When it comes to breast lifts the most common questions I get each day concern the probability, risk, and/or how we can avoid scarring. While I would like to be able to offer patients a 'scarless' breast lift, the reality is that breast lifts will always require incisions and to get a great cosmetic result the type or placement of incisions is not dependent upon what I would prefer to do but rather it is dependent upon how much breast sag or ptosis a patient exhibits, the patients balance between skin and breast tissue and where this laxity in skin and tissue exists.
Gaining in popularity is something called the vertical lift, which involves a scar around the areola and then straight down the breast, eliminating the underneath scar. Proponents think that the shape is good, that the breast maintains a lot of projection over time without bottoming out, and that the underneath scar is avoided. I believe that many of these breasts look overly projecting to my taste, and that bottoming out can be minimized with the inverted T style pattern. I also feel that the underneath scar is rarely seen, and that the scars that are seen - around the areola and going straight down, seem relatively more visible with this technique since it requires some bunching up of the skin during closure. Understand that some of the best surgeons in the world argue with one another about this issue at meetings all the time!