Seeking breast lift WITHOUT vertical scars. Any suggestions?

The periareolar mastopexy popularized by Benelli and Goes few decades
ago is the most frustrating novelty and progress in cosmetic surgery
(followed closely by endoscopy).Essentially these are the flaws of the periareolar mastopexy in the best hands and correctly executed:-flattened breast, "fried egg"-shaped-"sun
beams" around the areola due to the folds made to encircle a large
circular edge downsized to a tiny periarolar edge of the wound-overtension of the scar, leading to hypertrophic scarring of awful cosmetic quality, if not keloyd-this
overtension enlarges the areolas looking like cookies, furthermor
elongated vertically most of times (even necrosis of it due to poor
blood flow caused by overtension)-cutting away sking all around the areola leaves the areola in the same place, this means no uplift of NAC at allYou
are not the first and will not be (unfortunately) the last to become
victim of the seducing "scar-less" uplift. It is not a matter of finding
the "best surgeon" to perform it, it is question of finding a surgeon
who does not practive this technique.

I agree with you about the vertical scars being a 'deal breaker'. As a plastic surgeon, the vertical incision down the center of the lower pole of the breast is unacceptable. For this reason, many years ago, I began developing a new method to rejuvenate the female breast with the least incisions possible.  A longer lasting technique was also needed than what was being seen with the old standard lifts. The Horndeski Method (TM) was designed to create upper pole fullness without implants and without the need for a vertical scar. The breast is secured permanently to the underlying chest muscles providing an active lift. Your areolas can be easily reduced as well with this method.I hope this helps.Best wishes.Gary Horndeski M.D.

Hi WTS,I am sorry but it sounds like you are in a tough situation.  If you desire a smaller implant, and could live with a the same size areola, you could be a candidate for a dual plane augmentation, but I would have to examine you and would have to discuss your tolerances.  See the excellent answers below.  These would reduce your areola, like you desire.  So there are many options.  Put an index card in your breast
fold. If your nipple is at the edge of the card or below, then you would
be a candidate for a lift, either a vertical or anchor or areolar. If you
nipple is above the edge, you could be a candidate for an internal lift called
the dual plane.  All the best, Dr. Joe

It is very difficult to accurately assess your particular situation from the description alone. Generally speaking, while the vertical scar may be the deal breaker for you, it is also probably going to be the deal maker for you. When the breasts sag and droop they typically have loose and stretched out skin across the lower aspect of the breasts. When this skin is removed, the best way to then tighten up the breasts is to bring the skin together in the horizontal and vertical directions under the nipples. I will also tell you that it does not always take a big implant to make a big difference for patients and just because someone has implants it does not mean that they necessarily have big breasts. You might be a good candidate for a minor lift with a small implant but you may need a vertical scar if you want your areola reduced and your skin tightened. I would encourage you to have a couple of different consultations to really see what your different options may be.

The periareolar breast lift involves an incision around the areola without the vertical scar.  It also allows your surgeon to resize your areolae.  It is not an appropriate breast lift if you have significant sagging.

When performed well the vertical scars from a breast lift heal great and can be nearly invisible. Despite knowing this and the fact that when needed the vertical incision can be immensely valuable in shaping a breast some patients do choose to opt out of the vertical incision. A purse string areolaplasty/lift and a horizontal incision may be used to give you the best shape possible without the vertical incision.  An implant or fat grafting may be good adjuncts to shaping your breast as well as improving overall volume and upper pole fullness.All the best,Dr. Remus Repta

It all depends on what you look like.  There is such a "lift" that avoids the vertical scar, but most surgeons feel the shape is unacceptable unless it is combined with an implant.  Don't limit yourself by the presence of a scar -- it can severely compromise the shape.  Good luck!

There really is not an effective breast lift that does not involve a vertical or combined vertical and horizontal scars. The perareolar 'lift' is effective at reducing the size of the areola but really has a very minimal lifting effect.

In my practice, I divide breast lift options by distance from the sternal notch to the nipple. If the distance of the notch to nipple is less than 25cm's , then you can get a circumareolar mastopexy. My technique is a Goes Lift with internal Seri mesh. The shape is good and round. The lift is very durable. For patients with dense breasts, the projection is excellent. However, for those patients with fatty, flat breasts - the shape may lack some projection. This can be corrected with a small implant.If the distance is greater than 25 cm's, then I offer a Lejour or Hall-Findlay Lift. Both of these techniques offer a lollipop scar but are not the same. The shape of the Lejour and durability is far superior to the Hall-Findlay. The only patient getting the Hall-Findlay are those with previous scars on the upper half of the breast.If you would like more information on Breast Lifts, please read my book "Cosmetic Breast Surgery - A Complete Guide From A to Double D".

The are two types of breast lift without a vertical scar, the upper crescent, and the periareolar lift. If the areolar diameter is already large, then only the periareolar lift is going to be acceptable for you. As the pattern tends to flatten the breast you see it most often with an implant to improve fill and projection. This is one option you can look into.