Severe Drooping

Droopy Breasts Corrected by the Benelli Mastopexy Procedure

Although breast implants and breast enlargement with fat breast transfer can give some lift to  saggy breasts, they will not compensate for droopiness beyond about 1 inch.  For droopiness beyond 1 inch, a breast lift procedure is required.

Case 1: The Benelli Mastopexy. In this case, a Benelli breast lift (mastopexy ) was performed as part of a mommy makeover. A mommy makeover is a procedure that combines breast enhancement surgery, such as breast lift or breast augmentation, with a tummy tuck and liposuction of the abdomen.

In this breast lift procedure, the patient did not want any breast implants and desired a smaller breast size. Whenever a breast lift procedure is performed without implants -it is also a breast reduction procedure. Notice that when breast lift surgery is used alone, the final breast size is reduced by ½-1 cup size from the original. Here the final breast size was reduced from a DD to D cup. When a Benelli breast lift procedure is performed without implants, it is sometimes necessary to make a vertical incision down the midline of both breasts to remove the excess skin-as was the case here.

Case 2: The Benelli breast lift with saline breast implants. This patient had a Benelli periareolar breast lift with saline implants. This patient did not want to be smaller than DD, so saline breast implants were used to balance the volume loss from the breast lift procedure. Since the breast volume was not changed from its original DD size, this combination of Benelli breast lift with saline breast implants is properly called breast enhancement surgery-rather than breast augmentation. When there is breast lift without breast enlargement or breast reduction, it is called breast enhancement surgery.



Case 3: There the mommy makeover is combined with a Benelli breast lift and silicone breast implant, which gives a final cup size that is larger than the original cup size. The patient’s original cup size was D, her desired final cup size was DD. When a breast lift procedure is combined with breast implants which result in breast enlargement, this is called breast lift with augmentation-rather than breast enhancement.

Notice that when using an implant with a Benelli lift, it is often possible to avoid the vertical breast was seen in case 1 above.

Also, notice that in a Benelli breast lift, there is always a circular cookie-cutter incision around the areola (nipple). However when this circular incision is placed within the-colored portion of the areo la, as opposed to the outer border of the areola, it is easy to camouflage.


Compare the final result of the cases 1-3. In cases 1-2, the patients started out as DD before the breast lift procedure.

  • In case 1, no implant was used, which resulted in a reduction from DD to D cup. Thus case 1 was breast lift surgery with breast reduction. Since it was combined with a tummy tuck, it is a mommy makeover with a Benelli breast lift procedure.
  • In case 2, a saline implant was used to maintain the original breast size-this is properly called breast enhancement, not breast reduction. The saline implants , balance the volume loss from the breast lift procedure. Also notice how the Benelli breast lift was used to make the areola smaller-while simultaneously lifting it up by 1.5 inches.
  • In case 3, a Benelli breast lift procedure was combined with a silicone implant to create a larger breast volume band before. Since this procedure was performed with tummy tuck and liposuction, this is called a mommy makeover with a Benelli breast lift and breast augmentation with silicone implants.


Droopy Breasts Corrected by the Inferior Pedicle Mastopexy

Case 4: The Inferior Pedicle Mastopexy.  In this case, most of the breast is below the inferior mammary line. The ptosis (drooping) here cannot be overcome with an implant and/or Benelli mastopexy procedure. An inferior pedicle mastopexy is required.

With this technique, a pie-shaped wedge of breast tissue around the areola is cut and lifted up. The pie-slice can be large or small. The larger the pie slice, the larger the breast tissue to be kept. Since the left breast is larger, a smaller pie slice needs to be taken on the left than the right. The remaining breast tissue (which is below the inferior mammary line) is removed.

For patients who suffer from upper back pain (from large breasts) very small slices are kept-resulting in B-cup breasts.

There is a limit to how much breast tissue can be kept. Most of the breast tissue below the inferior mammary line will have to go. Ordinarily, this would result in a smaller breast (C cup). However, since the patient wanted to be a D cup, an implant was also used to replace the breast tissue removed.

When we use implants with inferior pedicle lifts, we like to place the implant below the muscle.