What are the different options available?
The most common type of mastopexy used today is called a vertical mastopexy. It has a “lollipop” scar pattern that courses around the areola and then vertically down to the bottom of the breast (Figure 4, left). It is also referred to as a Lejour mastopexy, named after its developer. This method can be used for most patients. The more traditional option is called an inverted-T mastopexy and has an “anchor” scar pattern. This procedure creates a long scar in the crease under the breast in addition to the lollipop pattern (Figure 4, center). This method is reserved today for those with more extreme amounts of excess breast skin, such as seen following massive weight loss.
Internal lifting of the breast tissue can be done in many different ways. All include dividing the glandular tissue into portions and then rearranging it to push the breast mass upward. There is no consensus in the field as to which method is best. All make mastopexy more complex and substantially lengthen surgery time. Furthermore, as already stated, there are no scientific studies to prove that any of these internal lifting methods add long term benefit beyond what skin tightening alone can accomplish.
Mastopexy can be limited to a scar just around the areola (Figure 4, right). However, this method is not recommended by itself because it provides very little lift. Moreover, the scar around the areola often becomes thick and wide due to high skin tension around the areola inherent with this technique. This limited scar pattern can be useful as an adjunct to breast augmentation where it can make a large areola smaller or raise nipple position slightly.