Breast Lift, Mastopexy: Reducing surgical scars with a breast lift procedure

A breast lift corrects the following anatomic characteristics of the breast: Nipple position Skin redundancy Breast projection The standard and effective technique to lift the breast is known as a Wise pattern mastopexy, which creates a scar along the inframammary crease and from the IMF to the areola. There is also a scar around the areola.

Another, more recent, technique is known as a Short scar or Vertical mastopexy, which does not create a scar along the inframammary fold. The scar is shorter and provides adequate projection to the breast after surgery.

There are many different types of breast lifts available.  These range from around the areola lifts, to short scar / LeJour / lollipop lifts, to limited incision "T" incisions to conventional "T" incisions.  In general, the more the incisions, the greater the lift that is possible in the breasts.  When a great deal of saggy skin is present, larger lifts are necessary.

There is some evidence internal elevation and fixation of breast tissue may also help with the conduct of the lift over the long term.

Some patients have a periareolar or "Benelli" lift, with an incision just around the areola, in hopes of avoid the incisions of a conventional Wise pattern lift.  When a large breast lift is attempted through such an incision, characteristic problems can occur, with gathering of the incision, decreased areolar circulation (some patients can actually have nipple death), and large resultant nipple-areolar complexes.  It is in my opinion a mistake to attempt too great a lift through too small an incision.  We have redone many Benelli lifts to Wise patterns and have much more satisfied patients, with much less apparent scarring (even though the actual incisions are longer).

The patient should discuss with their surgeon whether the size is appropriate or needs to be increased or decreased.  They can then have a discussion of simultaneous breast implants / reduction, depending on the patient's needs.

For this reason, it is best to select the lift which will give the desired shape safely to the breast, then decide if the tradeoff (incisions) is worth it.  In the great majority of patients, it is.

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