I want to improve the shape of my breasts (more rounded. higher nipples) without implants. I thought mastopexy was my best option. After looking at pictures it seems this procedure leaves a lot of scars. then I came across the ubareolar mastopexy which claims that it leaves no scars. This definitely interests, but I don't quite understand what it is. Would this work for me? I don't expect miracles. I just want to improve the shape of my breast to where i don't feel ashamed, with minimum scars.
What's the Difference Between a Subareolar Mastopexy and Regular Mastopexy and Am I a Good Candidate? (photo)
Doctor Answers 9
To adequately address nipple position and shape, a circumareolar mastopexy is necessary.
Thank you for your question and the photos.
To adequately address nipple position and shape, a circumareolar mastopexy is necessary. If you want more volume, implant would be an option.
To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.
Routine mastopexy results in vertical scars
Your photographs show ptosis of both breasts and asymmetry. The left breast appears larger than the right breast. Since you do not want implants then the alternative would be to slightly reduce the larger breast to make them match. All this can be done through an incision around the areola. This would be a circumareola mastopexy, as opposed to a mastopexy requiring vertical scars such as a lollipop or a Wise pattern. Techniques that avoid vertical scars are more attractive since the vertical scar tends to widen in time and are highly visible. Another advantage of the circumareola approach is that your remaining breast tissue can be elevated on your chest wall.
Best of Luck,
Gary Horndeski, M.D.
Should I have breast lift? (photos)
Please re-consider your reluctance for implants. Your chest is broad, nipples lateralized, inframammary crease appears high, not a large amount of parenchyma, and you're lean with good skin cover. The areolae are small. Cannot advise with absolute certainty online, but my opinion, based on photos and your stated desire for improved breast aesthetics (which includes beatiful proportion with body) is for moderate to mid range profile implants with lowering of inframammary crease, and possible areolar mastopexy only if distance between sternal notch and nipples exceeds 22-23 cm. Find a good surgeon. You won't be ashamed, will likely be showing them off.
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There is no such thing as "subareola mastopexy" . If you want minimal scarring , you have two options - 1. crescent mastopexy, that involves scar at the upper border of the areola. This is very ineffective technique. 2. Periareolar or circum areolar mastopexy that involves scar around and at the border of the areola. It can also reduce the size of the areola. From your picture, that will be the most suitable procedure for you.
The truth is that there is no such thing as scarless surgery and, frankly, I would run from the office of any surgeon who purports to tell you otherwise. As plastic surgeons, we can recommend procedures to reduce the potential scarring and, for some patients, circumareolar mastopexy, in which the scar is placed in the areolar area, can be a wonderful operation. For others, it may not be the procedure of choice. All this depends on the degree of ptosis and other issues that require correction. In your case, the breasts are small and asymmetric. An augment/pexy may be a reasonable solution, as others have noted. Your's isn't a straightforward case and you should see several board certified plastic surgeons for opinions. I also think you should prioritize: what is most important? The breast shape, placement on the chest, size, scar location, etc. These are choices that you will need to make on the road to the decision for surgery.
Fixing breast asymmetry
Mastopexy refers to removal of some breast skin to raise the breast and nipple complex. The pattern of the skin removal is usually made to fit the patient's needs. It is not a one size fits all procedure. The pattern used governs the amount of skin scar that you are left with. It is currently impossible to do the lift without any skin scar whatsoever. You should stay away from anyone who makes the false claim that they can do the lift without any skin scars or anyone who does not fully describe the pattern of skin removal they would use in your case.
Your posted photos show asymmetric breasts with different shapes/distribution of breast tissue under the skin, a lower lying left breast and a different horizontal/vertical positioning of the left nipple to the midline vs. the right nipple. All of these issues cannot be resolved by just removing some breast skin even if the skin pattern removal on each side is different. Your case is not straightforward so you should consult with a few surgeons face to face before making a decision what to do.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Sub or preiareolar breast lift
We too are not sure what a scarless mastopexy could be, but in your photo there is an asymmetry in the skin envelope and nipple position that can be corrected by a periareolar or around the nipple lift, not a lot of scar but some never the less. If you could change your mind the addition of a modest breast implant could look very well.