my plastic surgeon wants to make a short, small incision underneath my breasts and I wanted to eliminate this extra scar and just do the short scar vertical technique lollipop scar. I am 5 ft 4 in. weigh 150 lbs and 39 years old. My skin elasticity is good. He says the cut underneath my breast will eliminate "dog ears" from the vertical incisions? Is this correct?
Am I a good candidate for the short scar vertical technique lollipop scar? I am a 36DD and want to be a 36 full C
Doctor Answers (13)
Candidate for vertical breast reduction
Hi, thanks for posting your pictures and telling us your story. The question that you ask whether or not you are a good candidate for a vertical breast reduction is only half of the question. The other question is "Does my plastic surgeon perform vertical breast reduction" The majority of US trained plastic surgeons have been trained on "Wise" pattern inferior pedicled breast reductions. Vertical reductions are popular in South America and Europe. From a technical and anantomic standpoint, you are a good candidate for a vertical reduction. Is the short T scar harmful; absolutely not. The additional horizontal excision eliminates the extra tissue that the vertical gathers which takes a few months to smooth out. Either technique will leave you with smaller and perkier breasts and hopefully relief of any neck, back and shoulder pain associated with having large breasts.
Short Scar Reduction Mammoplasty great procedure for most
I agree with your plastic surgeons advise that for you the the minimal Incision Breast Reduction/Breast Lift would be a Great Procedure for you.
The minimal incision Breast Reduction surgery using a “vertical” or “lollipop” scar technique. This method has been used in Brazil and France for many years but is performed by a minority of Plastic Surgeons in this country. The benefits include: approximately fifty percent less scarring, a narrower breast, better forward projection and shape, longer lasting improvement, shorter surgery time and less complications. In general, I have stopped using the older traditional “anchor” or inverted “T” incisions as these provide inferior results. The procedure is done under general anesthesia on an out-patient basis or in the hospital it there are additional medical conditions.
Breast Reduction Technique
Thank you for the question and pictures.
I think you will have a very nice breast reduction results, with the results depending more on the surgeon's skill than on the specific procedure/technique performed. It may behoove you to seek consultation with several well experienced board-certified plastic surgeons. Do your due diligence and see their patients in person or with the help of before and after pictures.
I hope this helps.
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You will do very well with a vertical lift
You will have a very nice result with a vertical breast lift. There is about a 1 in 20 chance that you might need a dog ear correction six months after your initial lift. Even if you do, the breast shape will be much better than if you have an inverted T lift. Good luck!
After 12 years of only Vertical lifts I reconsidered
The very young patients are the ones I try very hard to avoid the small horizontal scar.This is for two reasons, they scar much stronger (hypertrophic) and their excellent skin elasticity allows the bottom of the breast (the "dogear") to re-model in a reasonable time. After looking at my results objectively for the rest of the patients that require a significant elevation in nipple/areolar position, I feel I can give them a more beautiful and long lasting result. My advice is take the short scar.. if not you will probably want it later..
Short Scar Breast Reduction
Your plastic surgeon is correct when he or she states that the dog ear will be eliminated with a short horizontal incision but the the beauty of the short scar technique is that the dog ear retracts into the crease of the breast. You must allow time for this to occur but it does. I believe that you are a reasonable candidate but I recommend a complete exam by a board certified plastic surgeon.
Candidate for Vertical Lift
I do most of my cases using the LeJour, or vertical lift technique. The main limitation of the technique is the removal of large amounts of tissue for the reduction. Because you want to still be full, you are a good candidate for the technique.
"Dog ears" do happen with the vertical technique, but mainly when we have lots of excess skin left over from doing a big reduction, or in weight loss patients with very lax skin.
I dont see you as being a big risk for this, and these skin excesses can usually be dealt with at the time of surgery easily, or 3-6 months later as a minor office procedure.
A few of my patients in the link below share your size and shape.
As you can see, surgeons have differing opinions about the merits or detractions of either the purely vertical mastopexy or the anchor scar mastopexy. The benefit of a vertical mastopexy/reduction is that it eliminates the inframammary scar. Problems include poorly repositioned nipple (usually too low, but also too high), long vertical scar, wide areola, less than desirable scar appearance, and breast drop out. The benefit of the anchor scar mastopexy/reduction is finer scaring and more reliable breast shape. Problems include the inclusion of an inframammary scar, dog ears of the inframammary scar at it's outer ends, and breast drop out.
My experience with both has been substantial and seems to mirror the experience of most seasoned breast surgeons in this country: the anchor scar mastopexy/reduction, or a modified short inframammary anchor scar mastopexy/reduction is more reliable in creating a beautiful breast mound with fine scars.
You have fairly large and ptotic breasts making you a great candidate for a short inframammary anchor scar reduction. Choosing a purely vertical reduction will push the surgeon's ability to keep the vertical scar short, usually requiring a 'j' or 'l' extension to the scar' which is in reality forming half of the inframammary scar. You should look at pictures on surgeon's websites and see there results. You should also choose a breast specialist who is certified by the American Board of Plastic Surgery, and who is also likely a member of the American Society for Aesthetic Plastic Surgery.
Best of luck!
Vertical, short scar vs "T" incision breast lift
Thank you for the photos. You are an excellent candidate for a vertical or lollipop breast lift. As I said it before,one man's vertical lift is not the same as another's. I've been doing vertical lifts and reductions for over a decade with excellent results. I've done the anchor or T incision for ten years prior to this. People who continue to just do the anchor scar will tell you that the horizontal scar will stay in the breast crease and no one will see it. Wrong! There is a reason why you do not see photos of women with the arms elevated or at times a true side view, just to avoid showing the scars. The T incision breast reduction/lift makes the vertical scar 4.5-5cm long (unnaturally short), makes the breasts look more boxy (due to the short incision the breast tissue is forced medially and laterally) and the breasts tend to travel south and the horizontal incision to the north with time. With the vertical lift, the breast crease actually rises. The repairs that other surgeons are doing on the vertical lift patients is the result of poor surgery and poor understanding of the surgical concepts relating to this operation.
Crease incision allows better skin tailoring!
Vertical lifts are "all the rage" now that more and more surgeons have begun to learn these techniques of partial or modified breast lifting. The problem with this and other "newer" procedures is that surgeons become enamored with the "pros" of such less-scar procedures, and try to apply these techniques to more and more patients, some of whom may not be appropriate for short-scar or no-crease scar techniques.
(It's the old "I've got this new hammer, and everything suddenly becomes a nail!" attitude.)
Remember that while vertical lifts are perfectly good operations for some patients, they do NOT fill the bill for all situations, particularly since skin tailoring in one dimension only can be achieved with vertical lifts or lollipop lifts.
Skin tailoring in two dimensions (horizontal AND vertical) requires the addition of another scar in the perpendicular direction from the vertical scar--hence, the short or long crease scar. The length of the crease scar essentially determines the degree of skin tailoring medially and laterally, and making this too short makes the center of the breast axis short, whereas medially and laterally the excess skin sags (still), so the breast looks flattened on the bottom, or boxy in shape. Over time this softens and stretches to round out a bit, but here again is a limitation that either is acceptable or not. (Often not, and re-do surgery is the only solution)
If someone offered you a "no-scar" lift would you think it is a good idea? Or would you understand it for the "baloney" it truly is? If you need skin tailoring in more than one dimension, you should understand that "avoiding scars" may in fact be "adding residual laxity" and the need for a revision later to "fix" the inadequately-treated loose skin. This is NOT baloney, but is a question of judgment, not one of skill in execution of a specific technique (though that too plays a role).
In short, I would suggest that you not try to "fit" a desired technique to the surgeon's recommendations or even allow this to influence your choice of surgeon. Rather, your surgeon (if experienced and ABPS-certified) has the training, expertise, and numerous similar patients from which he or she has gained significant knowledge you do not possess. Follow your surgeon's advice. Those who would advocate a vertical lift only should be willing to show you numerous patients with similar anatomy for whom this proved to be an adequate choice, and provide information about the cost of additional surgery (and how often it occurs) for "the minority" of cases in which an additional scar later proved to be necessary!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.