Multi-Level Mammaplasty focuses on the modification of the Lassus technique, adjusted for the use in breasts of all shapes and sizes. This method relies on an upper pedicle relative to the areola and involves a lower central breast reduction, glandular shaping, and suturing. The tradeoff is that in order to ensure a fine-line peri-areolar scar, a vertical extension is added. However, this vertical scar fades over time and is partly obscured by the breast. The submammary horizontal scar, typical of the inverted T incision, is avoided through progressive gathering of the breast tissue during the reconstruction of the breast mound, precisely through trimming of the excess skin for a short, tension-free vertical suture. Moreover, the peri-areolar suture is not disturbed by the vertical suture with unnecessary tension. Still, in the larger breast, the vertical scar may extend to the chest wall. We accept this tradeoff and discuss it with our patients before surgery.

In this book, the authors present evidence to demonstrate that the Borenstein multi-level mammaplasty technique is safe and allows the precise reshaping of the breast with long-lasting results. Its advantages largely compensate for the addition of the vertical limb to the peri-areolar scar.

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