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

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?

Doctor Answers 12

Stick with your doctor

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.

Newport Beach Plastic Surgeon
4.8 out of 5 stars 39 reviews

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

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..

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 397 reviews

Dog ears after Mastopexy

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!

Parviz Goshtasby, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 2 reviews

Your results are great

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.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Revision mastopexy

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. 

Carlos Burnett, MD, FACS
Westfield Plastic Surgeon
4.9 out of 5 stars 37 reviews

Revision surgery

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.

Sohail Akhtar, MD
Manchester Plastic Surgeon
5.0 out of 5 stars 8 reviews

Common Problem of Vertical Mastopexy

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!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

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

Thank you for your interesting question and the excellent photos.  The problem you are facing is the exact unique problem with vertical mastopexy.  First of all, obviously your surgeon had to extend your vertical scar beyond the inframammary fold in order to get the result he was hoping for.  Then, on top of that he now has to do a revision which has to be done by either extending the vertical scar further, or excising the excess skin in a horizontal fashion, which will convert your mastopexy to an inverted T one, which seems to be what you needed to begin with, except that now your horizontal scar will fall below the inframamary fold.  This is a problem that occurs in a fairly large number of vertical mastopexies, and I always prepare my patients for this possibility when they insist on a vertical mastopexy.  

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

Revision for Extra Skin after Vertical Breast Lift Sometimes Necessary #breastlift

  • 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!

Joshua Cooper, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 44 reviews

Vertical mastectomy - excess skin needs revision

Thank you for your question about your vertical mastectomy.

Your surgeon is doing exactly the right thing.
This can be needed after vertical mastectomy.
The vertical mastectomy avoids the long crease scar of the anchor incision
But at times, there is excess skin after the swelling is down -
A minor in office revision is needed - and

Always consult a Board Certified Plastic Surgeon.
Best wishes. Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.