BACKGROUND: Vertical mammaplasty is an effective alternative to inverted-T methods. Among other benefits, it results in a significantly reduced scar pattern. There exists a subset of patients with mild macromastia and minimal ptosis who are candidates for a scar pattern that is further reduced. These patients are usually young and have limited enlargement of the areolae. The upper half of the circumareolar incision can be deleted in these patients to result in a Y-shaped scar pattern. This technique is also applicable to some patients seeking mastopexy with augmentation. METHODS: Ten patients meeting the criteria described were treated with Y-scar vertical mammaplasty and were reviewed retrospectively. RESULTS: Eight patients had breast reduction or mastopexy and two patients had mastopexy with augmentation. The average amount of tissue removed from each breast in the reduction group was 198 g (range, 76 to 382 g). The average follow-up period was 8.4 months. Problems encountered were minor and included inferior areolar fullness in three patients and an inverted nipple in one patient. One patient developed a unilateral lower pole deformity several months after surgery that required corrective surgery. All patients were pleased with their final surgical outcome. CONCLUSIONS: The Y-shaped scar incision design is useful in appropriate candidates to further reduce the scar burden associated with vertical mammaplasty. Retaining the normal transition from pigmented areolar skin to adjacent lighter skin in the upper half of the areola significantly reduces the perception of the overall scar pattern.
