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Can One Avoid a Vertical Scar in a Breast Augmentation?

asked 2 years ago by mum_88 in UK
Latest answer by David Finkle, MD
Question viewed 1,413 times
Tags: breasts, nipples, female, droopy, sagging, scar

I'm interested in Breast Augmentation to replace lost volume after breast feeding. I was told that I need a Mastopexy with anchor scar to achieve a good shape.

However, I'm not concerned with the current droopiness or nipple position and was hoping an implant might slightly improve feeling of fullness. The idea of the vertical scar really freaks me out and I'm wondering if I could get away with just a rounded implant if I am willing to deal with a bit of sagginess out of a bra or if the added weight would lead to an unacceptable degree of sagginess.

24 answers to Can One Avoid a Vertical Scar in a Breast Augmentation?

Avoiding a breast lift during breast augmention

Your best bet may be to have a breast augmentation to the size you need, then reassess if a lift is needed. This approach requires patience on the part of the patient. As many esteemed colleagues have pointed out, you are a bit of a borderline case. While staged surgeries might obligate you to a second surgery, it may also avoid a breast lift, and is unquestionably a safer route.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Freaking over a Vertical Scar in a Breast Augmentation Lift

In Plastic Surgery as in life, for each situation, our world is FULL of choices and options but only one or a few are really the best ones. Your breasts are deficient in 2 correctable ways - they are empty - and would benefit from more VOLUME (BREAST AUGMENTATION) - they are sagging - and would benefit from a BREAST LIFT (MASTOPEXY) Adding volume (placing an implant) will minimally lift the breast, if at all. Placing a VERY large implant in an attempt to bring about a "scar-less... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Avoid the vertical scar

You would be a very good candidate for an implant procedure without a lift (mastopexy). I would recommend placing the implant on top of the muscle to give you some lift and also I would choose silicone, it is more natural feeling when placing on top of the muscle. With Warm Personal Regards, David R Finkle, MD

David Finkle, MD
Omaha Plastic Surgeon

Beast Implants in slightly saggy breasts

While a breast implant alone will not lift your breast, it will give it an optical illusion of a lift in that there will be a greater degree of roundedness above the nipple to more closely match the tissue below the nipple. In your case where your level of sagging is a 3 out of 4 in terms of severity, the implants would need to be placed above the muscle. If you are willing to accept that the location of your breasts on your ribcage will not change and are willing to be happy with just a... more

Julio Garcia, MD
Las Vegas Plastic Surgeon

Although you may need a mastopexy to achieve the look you ultimately desire, a breast

Augmentation alone would significantly improve the appearance of your breasts. In particular, if you had gel implants placed under the rbeasts but above the muscle, you would be able to achieve a small amountof lift, and might be happy with the fullness in your breasts as well as the size. Just be aware that if you find that there is still too much droopiness in the breasts, you would then benefit from a second procedure to lift the breasts. If you are truly comfortable... more

Michael H. Rosenberg, MD
White Plains Plastic Surgeon

plasticsurgeryweb.com

May avoid a lift with implants alone and get an excellent result

An experienced surgeron should be able to give you an excellent result with implants alone, judging from the pictures you sent, as long as the size you desire will aloow for a large enough implant to fill your skin envelope.

W. Tracy Hankins, MD
Las Vegas Plastic Surgeon

Saggy Breasts and Breast Augmentation

Ptosis refers to truly saggy breasts. In this case the nipple is lower than the breast fold. Unless it is minor, it generally requires a breast lift to raise the nipples to the correct position. Glandular pseudoptosis refers to a situation where the nipples are set at the appropriate level of the breast fold, but skin and/or breast tissue lie beneath the fold. In this case, implant alone, or implant with minor lower skin excision will correct the condition. Based on your single photo... more

Karen Vaniver, MD
Seattle Plastic Surgeon

Avoiding Mastopexy Scars

From the single photo you have included, it seems that you would fall more into the category of pseudo-ptosis, as your nipples seem to be just at or slightly above the projection of your inframammary fold (where the breast meets the chest wall). I suspect you might be perfectly happy with just an augmentation. You can always decide on a lift later if you still feel the need.

Verne Weisberg, MD
Portland Plastic Surgeon

Breast augmentation with small amount of droop

Based on your photo, it looks like you have a fairly mild amount of droop. While you may not get a picture-perfect result with just implants alone, you may wish to consider having a peri-areolar breast lift done. This will help raise the nipple/areolar position by about 1 to 1.5 inches, and involves a scar around the outside of the areolar area, but not a vertical scar. I've used this combination frequently, and it can work very well.

Thomas Fiala, MD
Altamonte Springs Plastic Surgeon

www.plasticsurgeryinflorida.com

Breast augmentation with or without a lift

Mothers may find that pregnancy and breastfeeding contribute to loss of volume and firmness. If you're looking for perkiness, you'll need a lift--or, if you also want more volume, a lift and implants. A breast lift raises droopy breasts from one to several inches and excess skin is removed. If you just want to go bigger, the only way to do that is with implants. You can get an improvement in your shape and contour with breast augmentation as long as you don’t mind being a bigger... more

Michelle Copeland, MD, DMD
New York Plastic Surgeon

Vertical scar can be avoided with breast augmentation

Breast augmentation does not require any breast scar. If you are willing to accept a small amount of natural sagging, then I would recommend a Transaxillary Breast Augmentation with around saline filled implant. This will correct the volume loss with out any breast scar. Either at the same setting or at a later date, you could have a limited lift with a cresent mastopexy. The trade off however would be a scar along the upper edge of the pigmented areolar skin. I have had many patients... more

Steven L. Ringler, MD
Grand Rapids Plastic Surgeon

www.stevenringlermd.com

Vertical scar is not always need with a breast augmentation

Based on your picture, you appear to have two problems: 1) lack of breast volume 2) some breast sagging. The first problem can be addressed with a breast augmentation. This will reestablish the fullness you are lacking. The second problem is a little trickier. The ideal position of a womans nipple/ areola is in the center of the breast mound. Based on your picture, you nipple/ areola will likely be below this ideal position. To correct this problem you will likely require a lift. The... more

David A. Robinson, MD
Munster Plastic Surgeon

Breast scars

I would weigh in with the doctor. The implant will need to be placed in an aesthetic position which will be much higher than the breast. The breast tissue will flagg off of the implant and give a double bubble appearance. It will not look good, and will be worse than a mastopexy scar. My advice is to forget about implants if you can not accept mastopexy scars. You will be wasting money to make an unaesthetic breast.

Scott E. Kasden, MD
Dallas Plastic Surgeon

Can avoid vertical scar in all breast augmentations and in many breast lifts.

Hi. You can have just breast implants, going by your picture, and these are put in through a very short scar under the breast. Or you can combine implants with a breast lift that only leaves a round scar around the nipples. For severe sagging, we use a lollipop scar, but nobody needs an anchor scar for a breast lift.

George J. Beraka, MD
Manhattan Plastic Surgeon

Avoiding the vertical scar in Breast surgery.

Hi there- In cases like yours, where the nipple is still facing forward, but the breast tissue has sagged a bit behind it, I have had excellent results using a modified lifting technique approached only through the fold under the breasts, depending on your goals for shape and size. Discuss options with your surgeon and proceed with the option he/she and you are most comfortable with- remembering that the shape of the breasts is THE most important thing... In other words, if your breasts have a f more

Armando Soto, MD
Orlando Plastic Surgeon

Separate procedures may be your answer

When I have patients that are not convinced they want to do a lift I will offer them the option of doing separate procedures. I agree with the other surgeons that have posted on your question but you might want to do the augmentation, let things settle and then see if you want to do the lift. You have not lost any options by waiting to see how you look and feel after the augmentation. This might be your best way to proceed. Best Wishes Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Mastopexy with breast augmentation, or not

The key issues with mastopexy or breast lift are nipple position relative to the fold under the breast, and the acceptability of the scar pattern needed for a appropriate lift. Breast lift is generally performed with a scar around the nipple, a periareolar or round block mastopexy, for modest droop of the nipple below the fold, and a vertical pattern or lollipop scar if the droop is larger than three centimeters. If the nipple is at the fold or above you may consider augmentation alone, and... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Avoiding a bad scar with a periareolar mastopexy augmentation

You might really consider a periareolar lift as it allows the implant to be inserted and generally has very little scar and gives some lift. It can always be converted later into a full lift if the time comes when you need that. I have many examples on RealSelf so you can check the photos.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Avoiding Vertical Scar in Mastopexy

It is now very rare that an anchor incision is needed for a breast lift. A periareolar and single vertical scar, the so called “lollipop scar, is the most common. There are, however, other ways to handle the problem of droop. By just placing an implant, you will obtain some lift. Depending on how much droop you have and how large an implant you use, this may be enough, particularly if you are not worried about the droop. Another alternative is to do a donut mastopexy where skin from... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

You do not need breast lift based on the frontal view

Your nipple position is ok over the breast mount and I would not recommend lift and augmentation. You will get some lift with implant alone and if you need lift you can do it later on. I would recommend high profile implant to get more lift.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Breast lift (mastopexy): lollipop (vertical), crescent (periareolar), donut (circumareolar)

It is difficult to assess the degree of sagging (ptosis) that you are exhibiting based on a photograph alone. Other less invasive scars are available for a lift and you may be a candidate for a "crescent" (periareolar) or "donut" (circumareolar) lift (mastopexy).

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Breast augmentation and breast lift

The need for a vertical incision will partially be determined by how large you desire to go. If you and your surgeon select an implant that fills out your breast tissue, I don't think you'll need a vertical incision, but sometimes this incision is added during surgery if additional lift is required. I would discuss this with your surgeon, and be prepared for a vertical incision. Ask to see photos of the incision, which typically heals very well and should not cause you too much stress. Good... more

Nina S. Naidu, MD
New York Plastic Surgeon

Augmentation without Mastopexy

The determination on whether or not to have a masopexy with your augmentation rests with you in my opinion. As long as you are aware and accepting of the fact that you will likely still have a bit of sagging, I think this is fine. You can always opt for a secondary lift if you are unhappy.

John Whitt, MD
Louisville Plastic Surgeon

Vertical Scar

The vertical scar is needed to help lift the breast and tighten and shape the breast. Your breasts are already fairly ptotic (droopy). Without the lift at the same time as the breast augmentation, you are likely to get a misshapen breast which looks like a breast falling off of the implant. One option would be to plan a two state procedure. In the first procedure, you could have the implants placed. You could then wait several months for the implants to settle. You could then decide if... more