Lifting the Standards: A Systematic Review of Aesthetic Scarless Breast Surgery

Scarless breast surgery techniques, such as radiofrequency-assisted mastopexy, transaxillary and transumbilical augmentation, and liposuction-based reductions, have gained popularity for delivering aesthetic results while minimizing visible scarring. However, evidence on outcomes and complication rates across techniques remains variable. A systematic review of 11 studies with 1,517 patients undergoing scarless aesthetic breast procedures was conducted. Data on surgical techniques, patient satisfaction, anatomical changes, and complications were extracted. Outcomes were assessed through photographic reviews, global aesthetic scales, and objective measurements of nipple and areolar position. The average patient age was 34 years. Radiofrequency-assisted mastopexy reported a mean nipple lift of 1.2 cm, while the "Compass Rose" suture technique achieved an average areolar width reduction of 11 mm. Transaxillary and transumbilical augmentations demonstrated patient satisfaction rates of ≥90%. Reported complications were generally low and included hematoma (n=2), capsular contracture (n=2), implant malposition (n=1), and minor wound-related issues. Overall, complication rates were similar to or lower than those associated with traditional augmentation and mastopexy techniques. Scarless aesthetic breast procedures provide high patient satisfaction and measurable improvements in breast contour and nipple position, with complication rates comparable to conventional approaches. Future research should focus on standardized reporting and long-term outcomes to better define the efficacy and safety of these minimally invasive techniques.