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What are the differences between a traditional mastopexy, a vertical mastopexy and a circumareolar mastopexy?

A traditional mastopexy involves a circular scar around the areola, a vertical scar going down from the aroela into the inframammary fold, and a linear curving scar in the inframammary fold itself. A traditional mastopexy sometimes referred to as an anchor lift or an inverted T lift. A vertical mastopexy involves a circular scar around the areola, the vertical scar going down from the areola into the inframammary fold, but there's no scar placed in the inframammary fold itself. A vertical mastopexy is sometimes referred to as a short scar breast lift or as a lollipop lift. A circumareolar mastopexy involves the circular scar around the areola only and the circumareolar mastopexy is sometimes referred to as a Benelli lift or as a doughnut mastopexy.

I think the most important concept for patients to know about mastopexy surgery is this. The scars are not the most important thing. The most important thing is what is done internally to the breast to help support it over time and to maintain a beautifully lifted shape.

A mastopexy surgery that is a skin surgery only, a surgery that does not involve some internal re-arrangement of breast tissue is doomed to fail. Skin is elastic and it cannot support the weight of the lifted breast over time, so you have to do something to the glandular tissue of the breast to create a nicely projecting and long-lasting mastopexy result.

My strong preference is to use the vertical mastopexy technique as much as possible. In the procedure that I do, a segment of lower-pole tissue is removed. This is excess tissue that tends to hang below the inframammary fold and is not doing the patient any good cosmetically. This lower-pole tissue is removed and the medial and lateral breast tissue elements are brought up together at the bottom of the breast to tighten the lower-pole and to support the weight of the lifted breast over time.

In some patients, the vertical mastopexy leaves the lower-pole somewhat long and creates somewhat bottomed out appearance over time. This depends on how the breasts look preoperatively and tends to be more common in patients with very droopy breasts. In many of these patients, I will add a horizontally oriented lower-pole skin excision at the end of the vertical mastopexy that does leave the patient with a horizontal scar in the inframammary fold but it produces a more youthful, lifted, and tight appearing lower-pole and does not bottom out over time. And I believe that based on experience, most patients prefer to have that breast shape at the expense of a scar in the inframammary fold that no one ever really sees.

Make sure that the surgeon that you see for a mastopexy can clearly describe to you the technique they are using, not only to create breast projection but also to support the breast over time so that your mastopexy result will be long-lasting. Also be very cautious about circumareolar mastopexies. A circumareolar excision of skin is not truly a mastopexy or breast lift surgery. I will go into that in greater detail in another video.

While the Breast Lift Scar Might Seem Important, That's Not the Most Important Part

Dr. Michael Law describes the differences between the three main breast lift (mastopexy) approaches and resulting scars but he stresses that's not the most important part of this surgery.