Peri-Areolar Breast Reduction: The Donut Lift Technique

Peri-areolar breast reduction, also known as the Benelli or donut technique, offers minimal visible scarring by placing all incisions around the areola border. For appropriate candidates, it provides breast reduction with scarring that's virtually hidden.

What is Peri-Areolar Breast Reduction?

The peri-areolar technique uses a circular incision around the areola—the darker skin surrounding the nipple. By limiting the incision to this natural border, scarring is camouflaged where skin color naturally transitions.

The Incision Pattern

"Donut" pattern: - An outer circle is marked on the skin around the areola - An inner circle at the areola border - The "donut" of skin between these circles is removed - The outer circle is brought in to meet the areola

This allows removal of breast tissue and skin while hiding all scarring at the areola border.

Ideal Candidates

Peri-areolar breast reduction is best for:

• Minor breast reductions - One cup size or less
• Mild to moderate ptosis (sagging)
• Good skin elasticity
• Women who prioritize minimal scarring
• Those needing areola size reduction as well

Not ideal for: - Large reductions requiring significant tissue removal - Significant sagging requiring extensive skin removal - Poor skin elasticity - Women with very large areolas requiring major reduction

Advantages of Peri-Areolar Technique

Hidden Scarring

The primary advantage is scar concealment: - Scar follows the natural areola border - Color transition disguises incision line - No visible scarring in breast skin - Virtually invisible once healed

Areola Size Reduction

The technique naturally reduces areola size: - Common concern addressed simultaneously - Creates more proportionate areola-to-breast ratio - Part of the "donut" removed includes outer areola

Combined with Pedicle Techniques

Often combined with inferior pedicle method: - Maintains blood supply and nerves - Preserves nipple sensation - Protects breastfeeding ability - Provides comprehensive reduction with minimal scarring

Avoids "Bottomed Out" Look

Some reduction techniques can create a hollow or bottomed-out appearance. The peri-areolar method typically avoids this issue.

Limitations to Consider

Limited Reduction Possible

The technique only allows for modest reduction: - Larger reductions require additional incisions - Significant size changes need lollipop or anchor patterns - Primarily for minor adjustments

Potential for Flat Nipple Projection

In some cases, the technique can flatten nipple projection. Experienced surgeons work to preserve natural projection.

Areola Spreading

If too much tension is placed on the closure, the areola can spread over time. Modern techniques minimize this risk.

Skin Gathering

As the outer skin is "cinched" to meet the smaller areola, some temporary skin gathering may occur. This typically smooths over time.

What to Expect

During Surgery

• General anesthesia or local with sedation
• 1.5-2.5 hour procedure time
• Donut of skin/tissue removed
• Areola and nipple repositioned slightly higher
• Special closure techniques to prevent spreading

Recovery

• Days 1-3: Mild discomfort, swelling
• Week 1: Most return to desk work
• Weeks 2-4: Normal activities resume
• Months 3-6: Final shape visible

Results

• Immediate improvement in position and size
• Scar fades at areola border over 6-12 months
• Long-lasting results with proper tissue support

Comparing Techniques

Combining with Other Procedures

Peri-areolar reduction pairs well with:

• Breast augmentation - Minor reduction with implant placement
• Liposuction - Addressing fatty tissue around breasts
• Body contouring - Overall upper body sculpting

Is Peri-Areolar Right for You?

Consider this technique if:

1. You need only minor size reduction 2. Minimal scarring is a high priority 3. You have good skin elasticity 4. Your surgeon confirms you're a candidate

The best approach is consulting with a surgeon experienced in multiple techniques who can honestly assess whether the peri-areolar method will achieve your goals or if another technique would provide better results.