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

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.

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 whole2) Vertically from the lower part of the areola towards the fold3) Horizontally from the inner to outer portion of the breast along the fold - partial of wholeSome 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 scarYour
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.

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.