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Perky Breasts, Less Scars

Cosmetic procedures are constantly evolving. Education, information, and surgeons’ passing on their findings of which techniques work and which don’t allow the patient to benefit directly.

Marina del Rey plastic surgeon Dr. David Stoker has adapted a minimal incision breast lift, which can also be used for breast reduction, that results in perky, natural shaped breasts.

"The incisions are similar to the Le Jour technique but technically speaking the pedicle is different," says Dr. Stoker. "The idea is that the nipple stays attached and is rotated with the breast tissue into a more superior location. It can look almost as if the patient has had an augmentation. This is because the breast tissue is secured into the appropriate anatomical locations."

The incision is around the nipple and vertically down in a lollypop shape. This is almost a fifty percent reduction in scarring from the original technique, which is in the shape of an anchor. Because of the movement of breast tissue into a more perky position, a lot of patients are very impressed with how much projection they receive. "When the tissue is not spread out over a large area as with a droopy breast, when it is in a compact region, it will project a lot farther," says Dr. Stoker. "It can give a perkier shape than the traditional anchor incision technique."

Dr. Stoker combines The Laser Bra with these minimal incisions to obtain the best possible result. The Laser Bra is a technique where an internal bra is created with the patient’s own tissue to give long–lasting lift results. A CO2 laser is used to deepithelialize the patient's own skin, which makes it stronger.

Marina del Rey plastic surgeon and developer of The Laser Bra®, Dr. Grant Stevens explains: "With this technique, the skin otherwise discarded in a breast lift is treated in such a way with the laser that a bra is fashioned and secured to the chest wall. This “bra” holds the breast tissue up and in place. It is entirely internal and is done with the patient’s own tissue so there are no added problems with infection or rejection."

There are two main reasons Dr. Stoker has included this technique with his minimal incision lift. "It minimizes the blood loss from the procedure and it also allows me to use the patient’s own tissues - the strong dermal tissues - to suspend the breast tissue in a higher location to give a longer lasting lift."

There is no limitation to the amount of lift that can be gained using this procedure. In comparison to traditional breast lift surgery, the length of the operation and anesthesia time are decreased. "Because there are fewer incisions, the discomfort level is probably less as well," says Dr. Stoker.

This technique is not for breast lifting alone; it can also be successfully used for breast reductions. Through the same lollypop incision breast tissue can be removed and replaced to create smaller, perkier breasts. Dr. Stoker explains: "We tend to remove the breast tissue from the lower portion and side of the breast because that's usually what bothers the patients the most, what's hanging down and what's protruding under their arms. The breast tissue in the inner aspect and top of the breast is maintained. Then a pocket is created in the upper portion of the breast and the lower breast tissue is rotated up into it, resulting in more fullness up top."

The minimal incision technique creates excellent projection and shape. As part of a reduction the patient also gets a lift. "Most women who have a breast reduction still want to maintain cleavage," says Dr. Stoker. "Most want to stay perky and it's the perkiness that's not easy to achieve with the anchor type incisions. The anchor scar technique is more likely to result in a flatness and more likely to bottom out."

To ensure the final result appears natural Dr. Stoker overcompensates at first, which means the breast has a lot of fullness at the top. Over the ensuing months the tissues relax into a natural shape.

The glandular tissue and ducts for the most part remain intact so most patients do maintain sensation of the nipples and most probably maintain the ability to breast-feed.

While the incisions are minimal Dr. Stoker also uses techniques to ensure that the resulting scars fade over time. "When suturing, most of the tension is put on the deep tissues so the superficial tissues are almost kissing. The skin can then be closed with minimal tension. Wearing a supportive bra is helpful in decreasing tension on the incisions as well. The main idea is to decrease the tendency for the scar to widen."

Patients can expect a dramatic improvement after a minimal incision lift because it is successful at lifting or reducing the breast tissue and results in a very natural appearance. While it uses minimal incisions, it is not scar free, but with careful technique in time the scars may fade to thin lines.

Originally printed in Anti-Aging & Cosmetic Surgery Magazine