What is the difference between a lollipop and anchor incision with breast reduction?

Thank you for your question.  This is an excellent
one, as many people want to know the answer to this.  The incision pattern used for breast
reduction surgery depends on several factors: the elasticity of a patient’s
skin, how much breast tissue removed, and the desired results.  
 
A vertical incision pattern (often called the “lollipop” incision)
is a technique that involves making an incision around the areola and then a
vertical incision from the areola, down the center of the breast, to the
inframammary fold (where the bottom of the breast connects to the
chestwall).  One of the greatest
advantages of this method of breast reduction is that it often produces the
best looking breasts. Short-term, the breasts may even look as full and as high
as breast implants. Longer-term, as they soften and settle, they maintain great
shape —to my eye, better than the other methods of breast reduction.
 
The “anchor”
incision, which involves making a horizontal incision along the
inframammary fold. The anchor-shaped incision pattern allows me to manage the
great excess of skin that some women need to have removed with their breast
reduction.
 
In my practice I find it possible to use the Lollipop
incision is about 95% of patients.  The
other 5% of patients with extremely large breasts may need an anchor incision. 
This is all discussed and agreed upon prior to surgery!
 
Make sure you choose an experienced,
board-certified plastic surgeon.
Take time to specifically look at before and after pictures of real
patients who have had this surgery performed by your surgeon and evaluate their
results.  During your
consultation your surgeon can make a recommendation on which incision will be
best for you.
Best
of Luck 
Dr.
Romanelli

This decision is not really a patient decision.  It is a decision made by the surgeon based on what he or she feels will give you the best results. As a general rule, a lollipop incision is used for small or medium sized reductions, and an anchor incision is typical for a larger reductions.  More skin can be removed with the anchor incision. Your breast measurements also play a role in the type of incision that is best for you. If the length of the lollipop incision is too long, surgeons generally make a transverse or side to side incision to better shape the breast.  Also keep in mind that the bottom incision will also vary in length.  Discuss these details with your surgeon who can give you specific recommendations based on his or her examination. Best wishes to you.

Thank you for the question.
 It is not possible to give you precise advice without direct examination or viewing photographs. Some general thoughts may be helpful to:

 Different patients will present with different degrees of "sagging" (breast ptosis).  The type of breast lift indicated will mainly depend on the patient's physical examination and goals.  Breast lifting involves some degree of tightening and lifting of the breast skin envelope.    Very minor "sagging" may be corrected using a circumferential areolar incision (Benelli breast lift) ; more severe breast ptosis may require a vertical or "anchor" breast lift pattern.

Generally speaking, the difference between a vertical "anchor breast lift comes down to the pattern of skin/tissue removed. The resulting breast shape and resulting scars will differ between the two operations.  The vertical  breast reduction (or lift) will lead the patient with a "lollipop" pattern scar; the anchor breast reduction, on the other hand, will leave the patient with an "inverted T" pattern scar.

 You will find that there is no "algorithm" when it comes to determining what type of breast lift up patient should undergo.  In other words, you will likely receive differing opinions from different plastic surgeons.  

 Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.  Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available.

My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as  well.   I find that the use of goal photographs and computer imaging are very helpful during this communication phase. Working together you will come up with a good plan to achieve your goals.   
 I hope this helps.