Mammoplasty: In the J-L technique the incisions are smaller, but there are greater limitations regarding the modeling.

These operations are recommended for patients with large or drooping breasts.

It considers in reducing the large sized breast and at the same time correcting its anatomical position, making it graceful, with an adequate size and no droop and the nipples “looking” upwards and slightly sideways.

The incisions are similar for reduction and/or correction of the position. In our experience, the starting point for a mammoplasty is the Pitanguy technique, popularly known as the inverted T (or J-L) technique that has largely evolved, leading to progressively smaller scars.

The incision of this technique is carried out around the areola, with another one descending from the areola to the submammary sulcus and another in the submammary sulcus (not always necessary).

This technique has developed greatly due to the modifications by Professor Pitanguy who conceived it, and by the contribution of many plastic surgeons around the world that practice it and have improved their results.

Mammoplasty and incisions in J-L or vertical incision (technique of Ariê Pitanguy).

Today excellent results can be achieved in relation to the scars, a small T (or J-L) resultant scar, smaller than before, or only a periareolar or vertical scar, or still, only a periareolar scar.

As I always say, it all depends on each particular case. Each patient needs a tailored resultant scar, that should always be the smallest possible and without hampering the final breast contour, an issue that should be discussed with the patient in depth during the examination.

Mammoplasty by the Pitanguy technique: The inverted T-incision allows great flexibility in the modeling of the breast.

Why is it so important an in depth discussion about mammoplasties scars?

Because these scars, the smallest they might be and the better they become with time (breast scars evolve to their most unapparent aspect after around 18 postoperative months) will always be present and constitute the “price” the patient pays to have proportional and attractive breasts.

The Schwartzman maneuver performed according to Pitanguy, for greater preservation of the vascularization in mammoplasties.

Large and/or drooping breast are exchanged for more gracious and well placed breasts. Self-esteem and comfort is achieved, brassieres sometimes can be put aside, and the patient will be able to run and practice sports, but the surgical incisions will still be there.

It is a cost/benefit relationship that should be considered by each patient, who will follow up on it in a conscientious manner after being well instructed by his surgeon.

Mammaplasty using the tissue itself surplus of the fallen part of the breast, to fill the new breast. The use of silicone is avoided, but the fill is shorter and the form less durable.

We have observed in our professional practice that even when the scar is of worse quality, patients prefer the breast operated with the scars that the situation prior to the surgery. I understand that for this to happen the patient must be very well informed of all aspects of the surgery and decide consciously.