Popular Incision Techniques used for Breast Reduction and Breast Lift and the different scar patterns
The Le jour lollipop and anchor techniques are the two most popular incision choices when it comes to breast reduction or lifting surgeries. But how do they compare? And, which one is the best option for you?
Plastic Surgeons evaluate each patient independently to bring them the best breast results possible. Your body shape, proportions, goals, and concerns are all taken into consideration when determining the right boob reduction and lift technique for you.
Different Surgeons have different abilities and offer their favourite incision techniques.
Read more about Breast Reduction by Plastic Surgeons at Coco Ruby Clinic
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Read this article to learn more about both the lollipop and anchor techniques, and to find out which option is best for you!
What Are the Different Incision Techniques?
Your plastic surgeon has a range of different surgical technique options to pick from when performing your breast reduction and/or breast lift surgery. The final technique chosen will depend on your current breast anatomy, the amount of breast tissue and skin that needs removing, as well as your own personal aspirations. Some surgeons also only perform 1 technique.
Below are some of the surgical incision techniques implemented in breast reduction and breast lift procedures:
- Crescent technique – Rarely used in Australia
- Donut (Periareolar) technique – USed mostly in USA for saline implants
- Lollipop technique (also called vertical or short-scar) – the modern approach with less scars
- Anchor technique (also called inverted T or Robbins technique) – the traditional approach
This article will focus on the lollipop and anchor techniques that surgeons commonly use in breast reduction and lift procedures as well as the difference between the two.
Lollipop Vs Anchor – Incision Shape
The lollipop technique involves two incision lines;
- The first is a circular incision cut around the border of your areola. The areola is the pigmented area around the nipple.
- The second incision line goes down vertically from the lower edge of your areola to your inframammary fold (lower breast crease).
As the name suggests, the final incision pattern resembles that of a lollipop. It’s also sometimes referred to as the short scar technique, due to its less invasive approach. This makes it a popular choice in boob reduction and boob lift procedures.
Unlike the vertical lift, the anchor incision also known as the inverted T involves 3 incisions. The first two incisions are similar to that of the lollipop lift. The third incision gives this approach its anchor name and shape. It runs along your inframammary crease. This additional incision makes the inverted T the more invasive of the two techniques.
Lollipop Vs Anchor – History
Heavy sagging breasts have been a cause of concern for decades, thus giving rise to the art of reduction mammaplasty and mastopexy. A number of techniques have been developed in the past decades, most promising adequate long-lasting results.
Here’s a list of some of the famous surgeons in the history of plastic surgery;
Madeline Le Jour
In 1925, Dr Lassus was the first to describe the vertical scar approach for breast reduction and breast lift procedures. At first, it was combined with a horizontal inframammary incision. The final incision was the anchor incision.
Dr Madeline Lejour, a renowned Belgian plastic surgeon, revolutionized the vertical approach to how it’s known today. She shortened the vertical incision line to remain above the inframammary fold and also eliminated the horizontal scar completely. The final incision was the lollipop incision – “The Lejour” – Dr Craig Rubinstein’s favourite!
Betsy Hall Findlay
Dr Betsy Hall Findlay made improvements to the vertical breast mammaplasty to preserve breast sensation and milk ducts. The result of this change was a more elegant and aesthetic final result – the “Hall Findlay” approach. She proposed pedicle techniques not previously known to plastic surgeons to improve the vertical lift.
In 1956, the key-hole-shape pattern of Robert Wise became the workhorse for breast reduction and lift incisions for many decades. It is still used as the base for most newly modified boob reduction and boob lift techniques nowadays.
The “Wise pattern” was an improvement to the anchor technique. It involved a periareolar incision, a vertical incision in the middle of the lower breast pole, and a curvilinear scar along the breast crease. This versatile technique provides predictable reliable outcomes in women with heavy droopy breasts.
The Robbins or Anchor technique is one of the most commonly performed reduction mammaplasty and mastopexy methods. It incorporates the widely successful inverted T pattern of Robert Wise with inferior pedicle resection. This method preserves the breasts’ blood supply, retains nipple and areola sensitivity, allows large breast reductions and lifts, as well as providing excellent overall outcomes.
Plastic surgeons should be proficient in the various breast reduction and breast lift technique options, so they can accommodate the different circumstances of each patient. Ask your Surgeon.
Lollipop Vs Anchor – Who is an Ideal Candidate
Both the vertical and inverted T methods can provide more than satisfactory results. Especially in healthy women that are unhappy with their current large droopy breast shape, and the painful neck, shoulder, and back symptoms that women often suffer from as a result.
But what sets lollipop and anchor technique candidates apart?
Ideal Lollipop Candidate
The ideal candidates for the lollipop lift or reduction are those who:
- Are younger patients, with good skin quality
- Have noticeable breast sagging (ptosis)
- Need a moderate breast reduction and lift
- Wish for more discreet scarring
Ideal Anchor Candidate
The anchor lift and reduction technique is typically chosen for those who:
- Are older and with poor skin elasticity
- Have very large heavy breasts with severe ptosis
- Want the utmost degree of breast reduction and lifting
- Don’t mind additional horizontal scarring
Lollipop Vs Anchor – Advantages
Lollipop Technique Advantages
- Horizontally removes excess skin and tissue (firmer and perkier breasts)
- Preserves blood and nerve supply of the nipple and areola
- Less scarring
- Faster recovery period
Anchor Technique Advantages
- Can remove a large amount of excess breast skin and tissue
- Can Provide a more dramatic improvement in breast shape and position
- Some surgeons claim Longer-lasting results for some patients
- Allows for better flexibility when combining cosmetic procedures (Breast reduction + lift)
- Most popular for and taught by Public Hospital Plastic Surgeons
Lollipop Vs Anchor – Disadvantages
While there are many advantages to both vertical and inverted T approaches, we should not be blind to the disadvantages.
Lollipop Technique Disadvantages (for some surgeons)
- Limited breast access to the operating plastic surgeon
- More difficult to learn and perfect
- Cannot remove large excess amount of breast skin and tissue
- Not suitable for those desiring very large breast reduction
- Long-term results, but slightly less than the anchor technique
Anchor Technique Disadvantages (for some surgeons)
- Increased chance of breast tissue and nerve damage
- More severe breast scarring
- Longer recovery period
- Greater discomfort during your boob reduction or lift healing process
- Flatter box-shaped breast appearance (less perky) in infrequent cases
Lollipop Vs Anchor – Potential Risks and Complications
Despite the difference in the degree of invasiveness of each procedure, both Lollipop and Anchor incisions carry the same long-term risks. Here are some of the complications worth noting when undergoing reduction mammaplasty or mastopexy;
- Nerve damage and change to breast sensation (tingling, burning, numbness…)
- Infection particularly with an improper antibiotic regimen
- Poor wound healing, especially if you’re a smoker or suffer from diabetes
- Inability to breastfeed due to possible milk (lactiferous) ducts damage
- Unfavourable scarring
- Need for revisional surgery
Lollipop Vs Anchor – Recovery after Surgery
In the first few days, you will experience notable soreness and discomfort. As a result, pain, bruising and swelling reach their pinnacle levels during this time. A week after your breast reduction and lift procedure, the majority of your postoperative symptoms will decrease significantly, and by 2 weeks post-surgery they will almost be completely gone.
It takes around 6 to 8 weeks to fully heal from your boob reduction or boob lift surgery. The short scar lollipop technique’s recovery period is on the lower end of that spectrum. As there is less breast tissue and skin damage, and therefore faster-wound healing.
Regardless of whether your breast lift is done with the Lejour vertical approach or the inverted T, you should avoid any strenuous activity for an absolute minimum of 3 weeks post-surgery. Furthermore, you should always consult with your plastic surgeon and get the green light before your resume your exercise routine.
Lollipop Vs Anchor – Cost
It’s hard to put an exact price on any cosmetic procedure, regardless of the approach. There are several factors that can affect the cost of your procedure, for example;
- Your breast anatomy
- The extensiveness of your procedure
- As well as, plastic surgeon and hospital fees
- Geographic location also comes into play when determining the final cost.
- And, other factors
Breast reduction and/or breast lifts are done through the lejour incision tend to need more skill and training, and thus are slightly more expensive. However, you should never price shop when it comes to your body.
Phone the clinic team for an estimate of costs.
FAQs about Lollipop vs Anchor Incisions & Scars
Below are some frequently asked questions about lollipop and anchor techniques in breast reduction and lift surgery;
What is the best technique for breast reduction and lift procedures?
- What works for one patient, might not work well for another.
- Currently, there’s no “best” technique for breast reduction and lift procedures, this is because each technique has its own set of advantages and disadvantages.
- Consult your plastic surgeon for the best breast surgery technique option for you.
How big do breasts need to be to get a reduction?
- If your large breasts are causing undesirable physical challenges, such as;
- neck, shoulder, or back pain,
- Or, if they are causing you emotional burdens in the form of self-consciousness and insecurity, you more than qualify for breast reduction surgery. There’s no need to be of a specific breast size.
- Generally, the bigger your breast size, the more likely you will be to be eligible for Medicare or Health insurance coverage if you meet the criteria.
How many sizes can you go down in a breast reduction?
- Depending on your goals and your plastic surgeon’s recommendation, you can more or less go down to any breast size.
Will breast reduction make me look thinner?
- If you have a slim frame and large breasts, breast reduction surgery might make you look thinner.
- Overweight patients may see fewer changes, as breast reduction will not change your overall belly and body shape.
Do breast reduction and lift last for a lifetime?
- Breast reduction and lifts are cosmetic plastic procedures with long-term results. However, they are not impervious to weight fluctuations, pregnancy, menopause, or ageing.
- As a result, your breasts may regain some of their volume and sag, this may lead to revisional breast surgery in the future.
- Breast mammaplasty via an anchor incision is less likely to undergo future undesirable changes.
Medical Sources for Lollipop Vs Anchor Incisions and Surgery
Finally, below are sources and more information if you would like to do further research.
- NCBI Bookshelf on Breast Reduction by Darren Sachs and Karen D. Szymanski
- Ovid Technologies Insights on Breast Reduction by Elizabeth Hall-Findlay and Kenneth Shestak
- US National Library of Medicine on Vertical Breast Reduction
- ScienceDirect.com on Benefits and pitfalls of vertical scar breast reduction
- Taylor & Francis Online on Analysis of satisfaction after breast reduction comparing vertical scar versus inverted T-shaped technique using the Breast-Q questionnaire. Is patient satisfaction influenced by the amount of tissue removed?
- Scielo South Africa on Surgical anatomy of reduction mammaplasty: a historical perspective and current concepts
- MedScape Emedicine on Lejour Breast Reduction
- LWW Journals Review Article on Mastopexy and Reduction Mammoplasty Pedicles and Skin Resection Patterns
- British Journal of Plastic Surgery on A prospective quantitative comparison of breast sensation after superior and inferior pedicle mammaplasty
- ASPS Reconstructive Procedures on Breast Reduction (Reduction Mammaplasty)
- US National Library of Medicine on Unfavourable results following reduction mammoplasty
- Longdom.Org – Superomedial Pedicle vs. Inferior Pedicle Techniques in Reduction Mammoplasty
- ResearchGate.net on The Robbins Inferior Pedicle Reduction Mammaplasty
- Oxford Academic on Vertical Breast Reduction With a Medially-based Pedicle
- US National Libary of Medicine on Vertical Breast Reduction