The problem is skin. At that size, you can either leave a ton of extra skin (that may defeat the point of top surgery), or have the scars. That's the purpose of the long incisions - it only takes a very small opening to get the insides out, but if you want to remove skin, you just gotta cut it off.
They're long incisions indeed, but like Marcel says they can end up pretty much invisible, so it's not hopeless. But it's difficult to determine what the likelihood is, how most scarring ends up in the long term, because very few people post pictures at 5, 10, 15 years post-op.