Both the anchor lift and the vertical lift approaches are tried-and-true methods of performing a proper breast lift or mastopexy. The decision as to which approach to use however is not always black and white. Remember that while as much as 50% of the surgery itself is proper technique, the remainder is the result of the artistry of the surgeon. In my practice, I develop the final skin pattern during the actual surgery. As the tissue is manipulated and after the internal plication of breast tissue is complete, the skin is temporarily hemmed together with sutures until a cosmetically pleasing result is achieved. This is not unlike what your tailor does with your clothing. These "basting" stiches will then determine the best pattern of skin to resect. This displaces the concept of true anchor vs vertical pattern incisions as each incision is specifically customized not only to each patient's individual anatomy but to each individual breast! As you know, no two breasts are exactly the same so there should be at the very least some minor variances in the scar pattern between the two to create more precise symmetry with the cosmetic procedure. Said another way, you may end up with a hybrid scar between a full anchor and a vertical scar. Also, very few if any patients ever complain about the horizontal incision that remains very well hidden within the inframammary crease. The scar that is visible is the vertical one which will be present with both approaches. I tell my patients that in the battle between shorter scars versus better shape and form, the more pleasing breast shape should always take precedence.
Finally, the most important factor in your decision making process when choosing between two qualified board certified plastic surgeons may very well be to stick with the surgeon with whom you feel most comfortable. Did your surgeon spend the time to address your specific cosmetic concerns, did he or she discuss the best postoperative regimen to ensure a long lasting result, was postoperative scar therapy discussed, etc.
Hope this helps!
Breast Uplift/Reduction Incision
Though my preference for optimal shaping is to use the anchor incision both work well in the hands of an experienced surgeon. I have seen two patients who needed revision of their vertical incision surgeries presumably having had them performed by inexperienced surgeons. Make sure they can each show you many before and after photos of their own patients to prove their level of experience/expertise. Best of luck with your decision.
Both techniques work well with breast shaped like yours. I would suggest that the scars for both procedures are quite good in general. Ultimately, the best shape is the most important consideration. Some surgeons have more experience with the vertical pattern than others and you can expect a better vertical reduction from experienced surgeons familiar with that method.
Getting the optimal shape with a breast reduction alone is challenging. The benefit of a breast implant for better shape and much more superior fullness is unchallenged. You would be a candidate for a breast reduction and breast implant for the best of all worlds but you would need to find a surgeon experienced with this uncommon alternative not familiar to many surgeons.
I don't think you can go wrong with either experienced surgeon with vertical or an anchor approach.
Based solely on your photos, I would recommend that you go with the anchor lift. I think this will deliver the best results -- Dr. Nazarian
Thank you for your question and photos. I recommend that you consider the anchor lift/reduction. You have sufficient breast tissue to lift the breasts and achieve a great result without the need for implants.
All the best,
I would perform the anchor lift in your case. The problem with the lollipop lift is that I don't think it will give you adequate upper fullness. I think lollipop lifts for the most part look better when an implant is also used.
What is better an anchor lift or lollipop lift?
An Anchor Breast reduction/lift is essentially the same as a lollipop reduction/lift except that the scars are longer so more tissue is removed and the chances of reshaping the breasts as well as lifting them higher is better! I have been combining either one of these with my internal bra technique to try and maintain the form post-surgery.
I'm glad you are considering both. Each operation offers its own advantages. Unfortunately, some surgeons become dogmatic in their approach and are unwilling to consider other options.
Based on the photos you showed, and the size you say you are, I would think that the anchor or "Wise Pattern" incision would work out best for you. It will be the most reliable way to give you a very good result.
Differences between an anchor or lollipop scar in breast reduction
You are a great candidate for a breast reduction and the anchor incisions would be optimal for you. This approach allows the surgeon to remove more of your tissue along the entire inframammary fold (IMF) and sew the de-epithelialized dermal edge of the remaining tissue to the IMF. This will help hold the entire breast up and minimize further dropping or ptosis of your breasts postop. In my opinion, there is no real mystery to this decision that you are trying to make as the resultant distance from the nipple to the IMF should be about 10cm (+/-). Once the new nipple position is determined, if the distance is greater than that, the excess skin is ideally removed along the IMF with a resultant scar which tends to heal very well and is hidden.
Would an anchor reduction/ lift or lollipop/vertical lift be better for me? No implants
from your photos I think the amount of skin that will need to be removed will leave at least a small horizontal extension in the infra-mammary crease to avoid a dog ear pleat, so the small anchor is probably needed