Why Hasn't the No-vertical-scar Breast Reduction and Lift Technique Gained Wide Acceptance?

The around the areola breast lift is a nice lift, just weak.  It is best for small cases.  The physics of joining a large circle to a small circle creates a large amount of gathering when large lifts are performed with this technique and the nipple ends up looking bad.

Also, the effect of a purely around the areola lift causes a flattening effect of the breast. 

If the patient has circulation issues (i.e. prior subglandular surgery), the around the areola lift can kill the nipple.

The no-vertical scar breast reduction is just one of many tools available in the breast reduction toolkit.  Unfortunately, it is not for everyone, and the patient must have the appropriate type of breast to undergo the procedure.  When done correctly, the results can be very good.  However, if done on the incorrect patient, the breasts can look boxy and distorted.