How to Fix Poor Areola Scarring After Breast Lift

Purse-string tension after a Benelli lift

Many patients have had the suboptimal peri-areolar breast lift popularized as the Benelli lift. Higher areola tension comes from a lack of undermining and one purse-string suture that lifts the nipple and areola. That tension produces a starburst scar.

Incisions stay around the areola, and undermining is avoided there. The lift is on the order of 1 to 2 cm, while most patients would benefit from at least a 4 to 6 cm minimum lift. The peri-areolar lift does not reshape the breast optimally, so residual ptosis of the lower breast, a poor breast shape, and areolar scarring are the usual result.

How to fix poor areola scarring after a breast lift

Patients present after peri-areolar lifts with deformed areolas and breast mounds that are still too low. SurgiSculpt's modified vertical mastopexy is offered to fix poor areola scarring after breast lift surgery.

Tension moves from the areola to the vertical pillar along the inferior breast pole. The revised areola sits on that pillar, so the areola itself is not under tension. The new nipple and areola can be smaller, which removes the starburst. That smaller areola on the pillar is the revision used to fix poor areola scarring. The lift named for this operation is up to 6 cm.

The American Society of Plastic Surgeons describes a breast lift, also known as mastopexy, as surgery that raises the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. That sentence matches skin removal and reshaping. It does not set the 1 to 2 cm result, the 4 to 6 cm minimum, the 6 cm lift, the purse-string, the pillar, or the scar clocks.

Scar patterns left by each lift

Scarless lift

A scarless breast lift, also called a non-surgical breast lift, uses radiofrequency or microcurrent to stimulate collagen and tighten the skin, ultrasound to heat and break down fat cells and lift breast tissue, or dissolvable threads under the skin that later dissolve and leave no visible scar. The stated benefits are minimal scarring and a shorter recovery than surgery.

Those non-surgical options may be less effective for significant ptosis or a more extensive lift, and results may be less predictable than surgery. Ideal candidates have mild to moderate sagging and want a subtle change without surgery.

Crescent lift

A crescent breast lift is named for minimal sagging, a slight nipple droop, smaller breasts, and minimal scarring. The same section also calls it suitable for mild to moderate sagging and a subtle change in position and shape. Both ranges stay. It is often combined with a breast augmentation. It is not recommended for larger breasts or significant ptosis, and it is limited when sagging is larger or the nipple must be moved. Significant sagging or nipple displacement is said to need a more extensive mastopexy.

Donut lift

The donut lift, also called a periareolar lift, uses a circular incision around the areola, removes excess skin, and sutures the remaining skin to reshape the breast. The aim is a smaller, more elevated areola and a firmer shape. It is for mild to moderate sagging, with nipples just slightly lower than ideal, including patients who do not want a significant size change. A breast augmentation can be added for fullness. The circular scar can fade and can sit in the color change between the areola and the nearby skin.

Lollipop lift

The lollipop lift, also called vertical mastopexy, uses an incision around the areola and a vertical incision down to the breast crease. It is for moderate ptosis and a moderate lift, with fewer incisions than the anchor lift. Smaller breasts with mild to moderate sagging are matched to the lollipop lift. Larger breasts with significant sagging may need the anchor lift.

Anchor lift

The anchor lift, also called the inverted-T or Wise pattern lift, uses three incisions: around the areola, vertically from the bottom of the areola to the breast crease, and horizontally along the crease. It is more invasive than the lollipop lift and leaves more noticeable scarring. It is for moderate to severe sagging and larger breasts, including drooping after pregnancy, breastfeeding, or weight loss. A later line spells a traditional breast lift pattern Weiss. Wise and Weiss both stay.

Horizontal mastopexy

Horizontal mastopexy uses horizontal incisions in the breast crease to remove excess skin and tissue, reshape and lift the breast, and reposition the nipples. It is for extensive sagging, and the scar may be more visible than with other mastopexy patterns. Named risks are scarring, sensation changes, infection, asymmetry, and a possible effect on breastfeeding.

What the breast reduction scar account says

A separate section describes breast reduction scars, not a second clock for the lift. They are thin lines that start red or pink and may fade or blend with skin tone, from slightly raised to flat, around the areola, vertically to the breast crease, and horizontally along the crease.

A vertical or short scar is called less noticeable than an anchor or inverted T-shaped incision. Darker skin tones carry a higher risk of hypertrophic scars or keloids, thick raised scars past the original incision. Visibility also follows how much breast tissue was removed, surgeon skill, and dog ears at the scar ends, which can be revised with more surgery if needed. Wound care, limited sun, and follow-up are the healing steps named.

How breast lift scars change

One clock for breast lift scars runs like this. Week one: red, raised, and possibly tender. Week two: scabs start, and the scars may itch. Week four: scabs start to fall off, and the scars are pink, still raised, and possibly firm. Six weeks: they start to flatten and the pink begins to fade. Six months: they lighten, blend, sit lower, and soften. After a year: likely light pink or white, and significantly flatter and softer.

A first-person diary keeps a second clock. At one week it reports less swelling and inflammation, scars still forming, red and slightly swollen, tenderness with movement or touch, pain managed with prescribed medication and rest, and scars kept clean and dry. At two weeks it reports less inflammation, scars that have started and are still quite visible, no heavy lifting or strenuous exercise, dry clean incisions, no direct sunlight, and ointments or silicone sheets if the surgeon recommended them.

At one month the diary reports faint pink color, smooth texture, less elevation, breasts settling into a more natural position, and scars still slightly visible. At three months the scars have faded, the pink tint is down, the raised texture is flattening, and faint pink or red may remain. Care then is silicone gel or sheets, massage, sun protection, and follow-up.

One year after breast lift surgery, the diary says the scars have thinned and flattened and the pigment is usually a pale white. The clock above says light pink or white at one year. Both color notes stay. The scars may still show, and complete disappearance may not be possible. Care named then is massage, silicone-based sheets, and sun protection.

Massage, silicone, Embrace, lasers, and sunscreen

Scar massage

Scar massage uses light vertical, horizontal, and circular fingertip motion. It is said to increase collagen, flexibility, and comfort, and to break down scar tissue and increase blood flow. It starts about two weeks after surgery, once the incision has begun to heal, for about 10 minutes, up to three times a day.

Silicone sheets and gels

Silicone sheets are for raised or hypertrophic scars, worn 12-24 hours a day, to reduce redness, thickness, and itching. Scar gels are for flat or atrophic scars, applied 1-2 times a day, to soften and flatten. A plastic surgeon or dermatologist should be asked first, including about allergies or sensitive skin.

Embrace dressings

Embrace dressings are silicone-based bandages with FDA approval for scars. They support the skin and reduce tension. The silicone is said to hydrate skin, reduce collagen production, and limit inflammation. Studies are mentioned for assorted surgical scars, with a stated gap for breast reduction scars in particular. Massage above is said to increase collagen, and Embrace is said to reduce it. Both statements stay.

Fractionated lasers

Fractionated lasers make micro-injuries that start healing and collagen, to smooth texture and lessen discoloration. The course named is 3-5 sessions spaced 4-6 weeks apart. Redness, swelling, and peeling usually settle within a few days. They are discussed for breast reduction scars that reach deeper tissue, including raised or indented scars and redness or pigment. Treatment waits until the scars have fully healed. Annual maintenance sessions may be used.

Sunscreen

Sunscreen here is broad-spectrum, at least SPF 30, applied 15 minutes before going outside and again every two hours, or sooner with sweat or swimming. The products named are Neutrogena Ultra Sheer Dry-Touch Sunscreen, EltaMD UV Clear Broad-Spectrum SPF 46, and La Roche-Posay Anthelios Melt-in Milk Sunscreen SPF 100. Ultraviolet light can darken new scar tissue.

Revision operations for areola scars

After mastopexy, the named ways to correct areola scars are vertical mastopexy and reciprocal skin grafts. The vertical scar runs around the areola and down to the inframammary fold and is said to improve breast shape, with a longer recovery and a possible shape change as the disadvantages. Reciprocal grafts use the patient's own skin from another site to cover the areola scar. Graft rejection is named as a risk. No rejection rate is given.

Scar revision removes damaged tissue and resutures the incision. Modified vertical mastopexy, in this part of the account, repositions the areola and reduces excess skin. Severity, skin type, and the desired outcome decide the choice, with a qualified plastic surgeon named for that decision.

SurgiSculpt's modified vertical mastopexy takes its incision from a traditional breast lift called the Weiss pattern, folded into the originally published vertical mastopexy to reshape the breast and fix poor areola scarring after a breast lift. The anchor section spells the three-incision pattern Wise. Vertical mastopexy can also include an implant at the same time without compromising nipple and areola survivability.