There are lots of ways to minimise scarring.
1. Choice of technique
You can elect a minimal scar technique. These techniques are; a) liposuction alone or b)"vertical " breast reduction techniques.
All these choices are open to you but the key is to understand how appropriate those choices may be for your individual needs. For instance a decision about liposuction is influenced by age (younger women's breast have more dense glandular tissue and are therefore more difficult to reduce with liposuction) and how much drooping of the breasts is present. If you have significant drooping you may need your nipples repositioned upwards as well as the weight of your breast reduced which may not be able to be achieved by liposuction alone. Everyone is different and you need individual assessment and advice.
2. Scar management
Before and after a reduction procedure you will routinely get advice on scar management techniques to get any scarring produced to settle as favourably as possible.
It is important to understand that for most women who decide to have a breast reduction the severity of their symptoms (usually neck, back and shoulder pain, etc.) mean any scars resulting from the breast reduction procedure they choose are acceptable to them as a trade off for being symptom free.
This is the key decision in considering whether breast reduction is right for you.
The extent of scarring depends on which procedure you choose. The scars range from multiple small scars (around 5mm each) for liposuction alone, to scars around the nipple and vertically under the nipple to the breast fold if you choose a "vertical" technique or to scars around the nipple vertically under the nipple to the breast fold and along the breast fold (the anchor pattern) if you choose the inferior pedicle or similar technique.
Scars will fade over time but not disappear. There are multiple ways to manage scars after surgery. These include taping, massage and silicone gel. I have never had a patient choose to have their scars treated with laser after breast reduction. I am sure it is possible but would be rarely, if ever required.
Liposuction is the closest thing to a scarless breast reduction. You have multiple small (~5mm) scars so it is not totally scarless.
Whether liposuction is the best option for you will depend on several factors. The breasts of younger women who have not had children have dense breast tissue composed of gladualr tissue which is not able to be removed by liposuction. In addition if you have a significant problem with droopiness (ptosis) liposuction alone may not be able to achieve repositioning of the nipple and areola.
