I have moderate tubular breasts and from some of the scientific journals I've read, a peri-areolar incision should be sufficient for releasing the constricted mammary tissue, correcting areolar hernias and inserting implants. Why then do some plastic surgeons use a lollipop incision for tuberous breast corrections when the scarring is so much more hideous?
Why Do Some Plastic Surgeons Use a Lollipop Incision for Tubular/Tuberous Breast Correction?
Doctor Answers (6)
What to do with a tuberous breast?
Definitely, when it comes to breast lift surgery it can be confusing. Appreciating the anatomy and determining whether the nipple position truly needs to be elevated is the first step. Typically, in a tuberous breast the nipple position only slightly low but may appear lower due to a deficiency in the lower breast skin or tightness. Therefore, to correct the problem a periareolar incision is used and a implant is used to expand the lower part of the breast. Using a lollipop incision or skin excision below the nipple would be the opposite. So, the surgeon would have to have another reason to perform this type of incision.
Incisions for tuberous breasts
The incisions used for tuberous breasts really depends upon the extent of the tuberous deformity and the ptosis. Sometimes a circumareola incision is enough and sometimes a vertical is necessary.
The answer to the question of whether to perform a lollipop scar or simply a donut scar depends on on every important issue. does the nipple position need be raised and how much? If the nipple does not need much or any lift at all, a donut scar probably would work fine for many tubular breasts. However, if the nipple is too low down and need s to be lifted the lollipop works better. Although the is more scar, the lollipop will prevent the areolae from becoming too wide.
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Lollipop incision for tuberous breasts?
Every surgeon knows what works best in his hands. This condition requires both skin reduction and expansion. You probably won't find any two surgeons that do it exactly the same way, but they all deliver a big improvement. Dr Foster Lake Tahoe Plastic Surgery
Tubular/Tuberous Breast and Peri-Areolar vs Lollipop Incision
You are correct, in most cases a tubular/tuberous breast shape can be corrected using only a peri-areolar incision. However, there is a limit concerning the amount of skin that can be removed with this technique. If there is a significant difference in the diameter of the outer and inner skin cuts, it could result in puckering around the areola. If there is significant loose skin and/or sagging of the nipples the added lollipop scar may be justified. Which type of incision will be best in your case is probably going to be a judgement call on the part of your surgeon. If you are uncertain you could have the peri-areolar lift and if puckering becomes an issue, you could convert the periareolar lift to the lollipop lift. Best of luck.
Lollipop incision for tuberous breasts
Every patient is different. Likewise every surgeon has their own approaches to tuberous breasts.
I have found that unless there is significant droop, most patients with tuberous breasts are best treated with a periareolar approach. The vertical scar of the lollipop incision is useful for tightening an excess lower pole which is usually not a problem in tuberous breasts.