevent this complication, a good rule of thumb is to achieve one’s optimal health well ahead of the surgery.


The use of antibiotics and good hygiene (washing one’s hands before and after changing the dressing) can also reduce risk of infection and its subsequent problems such as wound separation and poor healing.


  • Avoid over-exertion


The truth is, patient cooperation will also play a crucial role in the prevention of complications. It is important to avoid heavy lifting and strenuous exercise for a minimum of three weeks postop to avoid wound separations, persistent swelling, and other things that could compromise one’s recovery.


  • Avoid premature removal of sutures


Non-dissolvable stitches, which are usually used to “hold” the superficial layer of the wound, should not be removed prematurely lest wound breakdown may occur.


Furthermore, certain suturing techniques such as monofilament are believed to be less prone to “spitting.”


  • Avoid smoking


The general rule of thumb is to avoid smoking three weeks before and after surgery to give the body ample time to flush out the effects of nicotine, which is a strong vasoconstrictor (it shrinks the blood vessels that the nutrient supply going to the wound is greatly diminished).

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Breast lift for large sagging breasts faces unique challenges, which must be recognized and assessed well in advance of the surgery to achieve impressive results, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


One major caveat of breast lift for large sagging breast is the susceptibility to drooping recurrence because of the sheer weight of the breasts. Nonetheless, this perceived challenge could be offset by several techniques, which have been explained below by Dr. Smiley:


breast lift for large sagging breasts

  • Achieve one’s optimal health


Dr. Smiley only performs breast lift on patients who are near their ideal weight, which they are able to maintain for at least of six months. Not only it ensures more precise tissue resection and thus more predictable long-term results, women of normal weight are also less likely to experience healing problems, infection, and unacceptable scarring compared to obese patients.


Obesity—along with diabetes, blood disorder, and other serious medical conditions—is closely linked to increased risk of complications after any type of surgery.


  • Simultaneous breast reduction


If the saggy breasts are hugely disproportionate in relation to the patient’s [thinner] frame, she may ask for a simultaneous breast reduction, which not just improves “body proportions” but also makes the breast less susceptible to the effects of gravity and aging.


It is important to note that breast reduction and breast lift share the same incision sites; hence, additional scarring is not an issue.


  • Anchor breast lift


Modified breast lift techniques—i.e., they result in fewer scars and possibly shorter recovery—give patients more options. Nonetheless, women with large sagging breasts can achieve no or very little improvement from them.


The anchor breast lift remains the best option for women with large sagging breasts; this is particularly true for someone needing a simultaneous breast reduction.


During an anchor breast lift, doctors create keyhole-shaped incision above the nipple area and then an anchor incision pattern that goes from the right to the left side of the lower breast pole. The goal is to remove some of the excess skin and elevate the breast tissue with the use of internal sutures.


The resulting scars go around the areola’s perimeter (perfectly blends at the dark-light skin junction), vertically between the areola and the submammary fold, and parallel to the fold.

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The wise pattern breast lift, which is also called as anchor lift due to the shape of its resulting scar, is reserved for women with significantly droopy breasts—i.e., the nipple falls way below the submammary fold.


This “standard” breast lift technique uses donut shaped incisions around the areola’s perimeter, with the scar expected to lie precisely at the dark-light skin junction so it blends nicely to the “background.” Furthermore, vertical incisions between the nipple area and the submammary fold, and another one placed horizontally along the crease are created for additional lifting effect.


wise pattern breast lift

As a stand-alone procedure, the wise pattern breast lift is a powerful tool to reshape the saggy breasts, although it has no or very little effect on the fullness of the upper pole. Hence, some patients choose to have implants at the same time as their surgery.


Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently demonstrated breast lift surgery combined with implants on his Snapchat account, a combo procedure that further ensures a good breast shape.


The female patient shown in the video also had her areola reduced in size to achieve more proportionate results, before it was elevated about 5 cm from its previous saggy appearance.


Dr. Smiley also tightened and elevated the breast tissue with internal sutures, instead of relying solely on tightening the skin, which over time could relax and sag due to the effects of continuous aging and gravity.


Meanwhile, the patient has asked for a “double D” cup henceforth she required larger implants, which her body can accommodate because of her wide chest wall. Dr. Smiley says it is important to measure the pertinent anatomical features such as the chest and breast dimension during the implant selection process.


By using implants that the chest and breast dimension can accommodate, most known implant-related risks can be avoided, says Dr. Smiley.


The scars around the areola’s perimeter and along the submammary fold are well concealed; however, the vertical scar in the lower pole is in a more obvious location and thus concerns most women. For this reason, the celebrity plastic surgeon highlights the importance of meticulous wound closure.


In all his patients, he closes the dermis [deeper layer of the skin] and just allows the skin wound edges to kiss each other to ensure the best scar possible. To further reduce the amount of superficial tension and thus help the scars fade and blend nicely, he also uses tapes or steri-strips.

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The appearance of breast lift cleavage is one of the most pressing concerns of patients. While the surgery to some extent can provide additional upper pole fullness, the real issue is how long the “effect” can last.


It is important to note that breast lift primarily reshapes the lower pole of the breast, which is the area between the nipple and the submammary fold. Basically, it repositions the low-lying, downward pointing areola and tightens the breast tissue of the lower pole with the use of internal sutures.


breast lift cleavage


In standard technique, the resulting scars go around the areola’s border, vertically between the nipple area and the submammary fold, and parallel to the breast crease; hence, it resembles an inverted T or anchor, according to the California Surgical Institute website.


As a stand-alone procedure, the improvement in breast lift cleavage appearance is very minimal—i.e., the upper pole has a concave appearance while the lower pole has most of the volume. Simply put, the overall breast shape resembles a teardrop.


But a good number of breast lift patients want more fullness in the upper pole, which can be accomplished with a simultaneous breast augmentation via round implants, which in essence are like a flattened sphere. High profile implants are particularly ideal for women seeking fuller-looking upper cleavage because they “stick out” more from the chest wall.


It is important to use implants that reflect the underlying anatomies, particularly the breast and chest dimension, to prevent inadvertent implant displacement (going “south”), rippling, and palpability.


Meanwhile, implants that are too big for the anatomical dimension can spell disaster because patients seeking breast lift surgery have poor skin quality to begin with. For this reason, surgeons not just reshape the skin, which cannot support the new contour over time, but also the actual tissue by using internal sutures.


However, some women do not like the idea of using synthetic implants. For these patients, fat grafting or injection to their upper breast pole can be a good alternative. (Note: About 100 cc of purified fats are often enough to achieve fuller looking upper cleavage.)


Another possible alternative to implants is auto-augmentation technique in which some of the tissue in the lower breast pole is rotated and lifted higher with internal sutures to create additional fullness in the upper pole. This method only works for women with ample amount of breast tissue.


While repositioning the lower pole tissue, it remains attached to its blood supply (stalk) to prevent healing problems.

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