Lollipop Vs. Anchor Incision Breast Lift, Which Should I Choose?

I've had two consultations with different surgeons. One of them said they would use the B type pattern, which would result in a J shaped scar. The other said that won't be enough lift and won't be long lasting. He wants to do the full anchor type lift. Both said they would do internal reshaping of breast tissue. The one suggesting the anchor type lift has been practicing for quite a bit longer and is slightly more expensive. Now I'm not sure which one to go with. Thanks for your answers.

Doctor Answers 23

Which breast lift techniques give the best results?

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Thank you for the photos. Based on these, I would choose a short scar, or lollipop breast lift technique. As you can see from the previous answers, this is the preferred way to go for long lasting results with minimal scars and good projection. I've been doing the lollipop technique for 11 years, never regretted it and never returned to the anchor scar in any size breast! The anchor scar technique uses the skin as a brassierre to hold the breast, with an unnatural short vertical scar that forces the breasts to become more boxy in shape and loose superior fullness. The surgeons who use this technique will note (if they follow their patients long enough) that the vertical scar will stretch, the horizontal scar will move up on the breast and the breast slides south under the scar with loss of volume superiorly. In the vertical or lollipop lift, the breast crease moves up, shape of the breast is round at the lower pole, maintains superior fullness and anterior projection. You would need a little liposuction of the axillary fullness that shows in your photos. If you want to pay more for the longer scar, than see the more senior surgeon ( it seems he charges more because he has more work to do closing the longer anchor incisions).

Lollipop or Anchor Technique for a Breast Lift

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There are a variety of techniques for these operations. Most commonly there is an incision around the areola and another between the areola and breast crease. This technique is referred to as the “#lollipop” technique and avoids a long scar in the crease under the breast (older #anchor technique). On occasion, especially with mastopexy, these incisions may be modified and more limited. If breast sagging is minimal, the procedure may only require the incision around the areola. It is unusual to use the “anchor” or “inverted T.” This is an older method that creates as much as twice the scar and can flatten the breast, creating less forward projection and suboptimal shape. We prefer to use the #short-scar technique, “lollipop scar” or “#donut lift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Lollipop and Anchor Incisions

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It’s not unusual for patients with breast sag to request procedures that limit the extent of scarring.Unfortunately, these efforts often result in significant compromises regarding the quality of scars and ultimately the shape of the breast.Limited incisions can create tension on wound closures that result in spread of scars and actual distortion of the breast shape.

It’s important to remember that breast sag is usually accompanied by excess skin and failure to address this problem can result in a less than optimal result.Breast lift surgery often requires removal of excess skin in multiple dimensions to achieve the best possible result.

Patient’s with breast sag are always unique.They have specific anatomic findings and personal aesthetic goals.It’s virtually impossible to recommend one of these procedures in the absence of a physical examination.It’s therefore important to discuss certain concepts that are relevant to the surgical procedure.As a general rule, the breast contour and the quality of the scars are more important than the length of the scars.

In some cases, the degree of sag may be greater than the capacity of a lollipop mastopexy to deal with the excess skin.Performing this procedure, under these circumstances can result in tension on the closure with spread of the scars.In this situation, an anchor incision would be a far better option.

It’s important that you consult a board certified plastic surgeon who has extensive experience with these procedures.You have already seen multiple surgeons who have recommended multiple approaches.I suspect that it’s probably reasonable to start out with a lollipop incision.If you have excess skin, it can be easily converted to an anchor incision at the time of surgery.Make sure you have discussed all of these options with your surgeon before proceeding.

Breast Lifting: Pick Surgeon not Technique.

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Thank you for the question and pictures.

In the process of selecting a plastic surgeon,  I would suggest that you take the surgeon first ( after careful due diligence)  and allow him/her to help you with the exact technique necessary. This is because,  in the wrong hands,  you can end up with unsatisfactory results matter what technique is performed.

I would suggest you visit a few surgeons whose practices  concentrate on aesthetic surgery. Ask  to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.
You will find,  while doing your due diligence,  that there are many different “specialties” who will offer their services to you;  again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery.  

Based on the pictures alone,  I think you should do very well with a vertical mastopexy procedure.

Best wishes.


Anchor vs lollipop

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Based on your photos, there is no reason for you to have an anchor lift.  A vertical mastopexy which leaves a lollipop scar will lift your nipple and also allow the surgeon to push the breast tissue up to give you a little more upper pole fullness.  A well done vertical mastopexy makes the breasts look a little bit bigger and fuller, not as much as a implant does, but just a little bit.  A vertical mastopexy is not just about the scar, it's also about how the breast tissue is repositioned on the chest.

This may be a little judgmental, but I think the reason why any surgeon would recommend an anchor lift is because he/she is not familiar with the vertical techniques.

Seattle Plastic Surgeon, Dr. Lisa Lynn Sowder   

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Lollipop Vs. Anchor Incision Breast Lift, Which Should I Choose?

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Dear Dani; As you can read ALL the expert reviews there is a wide range of differing answers. I'm very logical, so I would offer the vertical or lollipop to minimize the scars. If you were not completely satisfied with the lift result than under local anesthesia convert to a full anchor lift. Yes 2 operations but it just makes sense because you can not convert the anchor to a vertical. BEst of luck. 


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Actually, you may not have a choice if breasts are too large with a lot of sagging.  There is no way to do a lift with that much extra skin without have a scar in the fold of your breast (anchor).  Looking at your photo, you should be able to have the lollipop.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon

Breast lift

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Sometimes there isn't a single correct answer, and that often confuses patients.  As surgeons, we get familiar and comfortable with some techniques more than others.  Communicate with your surgeon the ultimate size you wish to be, and left them do the best job possible.

David A. Lickstein, MD
Palm Beach Gardens Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast incision options

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Thank you for your question. There are three general elements of incisions that can be used on the breast.
1) Around the areola - partial or whole
2) Vertically from the lower part of the areola towards the fold
3) Horizontally from the inner to outer portion of the breast along the fold - partial of whole

Some combinations of these elements have different names.  For example:
Lollipop incision combines 1) and 2)
Extended vertical incision combines 1), 2), and the outer portion of 3).
Inverted T or Anchor incisions combines 1), 2), and 3)
Apron incision combines 1) and 3) and leaves out the vertical scar

Your surgeon will choose one or more of these based on the desired result as well as the physical exam. Some factors on the physical exam include nipple position, skin laxity and distribution of breast tissue. The lower the nipple, the greater the skin laxity and the more deflated the upper portion of the breast, the more likely you will need all three elements of the breast incision outlined above. 

A consultation would help determine what you are looking for. In general, however, the internal reshaping is the stronger determinant of how long the lift lasts.  The different incision patterns should be viewed as  means to redrape the newly shaped breast and address skin laxity.

Breast Lift

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Each surgeon has his/her preferences usually based upon experience and consistent results.  In other words two different surgical techniques may still result in a very good outcome.  So if you trust both surgeons equally, then the decision sometimes comes down to what technique you the patient would prefer.  Based upon your photos, a vertical (lolipop) mastopexy (breast lift) seems very reasonable.  Best of luck...RAS

Ryan A. Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 128 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.