Concentric Mastopexy Techniques

Concentric mastopexy techniques are breast lift procedures used in cosmetic surgery. The Benelli lift, and the Goes periareolar, named after surgeons, and the purse-string breast lift, named after a suturing variation—have the same basic technique: two concentric circular incisions; removal of the doughnut-shaped skin; then re-suturing the edges back to the nipple. The objective of all concentric mastopexy techniques is to restore the lift, shape and projection of the breast, with a minimum amount of scarring and no loss of nipple sensation.

Standard Concentric Mastopexy

• Sometimes called the "doughnut mastopexy," this technique is most often used on females with smaller breasts and mild breast drooping. Its name is derived from the doughnut-shaped skin that is surgically incised from the areola (darker circle of skin around the nipple) of the breast.

  Once this skin is removed, the nipple and areola can be moved up and sutured to a higher position on the breast. Sometimes this repositioned skin is excessive and will wrinkle or crumple up. If it does not smooth out in time, and the resulting texture is undesirable, the surgeon may suggest an additional procedure.

  An incision is made from the areola going back under the breast to the crease. Then, an excess strip of skin is removed, the two sides pulled back together and re-sutured. This typically removes most of the wrinkles and restores the original skin texture.

  Even with this additional incision, if it's needed, the concentric mastopexy technique results in fewer incisions and less scarring than the more common "anchor-shaped" and other non-concentric mastopexy procedures.

Benelli Lift

• This procedure starts off the same way: a doughnut-shaped circle of skin around the areola is removed, and the edges are re-sutured back in place. But to reduce the tension that results from pulling the shortened skin taut, causing the breast skin to stretch again, Benelli uses a series of "purse-string" sutures that are woven into dermal flaps, reinforcing the reattachment of the nipple, thereby reducing the amount of stretching.

  This does have the advantage of limiting the amount of visible scarring to the area around the nipple, but sometimes there are drawbacks: a wider areola, a more flattened breast contour and the appearance of stretch marks.

Goes Mastopexy Variation

• It's the same basic concentric mastopexy technique, except that after the incisions are made and the operation is ready for closure, a mesh is used to preserve skin around the areola and increase its adherence to the breast flap.

  The skin edges are then pulled together with "purse-string" sutures, causing the tension to be placed on the stronger breast flap instead of on the weaker areola area, as it is with other techniques.

  The advantage is that the areola, sitting atop a strong, mesh-enforced dermal bed, is allowed to heal distortion free, with no tension placed on it. This eliminates many imperfections and texture deformities to the areola area that are consistent with other concentric mastopexy techniques.