Your BEST option is to reconsider the vertical scar
As far as scars go, the vertical scar of a breast reduction is one of the best scars we put on the breast. It fades quickly and us usually imperceptible even at just 3 months. Yes, you'll find someone who will do it without a vertical scar -- that comes with a big consequence. It tends to flatten the breast and not give the best shape. Also, the recovery can be miserable. See a few ASAPS member surgeons in your area and look at some of their photos. Good luck!
Breast Lift without Vertical Scar
There are a variety of techniques for these operations. Lollipop lift (vertical lift), donut
(periareola) lift, Benelli lift, crescent lift, anchor lift (inverted T ). Most commonly, we prefer the
lollipop or donut lift because of the shape, small scars and easier healing.
Although the “anchor-shape” or inverted “T” incision is still more popular in
the United States, it represents an older technique with extensive scarring and
a less optimal result in many cases. These newer techniques are utilized in the
vast majority of cases, the rare exception being extremely large breasts. The
nipple-areola complex is repositioned higher, the excess skin is removed, and the
breast is reshaped in a pleasing contour and in a more normal position.
prefer to use a #shortscar technique,
#LollipopScar or #DonutLift” rather than the majority of surgeons in the United
States that use an anchor pattern lift which involve more significant scarring.
Breast lift without vertical scar.
The surgery is certainly possible in anyone, but based on the pictures you submitted, this may not be the best option for you. It appears that you have a large amount of breast tissue with a significant amount sagging below the base of the breast. That combination usually requires the vertical scar to obtain a better result as it gives the surgeon the ability to better shape the breast. The peri-areolar lift tends to not lift very much and also flatten the front of the breast. A full discussion with a Board Certified plastic surgeon will help you determine what is best for your situation.
Given the amount of droop you have there is no way to have a good result without a vertical scar. The scar does however usually heal very well and if you are willing to accept it, well worth the change in breast shape. Certainly find someone who will perform a lollipop incision so you avoid the scar under the breast at least.
Breast Lift Treatment Options
Performing a breast lift should not be an exercise of "One Size Fits All". In my experience, patients come in all sizes, shapes and particular requests. It is paramount for plastic surgeons to have an assortment of procedures that satisfy all reasonable requests.
An easy starting point is to determine the degree of sag. I use the measurement from the sternal notch to the nipple. From this number, I divide patients into three groups;
- sagging but less than 25cm's
- sagging but less than 35cm's but more than 25cm's
- sagging and more than 35cm's
Other factors that play into choices are scar concerns, previous breast scarring from surgery (breast biopsies/other surgeries), weight, breast density. In each group, I offer choices.
- Less than 25cm's, I offer a Lejour, Goes or Hall-Findlay.
- Less than 35 cm's, I offer a Lejour or Hall-Findlay
- Greater than 35 cm's, I offer an anchor scar/wise pattern/Mckissock (all the same!)
What are the different techniques;
- Lejour - a lollipop incision breast lift that gives a great shape, durable and perky.
- Hall-Findlay - a lollipop incision breast lift that gives a good shape but less perky. I use this technique when the patient has a scar (breast biopsy in the upper half of the breast).
- Goes technique- a donut mastopexy that lifts the breast from above the nipple, surrounds the breast with an internal mesh brassiere for added perkiness and durability. Less scarring but not as pretty or perky as the Lejour.
- Anchor scar technique for those with the biggest, suggest breasts - no other choice.
For more on Breast Lifts, please read my book, "Cosmetic Breast Surgery - A Complete Guide From A to Double D".
Vertical scar allows better shape
When I have a patient who has low nipples, as well as breast tissue that hangs below the crease under the breast, I recommend a lift with lollipop type incisions. The periareolar lift can be problematic - it doesn't truly reshape the breast, it tends to flatten the breast, and sometimes the areolas spread and become too large as a result of the tension on the incisions. The "lollipop" or vertical lift is usually a more predictable approach for improving shape. Some of the drooping breast tissue can be moved up to the central part of the breast to improve projection, and the scars are usually better because the tension is distributed better. Often the improved shape is worth the additional scar.
Each Plastic Surgeon will have his/her preferred techniques, so be sure to get an opinion from an experienced Board certified plastic surgeon who does many of these procedures.
Breast Lift without Vertical Scar
It might be possible to do a lift without a vertical scar but you would need a long scar in the inframammary crease under the breast that would possibly ride up above the crease. I think that it is probably best to accept the vertical scar. Best wishes.
Based solely on your photos, I would strongly advise you to avoid any surgeon who recommends a breast lift without a vertical scar. It will not deliver the kind of results that will make you happy. Best, Dr. Nazarian
Avoiding vertical breast lift scar?
Based on your photos- I would NOT recommend avoiding vertical scar- as it will not give you your most pleasing outcome in my opinion. I would recommend mastopexy with possible reduction. For more info you can view the video attached
Breast lift without the scar
That's a totally reasonable question and request. Certainly there are doctors that do that type of lift, and I'm one of them in NC. But there is a reason that most of us who do a lot of breast surgery don't start there in someone with your quantity of breast tissue. That reason is that the results are less predictable and the outcomes less likely to be ideal. When using only the scar around the areola, the skin can only be removed and tightened in one plane, or one dimension. As a result, when this skin is tightened, it tends to be cinched, flattening the end of the breast. The result is a strange shape. There are other reasons to avoid it as well.
The incision around the areola only is not a new operation, and it has been around for years. Most of us who frequently avoid it do so because there is a relatively small population of people who are likely to get their best results with that technique.
Looking at your pictures, you look like a great candidate for a vertical lift.
Of course, an exam and a discussion can change that.