What kind of incisions or techniques leave the least amount of scarring in a breast lift?

Hi there-
I agree with you- minimizing the appearance of scars on the breast is critically important. The whole point of a breast lift procedure is to make the breast more attractive and youthful, and this is defeated if scars are unfavorable or conspicuous.
I believe strongly in taking an aggressive approach to scars in this situation, with progressive suturing techniques and postoperative scar treatments as a complimentary service to my breast lift patients, so that they will never feel like the improved shape was not worth the scars they have.
Having said all of that, I also strongly believe that the technique for breast lifting should be determined by the patient's goals for breast shape, and the shape they are starting with. Each different technique (I do 4 different types) will tend to produce a characteristic change in the shape of a breast, and so the technique needs to be matched appropriately to the patient, using her examination and her goals as guides- otherwise you may end up with a small scar, but a funny or unfavorable breast shape.
I would find a board certified plastic surgeon you like and who has a lot of experience performing breast lifts of all forms, and talk to them openly about your goals and your concerns for the scars. Listen to their recommendations and see how you feel about them. But don't let yourself choose an operation solely on the scars if it otherwise would not be the best procedure for you.

Not every patient needs a breast lift.  If the nipples are in good position, then a volume restoration with an implant or with fat grafting can give the appearance of perkiness, slight nipple elevation and youthfulness. If the nipples have descended below the inframammary fold, then some lifting is usually necessary. 

When considering a breast lift, the amount and visibility of scarring can vary based on the technique used.
Crescent Lift: This technique uses a small incision along the upper half of the areola and results in minimal visible scarring. However, it's usually only suitable for women with mild breast sagging and may be combined with breast augmentation. It provides the least scarring but offers the least lift.
Peri-Areolar (Donut) Lift: This involves an incision around the entire areola. It is more common for moderate sagging and results in a scar that follows the natural edge of the areola, making it less noticeable.
Lollipop Lift (Circumvertical): This technique involves a circular incision around the areola and a vertical incision that extends down the breast. It is used for more significant sagging and leaves a scar that may be more noticeable but still relatively discreet.
Anchor (Inverted T) Lift: This technique is used for severe sagging and involves three incisions: around the areola, vertically down the breast, and along the breast fold. It results in the most scarring but is necessary for the most significant lift.
In general, smaller incisions provide less lift, and the appropriate technique is based on the degree of sagging and the patient's desired outcome. Additionally, scar visibility can be minimized with proper surgical technique, post-operative care, and scar treatment options.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

I think most patients who are on RealSelf are educated in the traditional mastopexy incision techniques:1) periareolar, either circumferential or crescentic2) lollipop, aka circumvertical, Hall-Findlay or LeJour3) T-scar, aka "anchor scar" or Wise pattern
What determines the visibility of scarring in a mastopexy result is affected by more than just the incision used. Tension across a scar is probably the biggest culprit to creating a widened or hypertrophic (thicker) scar, particularly when a surgeon is trying to tighten a breast pocket over an implant or heavy breast. Someone with weak or thin tissue lacking elastin and collagen and prone to stretch marks may be prone to widened scars. Wound healing issues or reaction to suture material can disrupt the wound and create wider or irregular scars. Skin pigmentation affects the color of the scar. Genetic predisposition to keloids or other conditions can also create undesirable results.
The best scars arise out of a combination of techniques to provide support for the implant or breast tissue combined with a degree of skin excision that does not put excessive tension on the scar, ideally in someone who is still young enough to generate good collagen and elastin to heal the scar. This may involve a mastopexy with a more modest implant size or small degree of breast tissue removal and reshaping to reduce weight, internal support of implants or breast tissue with absorbable mesh sling beneath the implant or around breast mounds, downsizing pockets with internal capsulorrhaphy to tighten the pocket around an implant and reduce the amount of skin that needs to be removed externally, and supportive permanent sutures such as goretex in the areola closure to prevent widening. In select patients with longer nipple to inframammary fold distances sometimes a single scar in the fold removing skin only horizontally may provide a nice lift without any visible anterior scar. Ultimately you will want a surgeon who is comfortable with both cosmetic and reconstructive breast work, who may often get referred revision work from other surgeons or doctor and is accustomed to using a wide armamentarium of techniques to achieve a superior result.

Excellent question. There are many breast lift techniques. If we classify them in regards to their scars we have 3-4 basic types. From smaller scars to bigger scars they are as follows:               1. Crescent Lift and Donut Lift, 2. Lollipop Lift , 3. J Lift and Anchor lift (or inverted T Lift)             The smaller the scars, the less lift we can achieve. In order to know which lift is best for you, an evaluation is needed to determine how much lift is necessary for optimal results.  Unfortunately, you can’t have surgery without scars, and scars never go away 100%. They do get better with time and in some cases, they may practically fade completely in a few years. But there are plenty of ways to treat unwanted scars like with silicone gels, lasers and more....so you don’t need to worry about it too much.
If you wish to lift your breasts, surgery will be worth the scars. Try to view scars as tools that help us lift the breasts. Larger incisions/scars simply translate to better results.Best of luck,Dr. Miguel Mota

I perform one of three surgical techniques for breast lift surgery. I strive to minimize the scarring required for each patient, but the technique I recommend will depend on the degree of ptosis, or sag, of the patient's breast anatomy. In order of increasing surgical intervention, the three breast lift techniques are:Periareolar: I solely make an incision around the nipple/areolar complex. The incision camouflages well at the border of the more darkly pigmented skin of the areola, and this technique is as close to "scarless" as exists.  Vertical: This technique requires the periareolar incision and a vertical incision down the lower pole of the breast to the inframammary fold beneath. The majority of my patients require this incision pattern, but these incisional scars typically heal well to thin, almost imperceptible lines.Wise Pattern (Anchor): I reserve this technique for patients with the most significant amounts of breast sag. It involves the vertical breast lift incisions plus another incision hidden in the inframmary fold beneath the breast.Patients are sometimes worried about scarring before surgery, but afterward, very few ever mention it to me. The surgery result is so transformative, and patients are overwhelmingly happy with its outcome. Overall, it is more important to undergo surgery with the right technique given your anatomy, because that choice will play a large role in determining your aesthetic outcome. I would suggest you visit a board-certified plastic surgeon who is experienced with breast and body cosmetic surgery, because there is a significant different in the outcome of a high quality breast lift versus a mediocre one.

Thank you for your question.  There are multiple options available.  Photos would be helpful to best answer your question. The type of incision needed is best determined by physical exam.I perform a liposuction breast lift/reduction known as Breast LipoLift®. This specialized technique spares more nerves and blood supply as well as removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast, I then remove the excess skin to tighten the breast and create a more proportional silhouette with better cleavage. This procedure is also more accurate than traditional breast lifts or reductions since I use 3D measurements to uncover size asymmetries. During the procedure I remove exactly whatever is more from the larger side to get as close to symmetry as possible. Since I perform this less invasively the recovery time is faster and drains are not necessary. Over 90% of my patients are out to dinner the next evening taking only Advil and Tylenol if even needed. The size would depend on the proportion with your body versus going for a cup size.  It has been proven to have less complications than traditional breast reduction (please see my Breast LipoLift® page web page) and should not affect nipple sensation, mammograms, cancer risk or breast-feeding. The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in breast plastic surgery.  Best of luck!    Dr. Schwartz Board Certified Plastic Surgeon#RealSelf100Surgeon #RealSelfCORESurgeon#RealSelfTopContributor

Depending on the size and shape of your breasts, the amount of skin to be removed, quality of skin and positioning of the nipples, will determine what type of surgical technique your surgeon may use.The three breast lift techniques include; Circumareolar technique involves a circular incision around the areolar. This achieves a small degree of lift and results in a scar around the areolar  This is also suitable for reducing the size of the areolar. Lollipop technique is named because of the scar it leave. It results in a scar that extends down the areolar and midline of the breast to the lower breast fold.  This procedure achieves a large degree of lift. Anchor technique involes an anchor shape scar that extends around the areola, down the lower midline of the breast and along the lower breast fold. This is required for those who require a significant lift. 
Like any surgical wound, the scar from the incision will be slightly red for a few months before it starts to fade.

If you are a suitable candidate, we can use your own breast tissue from the lower pole of your breast to provide more upper pole fullness. We have completed a 7 year study on the Naturabra internal autologous bra technique that shows that the results are long lasting and maintain the shape and projection of the breast while obviating a need for an implant. This usually involves a vertical approach which keeps the scars to a minimum as well.

There are multiple scar minimisation approach in breast lift surgery and they are determined by a combination of respective breast conditions, patient preferences and surgeon's skills & experience in achieving the optimal surgical outcome.

In general, there are 3 main scar patterns for consideration: peri-areolar scar, lollipop scar, and anchor scar patterns. Scar quantity does not equate scar quality. It's all about combining the appropriate breast lift technique ( with or without implants) with the optimal placement of scars on the breast mound in creating the ideal surgical outcome for the patient. While there are pre-determined scar propensity from patient's genetic or ethnic backgrounds, appropriate surgical execution with the right balance & tension during surgery and all the necessary post-operative wound care and scar management are also important in determining the optimal quantity and quality of the overall scar consequence in the long term.

Hope that helps.

Best wishes

Ellis Choy

If you are a candidate a periareolar or donut mastopexy only leaves a scar around the areola.  Most often however when sagging is more serious then a circumvertical (lollipop) scar is necessary.  Some surgeons prefer a Wise pattern which is the most scarring procedure where in addition to the lollipop scar an extensive scar under the breast inframammary fold is included.