when there is drooping involved as well. Dr. Horndeski in Texas makes some amazing claims but most surgeons in the USA have not adapted to his way. There is still a scar around the nipple. Shape is best improved with having some kind of vertical scar and I would employ the lollipop or vertical reduction if i was possible. If your breasts are huge, an anchor method would be needed to provide the best visual and aesthetic outcome in my hands.
Thank you for the photos and if you lose 20 or 30 more pounds you may not want a breast reduction as your breasts may get smaller. That said you would benefit from a lift either way as your breasts are drooping and that procedure will leave scars which should fade with time. Go on some complimentary consultations with experts in your area, compare fees and photos of prior patients and find your surgeon
from looking at your pictures you need a breast reduction that involves repositioning the nipple higher and removing some skin and breast tissue. I don't quite understand how this can be done scarlessly and if it can then I would love to know how :)! All kidding aside, it is impossible to reduce your breast size without incisions but the scars heal very well and I believe you will be very satisfied.
Unfortunately, scarless breast reductions and lifts do not exist, because large or sagging breasts have 'too much' skin for their size, and this can only be addressed by removing some of the excess.
I think a majority of ABPS certified/ASAPS member surgeons who have the training, experience, and skill set do care about your outcome. We've invested our lives to our craft, and we most likely ask our patients to pay above average fees. Your results and happiness are for most of us of utmost importance. And that is why scars are not an issue for the vast majority of our lift and reduction patients; we do the things necessary both in the operating room and after surgery to optimize your healing and minimize your scaring.
Best of luck!