Lollipop vs Anchor with Grade 2/3 ptosis? (photo)

For the lift, I typically start with the smallest incision and
custom tailor each breast lift to the shortest scar possible. Find a
plastic surgeon with ELITE credentials who performs hundreds of breast
lifts each year. Then look at the plastic surgeon's website before and
after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD Los Angeles, CA

There is a new technique called The Ultimate Breast Lift(TM). This technique reshapes your breast tissue creating upper pole fullness, elevates them higher on the chest wall and more medial to increase your cleavage. Aligning the areola and breast tissue over the bony prominence of the chest wall maximizes anterior projection and you may not need implants. This technique avoids the ugly vertical scars of the lollipop or boat anchor shaped incisions, maintains nipple sensation and the ability to breast feed. Plastic surgeons never use a vertical scar on breast augmentations yet routinely use vertical scars in breast lifts and breast reductions. I believe patients are entitled to the same quality of care with lifts as they are with augmentations and should avoid the ugly vertical scars. The weight of the breast is transferred to the underlying muscle and is more stable than either the lollipop or boat anchor shaped incision. If you are dissatisfied with the size of your breasts, implants can be placed at the same time or later if desired.

Best Wishes,

Gary Horndeski, M.D.

If you are pleased with your size, an auto-augmentation mastopexy using a vertical scar should produce a good result IF you are willing to accept the need for a revision to improve the bottom of the scar as you are almost certain to have some excess skin there. If you don't want to deal with that, the anchor will produce a more aesthetic early result but could leave you with dog ears at the lateral ends of your incisions. If a doctor can guarantee that you will achieve the results he states, then consider that but get it in writing and know what happens if you don't get the projection you anticipated from not having the vertical scar. Implant can be used irrespective of what technique you choose.

You have a grade 3 ptosis which is only improveable by a full anchor breast lift. A vertical lift will not adequately lift your breasts.

I prefer the vertical incision (lollipop) over the anchor incision.I find that it give as much lift as the anchor incision without the additional scarringYou seem to have quite a lot of breast tissue,so you may not even need implantsIf you still want implants I would consider cohesive gel or adjustable saline,

You may want to consider staging the two procedures: augmentation and the lift or reduction. Remember, the lift or reduction makes the breast smaller and the augmentation makes the breast larger. They are opposing operations and done together have a much higher complication rate. Depending on the total amount of skin and the size of the implant, you may be surprised that the amount of tailoring (lift) is less than expected. The deflation always makes the breast look saggier than it is. The lollipopr has less scar and helps to shape the breast.

Looking at your photos it appears that your nipple areolar complex is quite a bit lower than your inframamary crease. This means that the distance from your inframamary crease to the new nipple areolar location will be a significant distance. A lolly pop incision will move the nipple areolar complex to the correct position but the distance from your new nipple areolar location will be excessive and leave you with a significant amount of breast tissue hanging down below distracting from a perky lifted breast. You also have a relatively significant amount of asymmetry of your breast with your right breast being larger than your left. An anchor approach would allow the removal of more breast tissue from the larger breast to bring them into a much closer shape and size symmetry. If all you want is lifted and more symmetrical breast you could have a mastopexy with the anchor incision and avoid a breast implant. If you definitely want bigger breast I would recommend textured silicone gel fill implants under the breast or under the breast and muscle (dual plane) if you don't have a significant thickness in the upper pole of your breast in order to prevent the folds in the breast implants showing through.