Breast Reduction--Anchor Vs. Lollipop for Petite DDD? (photo)

Question

I'm 5'2'' 125lbs and have DDD breasts. My PS won't perform a lollipop procedure on me even though it's a modest reduction and I'm healthy because he says he doesn't like how the results look and that the new procedure is just a fad. But I've heard that the lollipop procedure leaves better shape, less scarring, and more possibility of breastfeeding. My procedure is already scheduled and being paid for by insurance. Should I cancel it and start the process over with someone who does lollipop?

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to be concerned about scarring
when they undergo breast reduction surgery.For this reason, they’re eager to undergo procedures that utilize lesser
incisions. Unfortunately, this may
require compromises that adversely impact the aesthetic results of these
procedures.Your
pictures suggest that you would benefit from a small to moderate breast
reduction.Unfortunately, severe breast
sag is present and for this reason an anchor incision will probably be
necessary.A lollipop incision probably
wouldn’t adequately address your breast sag in this situation.If
you’re considering breast reduction surgery it’s important to consult a board
certified plastic surgeon.This surgeon
can perform a physical examination and formulate a treatment plan that
addresses your anatomic findings and achieves your aesthetic goals.

Jed H. Horowitz, MD, FACS · Answer

Also known as reduction mammoplasty, #BreastReduction is an operation intended to reduce the size of a woman’s #breasts and improve their shape and position. Frequently, the areola (dark skin around the nipple) is also made smaller. Functional symptoms (medical problems) caused by excessive breast weight may be relieved or improved by this operation. #Liposuction may be used during the procedure
to reduce the size of the breast in selected patients. Liposuction alone has
the least number and size of scars but has the greatest limitations in shaping
and reducing the breast. Liposuction may be combined with the vertical method
to give an optimal shape to your breasts. Adjustments of the nipple and/or
areola can also be done at the same time.I prefer to use a minimal incision surgery with a “#vertical” or “#lollipopBreastReduction scar technique. This method has been used in Europe and South America for more than 30 years but is performed by a small number of Plastic Surgeons in this country.The trend toward using this much better procedure is growing as younger plastic surgeons learn this technique in their residency programs.The benefits include: approximately fifty percent less scarring, a narrower breast, better forward projection and shape, longer lasting improvement, shorter surgery time and less complications. In general, we have stopped using the older traditional “anchor” or inverted “T” incisions as these provide inferior results.

Gary M. Horndeski, MD · Answer

I do NOT recommend the boat anchor or lollipo technique.  I recommend a new technique called the Ultimate Breast Reduction with incisions around the nipple and inframammary fold without vertical incisions.  This results in upper breast fullness and maintains the ability to breast feed.  The traditional technique is the Wise pattern which was developed in 1957 and leaves vertical scars which are prone to widen and impossible to hide.  Insurance companies will pay for breast reduction IF you meet the weight criteria determined by body surface area.  If you do not like what your current plastic surgeon is offering, perhaps you would be better off seeing someone else.

	Best of Luck,

	Gary Horndeski, M.D.

Darryl J. Blinski, MD · Answer

Based solely on the posted photos I would do a full anchor but I have never examined you in person. Best to obtain 3 to 5 opinions in person from boarded pSs in your area.

Steven Wallach, MD · Answer

First, the vertical reduction using a "lollipop" type of incision closure has been around for years. It started to become popular in the early 1970's in Europe, and really sicne the early 90's has become quite popular inthe US. It really is a matter of how much tissue you want removed and how high the nipple has to be moved. Just fromt he photos it looksl ike you may be a good candidate. Go get another opinion. Good luck.

Steven Turkeltaub, MD · Answer

From the information that you have provided as well as the photos, I can concur with the anchor shaped scar recommended by your plastic surgeon. Performing a reduction and obtaining desirable 3 dimensional results can't be obtained with just a standard lollipop approach due to the natural pattern of excess skin. You are sacrificing shape in order to avoid a scar that usually heals well - not usually a wise trade-off. Except for very rare situations, I find that the lollipop approach both for a reduction and breast lift result in predictably inferiorly shaped breasts.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.

	Unfortunately, it is very difficult for me to give you good advice without direct examination. For your own peace of mind you may want to see an additional well experienced board-certified plastic surgeon to discuss options;  otherwise, you may always wonder if you made the right choice.

	Best wishes.

Richard P. Rand, MD, FACS (retired) · Answer

There are many ways to do the reduction. I personally prefer some form of T incision because it gives me better control and shape with better early as well as long term results. The only scar you eliminate with the lollipop is the least visible one in the crease and the ones that show (the areolar and the vertical) usually look worse because the extra skin is purse stringed together.

Ronald V. DeMars, MD (Retired) · Answer

Ask 5 plastic surgeons how to do something and you will get 5 answers and they will probably all be right. We all find ways to get good results, but those ways may be different than another colleague's. Most plastic surgeons in this country use the full anchor scar for reduction as shown by multiple polls taken over the years. I do. But I have many good friends who prefer the lollipop and get excellent results. Most of my patients are concerned with scarring and when the surgery is healed they almost never comment on the scars. Find a surgeon you are comfortable with, look at pictures of his patients to make sure you like his work, and then let him do the surgery his way. You'll be happy with the results.

Breast Reduction--Anchor Vs. Lollipop for Petite DDD? (photo)

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