The peri-areolar mastopexy plastic surgery procedure has the shortest length of scar. Despite the small length of the scar, it is quite common for the scar to be rather thick, ropy and most noticeable. The peri-areolar mastopexy does not manipulate or sculpt the breast gland but can reposition the nipple/areola 1-2 cm higher on the existing breast mound according to board certified plastic surgeons. The advantage to this procedure is the scar is limited to the skin around the areola and there are no other scars on the breast mound. The disadvantage is that this scar is often times under considerable tension and tends to heal with a thick, ropy consistency. Another disadvantage is that it is difficult to sculpt or shape the underlying breast gland through this incision.
The vertical mastopexy is a very popular alternative and involves a scar around the areola and in a vertical direction beneath the areola down to the crease under the breast. This “lollipop” shaped scar allows exposure to the underlying breast gland to adequately shape and sculpt the breast mound. Additionally, closure of this vertical incision allows the breast “pillars” to be sutured together in the midline which creates additional projection and support to the breast mound independent of the overlying skin. The advantages to the vertical mastopexy include excellent breast shape, projection and long-term results. The disadvantages of the vertical mastopexy include significant breast projection (some people do not desire this) and the fact that the surgical result on the operating table does not look like the final result which will be seen in 3-4 months. Another potential disadvantage to the vertical cosmetic surgery procedure mastopexy is the fact that skin is not removed in the horizontal plane and tightening of these tissues may take 4-6 months. The other advantage to the vertical mastopexy is that it avoids the transverse or “anchor” shaped scar.