Which Incision Should I Choose for my Breast Reduction? (photo)

My PS gave me a choice between The Short Scar or the Inverted T for my breast reduction. When I asked for his advice he told "it is ultimately my decision". I have no clue what to choose. My breast are 34 E or F. and the nipple is very low and my breasts are pendulous. I would like volume removed but I also want a MAJOR lift. I understand they are both great techniques but I need an HONEST opinion. Which is my best choice?

Doctor Answers 8

Breast reduction incision

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For a true breast reduction, the inverted T is the incision.  I would not perform a short scar incision on you given the degree of ptosis or sagging in the breasts.  In breast reduction, I do not think that, in most instances, the choice is the patient's to make.  The size, nipple to inframammary crease distance and nipple heights are the determinants and that the incision becomes a matter of medical judgment.  You really have to decide whether you are looking for a breast reduction or a lift and your priorities.  Then share these with your plastic surgeon.

Best type of breast reduction

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There are benefits and drawbacks to different breast reduction techniques and these should be thoroughly discussed with your surgeon before any decisions are made. Some of the choice will ultimately depend on his/her experience with certain techniques though. In my practice, I would strongly suggest a vertical reduction that avoids the horizontal component of the inverted T technique. I personal think that the overall shape and scarring are better with this technique, in my hands. But I perform a vertical reduction on 95% of my breast reduction patients and feel very confident that I can get the results that I want with that technique. Other surgeons will be more confident with an inverted T technique and will get great results too. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 87 reviews

Incision in Breast Reduction

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Asking you to choose the incision without thoroughly explaining the potential outcome of each is like asking someone needing surgery for abdominal pain to choose the incision without telling them what is causing the pain. Occasionally one can obtain the same result with either incision. In that case, the surgeon should choose the lesser incision. However, that is rarely the case. If an excellent result can be obtained with a vertical breast reduction incision, then that is what should be used. If the inverted T incision will produce the best shape and most long lasting result, then it should be chosen. What each incision will do also varies by surgeon. If your surgeon is a Board Certified Plastic Surgeon, I suggest you ask what his/her experience is with each incision in someone like you. If he/she is not Board Certified in Plastic Surgery or you are not happy with the answers you get, then seek another opinion.


Robert T. Buchanan, MD
Highlands Plastic Surgeon

Breast Reduction Technique?

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Thank you for the question.

I think the most important decision you make is choice of plastic surgeon, not specific technique. Once you have made this choice, based on careful due diligence, ask your surgeon to use whatever technique he/she feels will ( based on experience and judgment) will most likely achieve the results you are looking for.

Best wishes.

Choose the Surgeon, Not the Incision or Technique

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The short answer is - PICK THE BEST BOARD CERTIFIED PLASTIC SURGEON - AND NOT THE INCISION. Then ask him which procedure he is most comfortable with and will give you the best result. For the first half of my career, I performed the inverted T or "Anchor Pattern" breast reduction and for the second half a minimal incision surgery using a “vertical” or “lollipop” scar technique. The minimal scar technique in my hands is a far superior method.  This method has been used in Brazil and France for many years but is performed by a minority of Plastic Surgeons in this country.  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.  The procedure is done under general anesthesia on an out-patient basis or in the hospital it there are additional medical conditions.

Only the choice for breast reduction or not is yours to make

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Only the decision to have breast reduction is yours to make. The way the reduction is performed depends on professional judgement and skill, and years of experience with the procedure. Your surgeon alone is ultimately responsible for the result. Seems to be red flag here and a second opinion might be best.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Talk to your doctor

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An experienced board certified plastic surgeon should explain to you the different scars and procedures. It is their responsibility to explain to you why they would done one instead of the other. It is a cop out to put the ball in your court without fully explaining why they would use one instead of the other.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Choice of breast reduction scars

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You are a very good candidate for breast reduction. Vertical scar or inverted T scars work best in the hands of the surgeons who use them and recommend them to their patients. In my experience, you will have a better shape and better lift with the inverted T or Wise pattern incision. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 112 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.