6 months post-op from vertical mastopexy. Revision scheduled for September due to excess skin/tissue under breasts. (photos)

Question

I underwent vertical mastopexy by a highly-recommended plastic surgeon and am pleased with my overall results, but unhappy with the excess skin/tissue remaining under each breast. My surgeon is performing an in-office skin excision which I am told will easily solve this problem and not extend the vertical scar very much. Would you recommend this course of action? Are there alternatives to consider? Will this achieve my desired result of normal looking breasts?

Sohail Akhtar, MBChB, FRCS(plast) · Answer

Thanks for posting theses pics as it illustrates the problem that is sometimes encountered with vertical only mastopexy. A revision with further skin excision leaving a further horizontal scar ( final result - an anchor scar) will significantly improve the problem and may even shorten the vertical scar. Your scars are still quite red considering it is 6 months post op - silicone treatment might be worth considering after your next op.

Gerald Minniti, MD, FACS · Answer

Hello,This is a very common problem associated with the vertical mastopexy.  The reason is that most sagging breasts have a substantial redundancy of skin in both the vertical and horizontal vectors.  The most logical and direct means of addressing this redundancy is an anchor scar. Todays anchor mastopexies don't have to have such a long inframammary incision, however. Your revision can be done in the office, but let's be clear what the plan is.  You mentioned that your surgeon said it won't 'extend the vertical scar very much'. Well, if the plan is correct, it should shorten your vertical scar by the creation of a horizontal scar, approximately the length of your skin excess (dog ears). This revision will essentially convert you to an 'anchor' scar incision, which is just fine.Best of luck!

Joshua Cooper, MD, FACS · Answer

Occasionally, after a vertical breast lift ("lollipop lift") some women may be left with some extra skin under their breasts.When that occurs, it is best to undergo a revisional procedure to remove this excess skin.Your plastic surgeon's plan to excise this extra skin is the best course of action.  Thanks for sharing!

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well..

The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue..

Parviz Goshtasby, MD, FACS · Answer

Hello 'LAmama1', thanks for your question.  It appears that you have developed 'dog ears' after your vertical mastopexy procedure, which can sometimes happen with any surgery when there is excess skin left over at the ends of incisions. An office excision under local anesthetic should take care of the problem and I would agree with your plastic surgeon's course of action.  Good luck!-Dr.92660

Curtis Wong, MD · Answer

and the excess skin routine in vertical mastopexies.  A short transverse excision will resolve your problems and is much shorter than any anchor mastopexy result... always best to go your route as sometimes these bumps do go away on their own or become so insignificant that no revision is needed.  You're going to get differing opinions from those that do their procedures only one way... and in my opinion, those don't count when you cannot offer the whole menu of options.

Carlos Burnett, MD, FACS · Answer

Thanks for your questions. You do appear to have an excellent general result except for the skin excess. Your revision surgery will result in a modest transverse scar to remove redundant skin and certainly enhance your result. Good luck. DrBurnett#realself100

Juris Bunkis, MD, FACS - Account Suspended · Answer

You have a nice shape to your breasts.   The extra little "dog ears" at the bottom of the incisions can be removed in a minor procedure.    But your scars still look very fresh and you might benefit from waiting another six months before attempting a revision because some of these puckers flatten out on their own as the scar matures.  I'd wait if I were you.

Ronald V. DeMars, MD (Retired) · Answer

Hopefully you either misstated or misunderstood what the surgeon is going to do. The vertical scar already extends far below the breast and it would be inconceivable that it would be extended further. . The surgery that is done to correct this is a horizontal scar that should fall in the fold. The problem you have is not due to lack of surgical skill but rather a problem with this scar pattern.

6 months post-op from vertical mastopexy. Revision scheduled for September due to excess skin/tissue under breasts. (photos)

Answers (9)

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