Breast Lift - How Long Does the Horizontal Incision Extend?

Typically a "wise-pattern" breast lift involves tissue tightening in all dimensions, with resulting scarring around the nipple, down the lower half of the breast and completely under the natural breast fold (inframammary crease). The inframammary crease, horizontal incision, needs to follow the complete length of your natural fold. If you stop short, a "dog-ear", or skin pucker, results from excess skin beyond the level of the scar. When there is extra skin and/or fat folding around the sides, sometimes the scar can be lengthened to remove excess tissue fullness there. Your plastic surgeon will show you where the scars will be. 

Congratulations on your significant weight loss.

Most patients who have had this degree of weight loss benefits from breast lifting surgery (plus or minus breast implants);  often this surgery involves removing skin along the vertical and horizontal dimensions.  This is what the surgeon was referring to as the Wise pattern.  The horizontal incision extends to the side as far as necessary to remove loose skin.  Most patients prefer to have a scar on the lateral chest area as opposed to excess skin and/or adipose tissue. This trade-off of scar for improved contour is commonly seen with plastic surgical procedures.

I hope this helps.

A Wise pattern lift is another name for a vertical/horizontal lift or Lexer pattern or more commonly known as the anchor. Your excess upper back skin may require a back lift extending all the way around the upper back beneath the bra strap or extension to the arm also known as a thoracobrachioplasty.