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Over time and due to genetics, aging, weight fluctuations, pregnancy, breast feeding, lack of support and even chronic tanning, a very large number of women will experience drooping of their breasts known as ptosis. When they are seen in consultation in order to rejuvenate their breasts, I explain to them that they would benefit from a mastopexy (breast lift) with or without breast implants. For a “standard” mastopexy, the incision required to recontour and lift the breast is anchor shaped and extends from around the areola/ nipple area, then vertically downward to the crease at the bottom of the breast, then along this crease. When performed meticulously, most patients heal their incisions well though there are genetic and other factors that can affect the result.

When recommending and describing the incision entailed in a lift, invariably many patients express apprehension just with the vertical component – not even the one that encircles the areola. Some are so concerned about its presence that they either won’t pursue surgery or will only do so if the scar is limited to just around the areola which will yield an inferior result.

It has been my experience that the vertical component usually heals very well and at times even more inconspicuously than the other areas. By trying to limit the incision length and therefore the scarring by just employing an incision around the areola, the outcome is a flat breast with decreased projection and non-aesthetic contour. The reason for this is that by resecting the excess skin of the breast with the necessary purse-string tightening around the areola, it causes flattening in the exact area that should be the most projecting. Hence, the procedure is also called a donut mastopexy.

To better illustrate the difference between the two approaches using food comparisons, wouldn’t you rather have your breasts look more like a giant Hershey’s Chocolate Kiss, firm and conical in shape, than a flat donut? Unless you hate chocolate, I suspect that you would!

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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