Weiss/Anchor procedure vs. Vertical Incision or Lolliop? (photos)

You are a great candidate for a vertical, or lollipop breast reduction and lift. It has been at least a decade since I last used a Wise-pattern or anchor technique. In the exceptionally droopy breast it may be necessary to remove a small dog-ear of skin at the lower end of the vertical scar; this sits in the crease. The vertical technique cones the breast and raises the crease; the old Wise-pattern causes the crease to drop and can produce a boxy breast shape. I recommend you look for an experienced aesthetic breast surgeon who has kept up with the times! Good luck.

Breast reduction and mastopexy incision patterns are used to help shape and lift the breast . Choosing the right incision is based on measurements of the breast, specifically in the vertical and horizontal dimensions. The vertical incision pattern, really only narrows the breast and is prone to early sagging in the patients who need a horizontal incision which really lifts the breast. Based on the information provided, the vertical and horizontal incisions (WISE) would be a wise choice.

Thanks for your question.  If you are uncertain about having a Wise-pattern reduction and would like to learn about the vertical reduction I would recommend having another in-person consultation with a local PS.  In my own practice I recommend the vertical reduction in cases where I am removing less tissue or the breast requires less reshaping, and the Wise / Robbins reduction for cases where there is extensive tissue and skin to be removed. Each operation has distinct advantages and disadvantages.

 Thank you for your question. In looking at your pictures I do not appreciate a large amount of skin to be excised. As a result the vertical reduction pattern (lollipop) would be my preference. Using a superior medial pedicle for the blood supply should promote a much better appearance and longevity with less likelihood to bottom out. The only potential downside might be limitation in volume of resection. This would have to be determined by exam. Best of Luck!

Based enthuse photographs you would have an excellent outcome with the Wise pattern anchor style lift with reduction.  I do not think you will achieve a very good breast shape with the short scar techniques.

Thanks for the question, I use both incisions in my practice and in your case would likely offer a vertical or lollipop explaining there is a chance you may need a small horizontal at the bottom to make things flat

Thank you for the question and pictures. Yes, I think you will benefit from breast lifting/augmentation surgery. Most likely the breast lift will involve a vertical mastopexy or Weiss pattern mastopexy (more specific advise would necessitate in person evaluation). Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.
Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%. Patients should be aware of this higher revisionary rate; obviously, the need for additional surgery, time off work/life considerations, and additional expenses our “factors” that should be considered before undergoing the initial operation.
Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.
Make sure you educate yourself about the “trade-offs” associated with breast lift surgery, including the presence of scars. Most patients who are carefully selected and are doing the operation at the right time of their lives psychosocially, are willing to except the trade-offs for the improvement in breast (and nipple/areola) positioning on their chest walls..
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery/lifting ( regarding breast implant size/profile selection) is:


1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.I hope this (and the attached link) help.

Thanks for your photos and question.  I rarely perform the old anchor or wise pattern surgery for breast reduction and lift  in my San Antonio Plastic Surgery practice.  Over the past 10 years I have converted to the short scar technique and I and my patients have been very happy.I would recommend that you get a few opinions from Board Certified Plastic Surgeons in your area and find a surgeon that you trust and can relate to.  Then, trust your surgeon to make the decision for you.  But, make sure you see surgeons who perform the short scar technique and are comfortable with it. Good Luck.

Thank you for your question and photos.  You will likely get several opinions on the optimal proceure.  First, to clarify, the incision pattern does not necessarily dictate the type of lift.  For example, you can perform a vertical mastopexy with a superior, medial, or lateral pedicle (blood supply to the nipple) and use a Wise pattern/achor skin excision. However, a Wise pattern reduction usually refers to a central/lower pole pedicle with a standard anchor incision.  I prefer a vertical mastoexy (for optimal shaping) with a superior/superior-medial pedicle with the option for a transverse skin excision if needed to remove excess skin in the lower pole.  The criticism of a purely vertical/lollipop skin pattern is the pleating of excess skin in the lower pole. This can be concerning for some patients until the pleating goes away.  Unfortunately, in many patients, the skin does not always contract down and a transverse incision is required anyway.  Over the years, I have changed my technique to include many more transverse skin excisions to avoid the lower pole skin excess.  This incision typically heals well and is concealed under the breast, so in most patients it is not a huge problem.   The downside of a mastopexy is the requisite scarring, but the reward is a perkier, more shapely breast.  I tell my patients to try not to get fixated too much on the scars because in most cases they heal very well.  Good luck.  

Thank you for the photos and question and I rarely do the anchor incision anymore and looking at your photos you appear to be an excellent candidate for a SPAIR reduction-> a lollipop scarDr Corbin