Hi everyone. I've been thinking about a breast augmentation since I went from a D to an A, and I went to see a lot of surgeons. All of them said the same thing : "I can't do a breast augmentation without any lift." So I decided to just go for it. My surgery is next monday (August 22, 2011) and I'm very confident about the doctor I chose. The thing is I will have a vertical incision, witch scares me a lot. What are the others types of incisions existing right now that leave less or no scar?
Worried About Vertical Scar With Breast Lift- Are There Alternatives?
Doctor Answers (8)
Vertical Breast Lift Scar Best Option
Thank you for your question. There are other options than the vertical scar for Breast Lift. One of the most common is the peri-areolar, a circular scar around the areola.
It is important to see an experienced surgeon and view his/her results.
The peri areolar scar can work for smaller amounts of skin excess but larger procedures often leave puckering around the areola.
You want a properly shaped breast when finished. In my experience the vertical scar produces the most reliable good results.
Breast lift without a vertical scar
There are procedures for breast reduction and breast lift without using vertical scar. This procedure demands a long horizontal scar and creates a flat breast.
In my practice I have moved in the opposite direction eliminating the horizontal scar and relying on the vertical scar. Most common breast reduction scar and mastopexy scar is an inverted T or wise pattern scar. The reason why I moved to just a vertical scar is because it makes a better cone, a perkier breast with better cleavage. The 2nd reason is the vertical scar heals better than the horizontal scar and make fewer keloids within the horizontal scar.
If you think about it the horizontal scar causes the skin to be pulled down and will flatten the breast. Vertical scar causes the skin to be pulled medial to lateral and creates a cone which is a projecting breast, a breast with cleavage.
Breast lift with no vertical scar
There is a breast lift technique that does not require a vertical scar regardless of how saggy your skin is. This technique allows your breasts to be reshaped and suspended so that you have adequate upper pole fullness. Unlike the traditional vertical scar lifting techniques, the Ultimate Breast Lift utilizes an 'internal brassiere' to defy the forces of gravity and not rely solely on the skin envelope to keep breasts in place long term. The scars are hidden around the areola and under the natural crease of the breast, so there is NO VERTICAL SCAR. It is worth looking into.
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Breast lift incisions
There are different types of incisions used to provide a breast lift. The incision used depends on the severity and complexity of the each case. A limited lift involves an incision around the areola only. Without a photo, it is difficult to determine whether you are a good candidate for this type of incision. Communicate your concerns with your surgeon. In general, however, it is in your best interest to accept the incisions necessary to achieve the appropriate breast lift than to be otherwise unhappy with the results.
On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.
Mastopexy (breast lift) with minimal scar
This is the operation that I've performed almost exclusively for the last 10 years. The scar goes strictly around the areola and there is no vertical crease component. This is definitely not for everyone. Very full breasts are not a candidate for this operation. Many people think that the critical component is just the skin removal but that is the secondary portion of the operation. The key part is actually suturing the breast tissue together on the underside to elevate the breast and more of the long-term holding power comes from that rather than the skin removal. The incision around the areola is usually the kindest one to place on the breast. Hope this helps.
Types of scars for breast lift with augmentation
A breast lift requires repositioning the nipple/areola upwards and removing some skin.
The use of an implant as opposed to only a mastopexy without implant may allow a peri-areolar scar if the implant is relatively large with respect to the breast volume. It doesn't work, for example, if you are taking a C cup and putting in a small 150-250 implant. There is just not enough volume from the implant to make a large enough platform to tighten down a purse-string suture without flattening the breast.
On the other hand if a patient is an A cup, and had not previously been a D, implying a lot of stretched out skin excess, an augmentation to a C would take up a lot of the slack in the skin, decreasing the amount to be removed. If the degree of vertical lift was only 2-4 cm, then this kind of lift works well, and the scar is just around the areola.
When can you not do this and get an acceptable cosmetic result? When there is just too much skin to be removed. That's where your doctor's experience and judgment will guide you.
Another point is that it is easier to control areola size post-op with the standard mastopexy. With the peri-areolar mastopexy with augmentation, there is outward pressure on the closure. That can result in unpredictable widening of the areola later, even though all precautions are taken with one or more permanent purse-string sutures.
With your history of going from D to A, implying a lot of skin excess, the vertical technique sounds appropriate.
Vertical Scar Needed
It sounds as though your surgeon feels that you are too droopy for a minimal lift ( donut or crescent). The good news is that the vertical scar associated with the vertical or anchor mastopexy is usually (in my practice) the scar that heals the best and is rarely problematic. I suspect you will be happier with a well shaped, perkier breast and the scars will be of less significance. Good Luck!
Vertical scars with breast lift
There are a number of incisions for breast lifts, each appropriate for a specific situation. The more ptotic (saggy) the breast, the more likely a vertical incision will be needed. If you went from a D to an A, my guess is you have some significant ptosis, so a vertical incision is likely a necessity.
Bottom line, if you are very confident in your surgeon, trust his recommendations.