We have made major progress in breast lifts. There is less scarring and better shape. Also, very important, we are getting excellent long-lasting results.
The most common mistake is to use the skin to lift the breast. Very often, a breast lift -or mastopexy - is done by cutting out excess breast skin. This way, a tighter "skin brassiere" is created. However, as everyone knows, skin stretches. So, when you rely on the skin for the breast lift, the long term result is poor -- the breasts look flat on top and too full on the bottom, and the nipples can look too high and disproportionate.
The secret is to do the breast lift internally. The nipples are lifted and a conical shape is created with internal stitches. Of course, some excess skin is removed, but that plays no role in the breast lift.
The internal technique dramatically improves the long term results and minimizes the scars. Many patients can have a breast lift with a scar just around the nipple. This works especially well in women whose breasts have "emptied out" or "collapsed" after having children. Then, a "donut-type" lift is done together with breast implants.
In women with a lot of sagging who do not need implants, we usually use a "lollipop" scar. The long scar under the breast is never indicated for a breast lift.
George J. Beraka, M.D.