Surgeons will tell you they have some magical suture spell where the donut lift won't stretch. You're absolutely wrong. Even with Gore-Tex sutures, they still stretch — I fish them out of patients all the time when I revise failed lifts. The bigger-scar lift is what actually does the job.
A question came in: "When is it advisable to do a donut lift?"
My honest answer: Never. I would never do this procedure again if I didn't have to.
That probably sounds harsh, so let me explain why I feel so strongly about the donut lift (and its cousin, the crescent lift) — and why, even though nobody wants the bigger scars, the traditional breast lift is usually the right answer.
A donut lift (also called a Benelli lift or periareolar lift) is a breast lift where we make an incision in a circle around the areola and remove a ring of skin, then cinch the remaining skin back together.
On paper, it sounds appealing:
The studies say it can be used for patients with mild-to-moderate ptosis whose nipple needs to be moved 3 cm or less.
Here's the problem: in reality, it just doesn't hold up.
The donut/Benelli lift has the highest revision rate of the lift techniques. That's a big deal, because the whole point of a breast lift is to get a lasting, improved shape.
When you do a breast lift, you're making a deliberate trade:
You're trading a scar for an improved shape — and you want that improved shape to last and look good.
The Benelli lift frequently fails to deliver on the lasting part. So you've accepted the scar (even if it's a smaller one) and you don't get the durable result you were promised. That's the worst of both worlds.
The other major issue: the areola spreads. No matter what you sew it with.
When you cinch skin around the areola, there's constant tension pulling outward on that closure. Over time:
Some surgeons will tell you they have a special suture technique — some magical combination of stitches that prevents the areola from spreading.
They're wrong. Even with Gore-Tex sutures, they still stretch.
I know this firsthand because I fish those Gore-Tex sutures out of patients all the time when I'm revising failed Benelli lifts. The permanent suture is still there, intact — but the areola spread around it anyway. There is no suture spell that defeats the fundamental tension problem of this technique.
To be fair, there's one narrow scenario where I'll consider this approach:
Tuberous breast patients who are NOT droopy and just need an areola reduction.
In tuberous breast deformity, patients often have a large, herniated areola but aren't actually ptotic. For those patients, a periareolar approach to reduce the areola can make sense.
But even in that population, it's problematic — the areola frequently spreads regardless of what I sew it with. So even where it's most justified, I'm cautious about it.
While I'm at it, let me add another lift I dislike: the crescent lift.
For patients who need just a tiny bit of lift, a crescent lift involves:
It sounds like a clever minimal-scar solution. I hate it too.
Even if a crescent lift looks great right after surgery, the areola always stretches into a weird oval shape over time. The asymmetric tension (pulling up on just the top) distorts the areola into a shape that doesn't look natural.
This is the part that really bothers me, because it has long-term consequences beyond the immediate result.
The crescent lift destroys your superior pedicle — the blood supply that comes from above the nipple. This matters enormously if you ever need a revision to a different type of lift later, especially if you put an implant in:
So a crescent lift doesn't just give a mediocre result — it can paint you into a corner for future surgery. That's a high price for a tiny lift.
I know what patients want to hear: "You can lift my breasts with minimal scarring." And I understand the appeal — nobody wants the bigger scars of a traditional lift.
But here's the honest truth:
A breast lift is a great procedure, and the bigger scars are simply what does the job.
To genuinely move tissue in the way we need to — to create that higher, perkier breast shape that lasts — you need the appropriate incisions. The common lift patterns:
Yes, these involve more scarring than a donut or crescent lift. But they:
The scars fade significantly over time and are usually well-hidden in clothing and swimwear. And critically, the shape improvement is durable — which is the entire point of doing the lift in the first place.
Here's how I frame it for patients:
| Lift Type | Scarring | Durability | Areola Distortion | Future Surgery |
|---|---|---|---|---|
| Donut/Benelli | Minimal (periareolar) | Poor — highest revision rate | High — spreads | Limited |
| Crescent | Minimal (top of areola) | Poor | High — ovals out | Destroys superior pedicle |
| Lollipop (vertical) | Moderate | Good | Low | Preserved |
| Anchor (inverted-T) | More | Best for significant ptosis | Low | Preserved |
The minimal-scar lifts look better on paper because of the scar. But when you factor in durability, areola appearance, and future flexibility, the traditional lifts win decisively for most patients.
If a surgeon is recommending a donut or crescent lift:
If a surgeon is promising you a minimal-scar lift with a lasting result and a "special suture" that prevents spreading — be skeptical. The physics of tension on a periareolar closure don't care about anyone's suture preferences.
I genuinely don't like the donut lift (Benelli) or the crescent lift, and I avoid both whenever possible:
A breast lift is a wonderful procedure, but the bigger scars are what actually do the job. To move tissue into a higher, perkier, lasting shape, you need the proper incisions. The scars fade, the shape endures, and you keep your options open for the future.
Nobody wants the scars. But for a result that actually lasts and looks good, they're the trade worth making.