I want a breast lift and breast implants, but do not want the vertical scar. I want only the scar under the breast like you get for implants. Is this possible?
Possible to Put Scar Under Breasts for Lift and Implants?
Doctor Answers (16)
Promoted Local Answer
Under the Breast Scar for Implants and Mastopexy
Breast ptosis or sagging is graded from 0-4 depending on the position of the nipple in relation to the inframammary fold or under breast crease. If the nipple is a grade 1 than breast augmentation can give a slight lift. Unfortunately, using just an inframammary incision may allow to get rid of excess breast skin/tissue but it will not lift the nipple as needed in a breast lift. You may be able to get a better result using a periareolar incision and an inframammary incision.
Lift scars are not only in the crease
Sometimes you can't have what you want and this is one of those times. If you need a breast lift you must have at least an incision around the areola for a minor lift and also one down the breast and usually also in the crease for a more significant lift. You just can't cheat mother nature and you won't get the best result and shape and look without it. Sorry...
Rarely can a breast lift be done that way
Think about it: if you put a horizontally under the breast, you only shorten the vertical distance between the nipple and the bottom of the breast. If you are one of the few whose nipples is high enough and there is no horizontal laxity, then that might work. But this also requires a long horizontal scar, and in actuality is not done very often. I'm aware of the Passot and Lalonde methods, but there are issues with their shape and that is why I believe they have not caught on much, and they do also require a scar around the areola.
I see more bad results from patients refusing mastopexy or the proper mastopexy than anything else. My advice is get the lift you need or simply don't do anything at all.
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Breast Lifting Technique?
Thank you for the question.
Unfortunately without examination are viewing photographs it is not possible to give you good advice regarding breast lifting surgery.
What technique of breast lifting will be helpful to you (if any) will depend on several factors including the quality of skin elasticity ( often poor after significant weight loss), the amount of “loose” skin present, the position of the nipple/areola complexes in relation to the inframammary folds and your goals.
The scars associated with breast surgery are often of concern for patients contemplating breast surgery (understandably). Exactly where these scars will be located will depend on the patient's physical examination and specific procedure performed. Ideally it is best to do these procedures when patients have completed pregnancies and are in long-term stable relationships.
Most patients undergoing the procedure at the right time in their lives will accept scarring as long as their overall goals in regards to size, shape, contour and symmetry are met.
If scars are not acceptable to a patient, it is best not to have the procedure performed (as opposed to having the incorrect procedure performed and being dissatisfied with the result afterwards). This decision is obviously a very personal decision that every patient considering breast surgery is faced with.
I hope this helps.
Scar position for breast lift with implants
There are many ways to limit the size and location of the scars when performing a breast lift with implants. It is possible to use a scar on the lower crease of the breast to place a breast implant. However a scar in this location will not lift the breast. For this reason, we typically avoid this scar when doing a breast lift with implants. Usually the breast lift scar can also be used to place the implants at the same setting. In our practice, the most common location of these cars is around the areola or around the areola with a small extension into the lower portion of the breast into the shape of a lollipop.
Go for the best breast shape, not a particular scar
Ask your surgeon which procedure will give you the BEST SHAPE. Having examined you, he can make that determination. Do not compromise the shape of your breast for scar placement. In the long run, all surgery has some form of scar. The key, is that the result/improvement should be well worth that scar.
You need to decide how much the scar would bother you and compare that to how much the shape of your breasts bother you. Treat the one that bothers you most. Look at photos of others who have had the proposed lift procedure. Look at their scars.
Breast Aug and Lift
There are many types of breast lifts and all involve some type of a scar. You can read about they on my breast lift page linked below. But in general they start around the areola and extend on the breast and at times along the breast at the crease.
You may be a candidate for an inframammary incision, one along the crease and then also a crescent which involves and incision around the top half of the areola. This is not a fit all procedure and you need to be examined and evaluated to see if you are a good candidate for this. Good luck.
Possible to put scar under breasts for lift and implants?
The most important thing to decide is if you want the nipple areolar position elevated on the chest wall. If you want it higher, then you need a scar either on the top half of the areola ("crescent mastopexy") if the distance to be lifted is small or a scar around the entire areola if the scar if the distance for the nipple to be elevated is significant.
The other set of variables is the balance between the volume of breast tissue and the skin envelope. By definition, a breast that needs to be lifted is drooping because there is an more skin than gland. Most breast lift procedures were designed to remove skin and tighten the skin envelope. They resect the skin needed to lift the nipple to its new higher position, plus the skin needed to tighten up the breast envelope.
When you add an augmentation, you now have enough volume (gland plus implant) so that the skin you need to resect is minimal. Most of the time, the skin resected to elevate the nipple areola complex is enough to get a tightened skin envelope.
For this reason I rarely ever do a vertical or horizontal scar on a Lift/Augmentation procedure. I haven't done a vertical scar, or for that matter a horizontal scar in a Lift/Augmentation for at least 3 years.
Take a look at the blogpost below for an explanation of the different types of scars in breast lift.
Scar vs. Shape
Breast lifts typically involve scarring around the areola, then the vertical extension and lastly the horizontal scar under the breast. Remember that you are lifting and not pulling down. The trade-off here is scar vs breast shape. If you need a breast lift, it is best to get the best procedure possible and just come to terms with the fact that there will be scarring. If you wish to avoid scarring and need a lift, that will result in less than optimal breast shape in the end. It is a difficult choice understandably. Discuss your options and concerns with your surgeon and get a realistic view of your expected outcome.
In certain circumstances
The only instance I know that a lower, transverse scar will give some improvement is for a condition called pseudo-ptosis. When the nipple is at a near normal position but there is bottoming out of the breast. A transverse excision of skin and breast tissue will get rid of the hanging tissue beneath the nipple, but the scar is usually quite long, and the procedure does not elevate the nipple. Internal suturing of the breast tissue will give some minimal improvment.
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.