I'm sort of on the verge of needing a breast lift and wondering if the scars are not worth the trade-off... what kind of incisions or techniques leave the least amount of scarring?
Scarless Breast Lift
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Are breast lift scars worth it?
Thanks for your question. It happens to be an excellent question.
The key to breast lift is really determining when the degree of droop of the breast makes the scars a worthwhile tradeoff.
When I see a patient who comes into the office and the breasts are hanging down around the bellybutton the answer is simple. But with only mild or moderate degrees of droop the scars may just not be worth it.
Sometimes smaller procedures such as a Peiareolar or crescent left may be worthwhile. When the nipples are well below the fold of the breast these options will fall short.
All board certified plastic surgeons are trained to minimize scars by using appropriate surgical technique and minimally reactive suture material. Unfortunately, sometimes genetics cannot be controlled by these measures and a patient can make a thick or wide scar.
As you embark upon this I would first suggest that you determine what type of lift you need and then ask yourself whether it would be worth it in the rare instance you made an unaesthetic scar.
As a final word even with breast lift all breasts that have natural volume will eventually regain some degree of sagging. Personally, I don't mind some droop of the breast because I think it looks much more natural.
Breast lifts are wonderful today
In my opinion, using an implant to lift a breast is a losing situation for the patient. Typically the size of the implant necessary to remove the sag is too large for the patients ultimate aesthetic desires. If you are sagging and want llarge breasts then fine. But if you want to be lifted and desire to remain around the same size then just get a lift! The Donut Mastopexy is a deceiving term - There are many different types of procedures that utilize a scar only around the areaola - The Benelli mastopexy, The Goes mastopexy, Skin Only Mastopexy. In my opinion, the only one that give a beautiful, durable shape is the Goes Mastopexy.
Breast lift - Minimizing scars is important
I agree with you- minimizing the appearance of scars on the breast is critically important. The whole point of a breast lift procedure is to make the breast more attractive and youthful, and this is defeated if scars are unfavorable or conspicuous.
I believe strongly in taking an aggressive approach to scars in this situation, with progressive suturing techniques and postoperative scar treatments as a complimentary service to my breast lift patients, so that they will never feel like the improved shape was not worth the scars they have.
Having said all of that, I also strongly believe that the technique for breast lifting should be determined by the patient's goals for breast shape, and the shape they are starting with. Each different technique (I do 4 different types) will tend to produce a characteristic change in the shape of a breast, and so the technique needs to be matched appropriately to the patient, using her examination and her goals as guides- otherwise you may end up with a small scar, but a funny or unfavorable breast shape.
I would find a board certified plastic surgeon you like and who has a lot of experience performing breast lifts of all forms, and talk to them openly about your goals and your concerns for the scars. Listen to their recommendations and see how you feel about them. But don't let yourself choose an operation solely on the scars if it otherwise would not be the best procedure for you.
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Breast lifts and scars
There are many different types of breast lifts available. These range from around the areola lifts, to short scar / LeJour / lollipop lifts, to limited incision "T" incisions to conventional "T" incisions. In general, the more the incisions, the greater the lift that is possible in the breasts. When a great deal of saggy skin is present, larger lifts are necessary.
There is some evidence internal elevation and fixation of breast tissue may also help with the conduct of the lift over the long term.
Some patients have a periareolar or "Benelli" lift, with an incision just around the areola, in hopes of avoid the incisions of a conventional Wise pattern lift. When a large breast lift is attempted through such an incision, characteristic problems can occur, with gathering of the incision, decreased areolar circulation (some patients can actually have nipple death), and large resultant nipple-areolar complexes. It is in my opinion a mistake to attempt too great a lift through too small an incision. We have redone many Benelli lifts to Wise patterns and have much more satisfied patients, with much less apparent scarring (even though the actual incisions are longer).
The patient should discuss with their surgeon whether the size is appropriate or needs to be increased or decreased. They can then have a discussion of simultaneous breast implants / reduction, depending on the patient's needs.
For this reason, it is best to select the lift which will give the desired shape safely to the breast, then decide if the tradeoff (incisions) is worth it. In the great majority of patients, it is.
Breast Lift Scars - "Minimal Scar Lifts" May not leave minimal scars
For several years I have been using a 'vertical scar' technique for most breast reductions, which eliminates the long, horizontal incision in the inframammary fold below the breasts. I have also adapted this technique for breast lift surgery, and have been extremely pleased with the results. As with breast reduction patients, this new technique not only eliminates the horizontal incision, but also creates more impressive breast projection and maintains it better over time. The breast lift procedure I perform not only removes breast skin but also moves some lower pole breast tissue to a higher position, increasing the projection of the nipple/areola area.
Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'.
All surgery results in scars. On my website, I show before and after patients at all stages of healing from just weeks after surgery, to several months after. The vertical scar will typically fade to a thin, white line that most patients find acceptable and definitely worth the trade off of perkier, more youthtful breasts, but only you know if the trade off works for you. Please view my videos about breast lifts and scarring.
Most breast lift patients need a "lolly pop" scar.
1) If you have only a little sagging, maybe you just need breast implants, which are put through very short incisions in the armpit, or in the fold under the breast, or under the nipple.
2) Also, if you have minimal sagging, an internal lift can be done through one of the scars described above.
3) Some patients (depending on the anatomy), can get a good lift with a "doughnut" scar just around the nipple.
4) If you have a lot of sagging, then you need a vertical breast lift with a lolly pop scar. This can be done with or without implants. But is the MOST scarring that you might need. For breast lifts, I never use the traditional longer scars that look like an upside down T.
5) The thing to understand is that, if properly informed, most women are happy with the trade off. Afterwards, you have some scars (which fade but do not disappear) BUT you have nice, perky breasts. It usually is a trade off, though.
Don't compromise your result by trying to minimize scars.
Marian, Many patient are afraid of the scars / incisions used to perform breast lift surgery. However, in general, these incisions heal very nicely. It is a shame when patients compromise their result by demanding shorter or fewer incisions. There are minimal incision breast lifts, but these are best for people who only need a minimal lift. For people who need more extensive lifting, then you need longer or different incisions to achieve a nice aesthetic result. Sometimes, if you have an implant placed at the same time as the lift, then you may not need as long of incisions, but this also depends on your anatomy. I hope this is helpful. David Shafer, MD New York City
Scarless breast lift
Fortunately, you do have another option other than the ones mentioned above. It is called the "Ultimate Lift". It is a technique that allows for the maximum amount of lift and upper pole fullness without the need for implants. The final results are very natural. Scars are hidden around the areola and in the natural crease of the breast mound. There is no vertical scar. I hope this helps you. Best wishes Dr H
Minimizing Scar with Breast Lift
I understand your concern about minimizing scars while improving the shape of your breasts.
There are different techniques to reshape the breast: the more the sagging, the more length to the incisions (scars).
If breast implants can restore volume to a deflated breast, scars for placement of an implant can be minimal.
The best way to find out what procedure might be best is to consult your plastic surgeon.
Scarless Breast Lift Not Possible But Lifted Breast Worth Minimal Scars
Thank you for your question. Every woman who is considering Breast Lift has the same question.
If you need a Breast Lift, Breast Augmentation or Implants will not lift the Breast.
A properly done Breast Lift should leave minimal white scars around the areola and possibly down the front of the Breast when a Vertical scar is needed.
In my 30 years in practice,all patients have been so pleased with the lifted Breast appearance that they are not troubled by the scars.
Most important, see and expert Plastic Surgeon who is experienced at Breast Lift-the quality of your scars does depend on the surgeons skill.