Which Is The Best Short Scar Breast Lift?
As with any surgical technique, a surgeon should use whatever will give the best result with the least risk. Short scar techniques for lifting a breast usually refer to procedures that avoid a long incision in the breast fold that is characteristic of a so called Weiss or inverted T pattern breast lift (mastopexy). Lejour, and more recently Hall-Findlay popularised the technique of vertical scar (or lollipop) pattern which avoided the horizontal scar during a breast lift (or breast reduction). Around the same time, Benelli was intensely arguing for a “round block” technique for breast lift that uses an incision around the areolar (periareolar) with no vertical or horizontal scar components.
Regardless of the particular technique, cosmetic plastic surgeons strive to create an “ideal” breast shape with minimal scarring and complications. A patient’s view of what appears beautiful may differ from our own, and we may alter our treatment plan accordingly. One simple short scar technique will never suffice for all patients, and it is critical to understand all major breast lift techniques if we are going to try to satisfy all of our patients.
Typically, a short scar in the midportion of the breast fold is not offensive to most patients, but extending the horizontal incision within 3 cm of the chest midline or laterally along the chest wall often results in objectionable scars. These extended breast fold scars are potentially visible when the patient wears a small bathing suit or low-cut dress. As such, the use of long breast fold incisions should be avoided if at all possible, including during extremely large breast reductions. Liposuction of the excess lateral breast fullness is a good tool to help contour the final breast shape and shorten the lateral incision.
Patients seeking the ideal breast shape and size are not always perfect candidates for a simple breast lift alone. They may require a breast implant to add volume to the breast especially after childbirth or weight loss. An isolated breast lift or breast augmentation can be relatively straightforward in select patients. However, combining breast lift with a implants during the same surgery can be a risky task for even the most experienced surgeon. Most patients, though, will choose a simultaneous procedure versus a staged one, even when informed of the added risk. In many cases, the added volume of an implant may benefit the patient not only with increased upper-pole fullness, but also with shorter scars because less skin excision is required. However, shorter scars may come at the cost of more tension on the incision sites. This could lead to wider scars and increased risk of wound breakdown.
Keep in mind the following when determining breast lift with or without implants:
- Major sagging with a nipple to breast fold distance greater than 10 cm will be a challenge to treat without a horizontal incision, unless the surgeon is extremely experienced in a vertical breast lift or using a very large implant. Ultimately, controlling the fold position and nipple-to-fold distance is more essential than trying to shorten a scar, particularly in the severely sagging breasts.
- When excessive bunching occurs when using the short scar technique, adding a short horizontal incision or lateral curve at the base of a vertical mastopexy can help improve results.
- In many sagging cases, an isolated periareolar breast lift cannot produce any noteworthy breast tissue lifting and often leads to an unappealing shape.
- Dense, heavy breasts are more difficult to treat with short scars because of the tendency to leave excess inferior pole breast tissue. This can lead to recurrent sagging if not removed or redistributed adequately.
- Patients who have large areolas and want a smaller diameter during augmentation and breast lift will benefit from the addition of a short vertical incision. The addition of the vertical limb helps control tension away from the periareolar scar and allows the surgeon to maintain a smaller areolar diameter (conversely, using a traditional “doughnut” breast lift during simultaneous augmentation carries a high chance of areolar diameter and scar widening even months after the surgery).
As with any surgical technique, your surgeon should use whatever will give the best result with the least risk. The short scar vertical breast lift can be a very rewarding procedure for both patient and surgeon, and can be used in many circumstances depending on the surgeon’s comfort level and experience.
Tags: Benelli, Breast lift, breast reduction, Hall-Findlay, inverted T pattern, Lejour, mastopexy, short scar breast lift, Weiss
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