Mastopexy Types, Incisions, and Scar
Mastopexy, also known as a breast lift, is designed to improve the shape and positions of the breasts that are sagging or appear uneven. The nipple is positioned to its normal location and the tissue of the breasts is redistributed to shape the breasts to a youthful, more pleasing appearance. A mastopexy enhances the breasts by restoring breast projection and improves the shape and symmetry of the breasts. It will not significantly change the size of the breasts unless the breast lift is done in conjunction with a breast augmentation or reduction.
A mastopexy requires a general anesthetic and can take 1-3 hours to perform. It may take longer if breast implants are inserted. There are various approaches to breast lifts but the best approach depends on primarily on the degree of breast ptosis (sagging). These various approaches are incisions that are made so that the scarring is either minimal or hidden. In this article, I will be discussing the different approaches and the scars they leave behind.
The anchor lift, also known as the inverted T, is the most common method and leaves the most scars. The incision is made around the areola, another along the breast crease, and then a vertical incision that connects the two. This oldest mastopexy technique is considered for patients with severe ptosis that require large amounts of skin to be removed in order to obtain a perkier shape. This incision may be used when a breast reduction is needed for patients with very large breasts or on patients with very pronounced drooping, mobile, and stretchy small breasts. Saline or silicone implants can be readily placed through an anchor incision. This technique is more extensive and usually takes longer to heal.
The lollipop lift, also known as a vertical lift is for those who have moderate sagging. The incision is made around the areola and then vertically down to the crease of the breast resulting in a lollipop shaped scar. Unwanted skin is removed from both sides of the vertical incision which creates a tighter pocket of skin to holdup the existing breast tissue. This results in a more rounded shape. It elevates the breast and can create some fullness in the upper portion of the breast. The incision around the areola is used to move the nipple areolar complex upward so that it is positioned properly on the newly reshaped and elevated breast.
A donut lift, also called the Benelli purse string lift, is for those that have moderate or mild sagging. This incision can support and allow the placement of breast implants. Two circumferential incisions are made around the areola margin. The intervening breast tissue is removed. This removes a donut of skin around the circumference of the areola. It may also be used to reduce the diameter of the areola. Tissue may also be removed along the superior border of the areola to get more lift of the breast itself. The areola and the breast skin are then sutured together, which tightens the skin in the process lifting up the breasts. If the patient wants implants inserted, a malleable silicone implant may be used. The incisional scar is usually barely visible since it is around the edge of the areola. When pushed to its limit, this approach can flatten the breasts and limit projection.
Crescent lift is for those who have a small degree of sagging. This is the least involved breast lift procedure. This operation removes a crescent of skin along the superior one half of the areola. The superior crescent elevates only the nipple areolar complex. It does not elevate the breast itself. Implant may be used in conjunction with the lift for upsize, projection, and upper pole fullness (cleavage).
Few women have breasts that are a good candidate for this procedure. Trying to use this operation on inappropriately shaped breasts creates an oddly shaped breast. The fewer, limited scars associated with the superior crescent are a poor tradeoff if the shape of the breast is not right. These types of mastopexies get their name by the pattern of the incisions used. All of them scar but most fade considerably over time as the breast tissue softens.