I recently had consultations with a few different DR's in my area. One, wants to give me a lollipop reduction (saying the lift would be greater, minus the anchor scar)with implants. The second, said just to get a anchor lift with implants. I want to keep my nipple and blood supply attached. I do as you can tell need a lift and I've lost breast volume.
Lollipop Reduction vs. Anchor Lift - What Would You Suggest?
Doctor Answers (20)
Anchor or lollipop lift for deflated breasts.
Thank you for your photos, they help in formulating my response. My first question would be, "When you are in a bra, are you happy with the volume/size of your breasts?" If the answer is yes, you do not need an implant and a lift will give you the same volume but a better shaped, more youthful breast. The volume of your breast would be tucked inside a smaller envelope of skin so the skin is plumped out and the breast looks full and round. A predictable, easily measured pattern for this is the anchor pattern. This is used by the majority of plastic surgeons for its ease of use and predictable results. The nipple and areolar stay attached to the breast so blood supply and nerve supply are not affected. If you want more volume you will need an implant. Surgeons differ on whether to do the implant at the time of the lift or later once the breasts have reached their final position. I prefer to wait, for 2 reasons. Many of my patients are happy with the new shape and contour of their breasts and decide they don't want the implants and the potential problems they could cause. Also it is harder to get the implants positioned exactly correctly at the same time as a lift because the breasts will settle some after the lift.
Lollipop or Anchor?
As you can see from the answers here, just as you found in your consultations, experts may disagree on the optimal technique. You can see that we even disagree on whether it is OK to do the breast augmentation at the same time.
Skin removal pattern (shape of the scar) and internal (breast reshaping) may be entirely different considerations.
You appear to be a great candidate for breast lift to improve shape and position, and breast augmentation (implants) to restore volume. The implants can also play an important role in shaping.
As you try to sort out the best solution for you, you may find it helpful to look at your surgeons' before-and-after photos; ask to see photos of someone with breast drooping and deflation similar to yours and be sure the "after" photos are at least 6 months (preferably, a year) post-op. Compare the appearance (shape, position) of the breasts and the scars.
Selecting a breast lift procedure
Your breast are long and deflated and for your best result you would need a lift and implants. If you have sufficient breast volume you may want to only consider a breast lift. The breast tissue that is below the crease can be used to fill in the central and upper quadrants. If you want to be smaller then a small reduction can be done at the same time.
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Breast Lift Technique?
Thank you for the question and pictures.
Based on your pictures I would suggest a full ( anchor) mastopexy.
Although patient's concerns regarding scars are very understandable I would suggest that their first concern should be obtaining the best results possible (scarring concerns should be secondary). Most patients undergoing this procedure will accept scarring as long as their overall goals in regards to size, shape, contour and symmetry are met.
PHOTO: Pronounced sagging/droopiness (ptosis) and options for breast lift (mastopexy): anchor versus lollipop
From the appearance of your breasts, I would advise vertical and horizonta scar mastopexy (anchor) because you would have signficiant cutaneous redundancy and pleating from a vertical which would likely require revision.
Lollipop vs Anchor Breast Lift!
If you are satisfied with the volume (with breasts supported in a bra) you do not need an implant. Although the lollipop lift is preferred, in your case, with so much skin, an anchor lift would be indicated. The lollipop scar may extend onto the abdomen or require revision with a scar in the inframammary crease anyway.
Lollipop and anchor pattern breast lifts
Most of the issues are covered in the answers so far. I would strongly advise against an implant at the time of the lift procedure. You don't need volume and the implant will work against many of the issues involved in maximizing the result for the lift including the risk of complications and the need for a revision.
Lifting the breast up to the correct position with the nipple-areola attached and getting it healed there is one thing and in serious sagging such as yours this is difficult enough. The pattern of incisions used to accomplish this is a separate issue. There is no "lollipop" or "anchor" lift in reality. Many plastic surgeons do not have the experience to separate the lift from the pattern of the skin takeout and major lifts with a long shift up to the correct nipple level require a fair amount of experience if done with a lollipop type incision. Not all plastic surgeons will feel comfortable with that. An anchor-type incisional scar approach is simpler and more predictable.
In summary, I would recommend a breast lift alone which can be done with a lollipop-type scar if the plastic surgeon is experienced with this and no implant is utilized. If an implant is ultimately felt to be needed, it can be done later through existing incisional scars.
Safest way to approach sagging breasts
Based on your photos above which show grade 3 ptosis (sagging) I would recommend a wise-pattern lift (anchor-type incision). It appears that you have a fair amount of excess skin that a vertical incision alone (lollipop incision) can not address. I would not place implants in you at this time. If you desired an increase in size/volume you could have implants placed at a second stage, 6-9 months later. The reason you want to perform these in separate stages (in your case) is because you will have less risk of jeopardizing the blood supply to your nipple/areola. In addition, your cosmetic outcome(shape) and scar will be much nicer if you stage these procedures.
Please consult with a board certified plastic surgeon for a comprehensive exam and review of your surgical options.
You need a significant lift possible only through an anchor type scar
The addition of an implant can add volume if that is what you want.
Placing an implant into an incompletely lifted breast will add volume but over time you will become unhappy with the sagginess of your breasts.
Martin Jugenburg, MD
3rd degree ptosis in your case = Anchor lift. Implants optional.
Based on the picture you shared, your case is certainly very challenging in that you have what we call third degree ptosis. That is the most extreme form of droop related to excess skin, loss of breast volume and downward directed nipple areola complexes. The vast majority of augmentation mammoplastys that I perform utilize the vertical “lollipop” incision or periareolar because it allows for a bit more lift to the breast. But in a case such as yours I would likely recommend the anchor incision approach since there is just too much redundant skin, even with a larger prosthesis, to remove in a vertical fashion or J type incision. If a prosthesis is added, then it is important to place the implants submuscularly to avoid long term bottoming out of the breasts. With either technique the blood supply to the nipple areola can be safely maintained if performed precisely.