There are three basic skin incision patterns for mastopexy surgery. The extent of skin excision, and therefore the length of the scar depends on the amount of skin, laxity or ptosis of the breast patients who have mild a ptosis can have a minimal mastopexy procedure such as a donut, mastopexy, a.k.a. Bonelli mastopexy. Individuals With moderate ptosis may need more skin excision, and this may require a lollipop or adding a vertical scar to the donut mastopexy. For patients with significant ptosis, an anchor or wife’s pattern, incision is indicated. Applying a lesser form of mastopexy may cause significantly compromise in the aesthetic, outcome. attempting a donut mastopexy, on someone who needs a more aggressive procedure will create flattening of the breast with potential significant widening of the scars and widening of the areola. Plastic surgeons I’m thrilled with leaving patients with excessive scars. Just like patients aren’t thrilled with getting them. Applying the wrong procedure will simply create a compromised outcome that is undesirable. Defined the right provider and choose the right procedure. I suggest having multiple inperson consultations with plastic surgeons in your community. Ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patient who had similar breast characteristics to your own. Bring a picture of your own breast to use as a reference when reviewing before and after pictures. You can then see firsthand what the results of each provider looks like using various techniques. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Highly experienced surgeons should have access to hundreds or preferably thousands of before and after pictures to choose from. Trying to attempt a major breast lift with a minimal scar is a big mistake and leads to revision surgery and disappointment. Best, Mats Hagstrom, MD