 Hi everyone, Dr. Saul here in Beverly Hills. We talked to you guys last weekend and we asked what were the topics you guys wanted to discuss. One of them came up as breast lift, specifically the Benelli breast lift. So let's go over a talk I prepared for you guys over the breast lifts. So Benelli breast lift. Why would you need a breast lift? Aging is one, genetics, pregnancy and weight loss. All of these what they have in common is that as you get older, your skin becomes thinner. Some people have genetic thinning skin, white skin, pregnancy. With pregnancy, your breasts enlarge, then involute, they get large, they involute. So the skin, another skin issue, weight loss, another skin issue. So most of them have with two things. Remember, breasts are not just fat, but it's a skin and fat. So you were working with two components. What does it address? Drooping breast. So if you have a breast or sagging, mild to severe, uneven breast, downward facing of the nipples. It's very important where the nipples are. You could see if they're straight ahead, looking down where the nipples are is very important. You don't want them too high either because when the nipples are too high, they might come out of your dresses or when you're wearing a bikini, you might see the top of the areola. So the positioning of the nipple is very important. And the other nipples that extend past the breast crease, that means how low they are if they're down low. So here's the degree of ptosis. Ptosis means how they fall down. Normally, this is your fold right there. That's your breast cleavage. I'm sorry, not cleavage, your inframamory fold. The nipple is supposed to be above it just right here. You see that. Okay, type one mild sagging, the nipple comes even with the fold. Type two, the nipple is below the fold. There is the nipple. Type three, it's pointing down to the ground. And lower breast sagging, you could see this is the breast tissue sagging now. And then the mouth position of the breast tissue can cause that. So there's four different kinds of breast lifts. This is just a little bit of where the nipple position is in relation to the mammary fold. So one of them is the wise pattern. This is the all time most used probably is the wise pattern. But a lot of people don't like it is because it has two scars. It has a vertical component and a horizontal component. You could see it looks like a origami where the skin is taken out and then it's all put together. The other one which became famous in the early 2000s is the vertical. The vertical takes out only a vertical, no horizontal aspect. It pulls the nipple up and it then brings in the breast tissue from the sides to give it that cone shape. The one you guys asked for the Benelli. The Benelli is also referred to as the donut. What it is is that a circle is made around and the skin is brought in like a purse string. And then if you have very mild ptosis or unevenness of the breast, we could always use the crescent which is like a crescent moon which a little crescent shape skin is removed to just lift up the nipple. So the scars you're left with, the Benelli, it's a scar around the areola. So that's why a lot of people say scarless breast lift is because it hides it between the dark and the light. The lollipop is a circle and it goes down. The anchor is the one that goes around. It has a vertical and a horizontal. And then the crescent which is just as I said, it's like a it's a crescent and it's and it's brought together so it's just the line on the top. So what kind of tissue is removed with each one? With the Benelli, as I said, it's a circle and it depends where your nipple position is. If you have a sagging ptosis three or four, a Benelli is absolutely the wrong surgery. You have to have minimal upward motion to use the Benelli. It's usually, I say, maybe one, two, three centimeters max. The vertical scar, you can move it up further. You can, because you're also taking skin in the lower pole, you can move it up higher. The inverted T is the one that you can really utilize in almost any case. Because remember, not only are you taking out skin in the vertical, but in the horizontal. A breast, the way a breast is shaped, if it's hanging low and you're just taking vertical aspect, what's going to happen to all the horizontal aspect? So going back to the request of the Benelli, so you can see how the Benelli works. This is your areola and your nipple. So we go and make a cut around. We dissect all around it. And then what we do is we do a per strength suture. It goes in, comes in, takes a little bit of the areola out in, out in, out in. We go continuously like this. And then we pull it up together. Like a lot of ladies have those per strength purses where they pull the string and the top closes. So this is the same thing. You pull the string and all this comes together. So what's the problem with the Benelli? Again, just to go again, periareola, lollipop and the anchor. This is the problem with the Benelli donut lift. If it's utilized in the wrong way, this patient came to see me. She has no implants. She wanted a minimally scar breast procedure. So what did she have? She had a donut lift. You can see the scar is all around here. You can see all around. She has a scar. So what happened over time is her areola, the doctor didn't make it this big. The areola was smaller. But over only over a few years, because of tension, that it's stretched. And because this skin is thinner than the rest of the breast, it made the areola almost the size of a saucer. Look at that. So what did we do? We did a traditional tea lift or inverted tea lift is there's a scar around here. There's a scar down and one in the fold. You could see the difference. And this is with an implant. And I've seen this patient recently and it's lasted her surgery seven years, eight years, and she's still going strong. You could see even in an African American skin, the scar is the vertical scar usually heals for some reason, it heals really well. And the horizontal aspect, if placed correctly, it's totally in the fold. Here's another on the lateral position. So you could see the nipple is moved up higher where it should be right here. And you could see again, I want you guys to see the scar. There's a scar going down and a scar going across. But it looks better than this. You could see even on the lateral, the left breast, look at the shape of the breast, look at how it's beautifully shaped. The scar after a few months, the scar lands right in the fold. Remember, for this case, it takes about nine to 12 months to see the final result. So eight things you should know about breast lift. One, breast lift will not increase the size of your breast, unless you do it with an implant or with fat transfer. Number two, your breast will look bigger for a few weeks. Yes, every surgery we do, there's always inflammation, rhinoplasty, facelift, BBL, everything has a duration of inflammation before you see the final result. You need to wear a comfortable bra after surgery, but one that also supports your breast. Remember, your skin is not that strong to support everything. So you need it for about six, six months. I would say a very strong bra to hold everything up to your wound strength is up to 80%. You need to stop exercising for about a few weeks. I would say usually I tell my patients four weeks of no strain use exercise. Smoking and alcohols are no-no's before surgery. You can't sleep on your belly. You can sleep on your side or on your back. Make sure you're eating healthy and there's always some scar associated with the breast lift. Again, if you have a breast, you have hollowness up top, the nipple is low. It depends to your surgeon. If you do an augmentation, it doesn't lift the breast. Remember, when you're adding weight to something, it doesn't lift it up. It even brings it down over time with gravity. The implants aren't made out of helium, so they don't lift it up. It might rotate the nipple, but it does not give you a lift. Here it is. Here's a lift with a lift. You are lacking the upper fullness because it doesn't, you can't mobilize the tissue all the way in the upper fullness. But if you want, if it depends as you see your surgeon, you know, you might need a procedure which is an augmentation which will give you fullness and a lift which is called the mastopexy for the positioning of the nipple. The positioning of the nipple is very important. It rejuvenates the breast. Even if you have a large implant, but the nipple is low, it looks like an older breast. But if you have a bigger breast and the nipple is higher, it's a rejuvenated breast. Thank you very much. Stay tuned for our next lessons.