If you’re considering breast reduction surgery, one of the most important decisions you’ll make with your plastic surgeon is choosing the right type of incision. There are two main breast reduction incision types: lollipop incisions and anchor incisions. This guide will help you understand which is more suitable for you.
Breast Reduction Incision Types
When you meet with your plastic surgeon, they’ll explain that there are primarily two approaches to breast reduction surgery, each with its own incision pattern.
| A Comparison of Breast Reduction Incision Types | ||
|---|---|---|
Vertical (Lollipop) Incision | Traditional (Anchor) Incision | |
| Best for | Small to moderate reductions | Large reductions |
| Scarring | Around areola + vertical line | Around areola + vertical + horizontal |
| Recovery time | 1-2 weeks off work | 1-2 weeks off work |
| Scar visibility | Less noticeable in clothing | More extensive but well-hidden in bras and bathing suits |
| Breast size removed | Up to 1-2 cup sizes | 2-3+ cup sizes |
| Reshaping ability | Good lift and shape | Excellent contouring when skin quality isn’t ideal or when there is a requirement for significant reduction |
| Best candidates | Younger patients, good skin elasticity | Any age, larger reductions needed |
| Nipple repositioning | Excellent | Excellent |
The Vertical (Lollipop) Incision
The vertical incision gets its nickname “lollipop” because the scar pattern resembles the shape of a lollipop. Your surgeon makes one incision around your areola (the darker skin around your nipple) and another that extends straight down to where your breast meets your chest wall.
Why will a surgeon consider the lollipop technique?
- Less scarring: Only two incision lines instead of three
- Faster healing: Smaller incisions typically heal faster
- Better for smaller reductions: Perfect if you want to go down 1-2 cup sizes
- Great lift effect: Excellent for addressing sagging while reducing size
- Younger-looking results: Creates a more youthful breast shape
Potential drawbacks:
- Usually limited to smaller volume reductions
- May require touch-up surgery if more tissue needs removal later
- Not suitable if you have very large breasts or poor skin elasticity
The Traditional (Anchor) Incision
The anchor incision, also called the “Wise pattern” or “inverted-T,” creates an anchor-shaped scar. Your surgeon makes incisions around the areola, down vertically, and then horizontally along your breast crease.
When the anchor technique works best:
- Large volume reductions: Can remove significant amounts of breast tissue
- Maximum reshaping: Offers the most control over your final breast shape
- Severe sagging: Excellent for removing excess skin
- Widely proven: This technique has been used successfully for decades
- Versatile approach: Works for almost any breast size or shape
Considerations:
- More extensive scarring initially
- Slightly longer recovery period
- Small risk of reduced nipple sensation
- May be overkill for smaller reductions
Choosing the Right Incision Type for Your Goals
Your plastic surgeon will consider several personal factors when recommending the best incision type for you. Here’s what influences their decision:
Your Lifestyle and Preferences
One of the factors your surgeon will consider is your lifestyle, particularly when it comes to the types of clothing you feel comfortable in, your activity levels, and age. Here’s how those factors might influence their recommendations:
| Lifestyle Factors and Breast Reduction Incision Types | ||
|---|---|---|
| Factor | Vertical Incision | Anchor Incision |
| Clothing preferences | Total flexibility even in halter or low-cut tops | Scars hidden by most bras |
| Exercise routine | Faster return to activities | May need a slightly longer break |
| Age and healing | Ideal for younger patients | Suitable for all ages |
| Future breastfeeding | Highly likely to successfully breastfeed | Moderately likely to successfully breastfeed |
Your Anatomy
Your anatomy also plays a role in determining which incision method is best for you. Here are a few of the factors your surgeon will take into account when weighing up breast reduction incision types.
Breast size and current shape
If you’re currently a DD cup or larger and want a significant reduction, the anchor incision typically provides better results. For smaller reductions (going from a D to a B+, for example), the lollipop incision often works beautifully.
Skin elasticity
Younger patients with good skin elasticity are often excellent candidates for the vertical technique. If your skin has lost elasticity due to age, pregnancy, or weight changes, the anchor technique may be necessary to remove excess skin.
Nipple position
If your nipples sit below your breast crease, you’ll likely need the additional reshaping capability of the anchor incision to achieve proper positioning.
What to Expect During Recovery
The recovery process is similar regardless of which incision method is used, but there are some slight differences to be aware of, particularly in the early stages of your recovery:
| Recovery in the First Week After Surgery | ||
|---|---|---|
| Both Incision Types | Vertical/Lollipop Incision | Traditional/Anchor Incision |
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Scarring Based on Breast Reduction Incision Type
While the scarring patterns are different based on the incision method, both types of scars tend to heal well and fade over time. Your scars will be pink and raised initially, but many patients report that their scars fade to thin, pale lines that are barely noticeable 12 months after their procedure.
Minimizing Scarring
Regardless of which incision type you choose, you can take steps to ensure the best possible outcome and minimize your scarring:
Immediate post-surgery care:
- Follow all dressing change instructions precisely
- Keep incisions clean and dry
- Don’t apply lotions or creams unless approved by your surgeon
- Avoid sun exposure to healing scars
Long-term scar management:
- Use silicone scar sheets or gel as recommended (usually starting 2-3 weeks post-surgery)
- Massage scars gently once cleared by your surgeon
- Apply sunscreen frequently to prevent darkening
Start With a Consultation at Harris Plastic Surgery
Dr. Harris and his team are experts at helping women meet their breast reduction goals. Whether you have a significant amount of tissue weighing you down or just need a slight reduction, Harris Plastic Surgery is here to help you live your best life. We can plan your breast reduction incision types to match your surgical needs and your desired outcome.
If you are trying to decide which of the breast reduction incision types would work best for you, we can help you decide. Contact us online or by phone/text message if you have questions or are ready to schedule your consultation.
Stephen U. Harris, MD FACS
Dr. Stephen U. Harris is a board-certified plastic surgeon and recognized expert in breast reduction and reconstruction surgeries, having performed thousands in his career. When it comes to patient care, his philosophy is that every surgery should improve his patient’s overall quality of life, not just their appearance. Dr. Harris stays up-to-date on all the latest advancements in breast augmentation, reconstruction, and reduction and is a recognized innovator in the field. In fact, he was the first surgeon at Good Samaritan Hospital to offer primary prepectoral implant breast reconstruction, as well as secondary prepectoral revision surgery.
Dr. Harris also serves as Chief of Plastic Surgery at Good Samaritan Hospital in West Islip, New York, and is an active staff surgeon (and former Chief of Plastic Surgery) at South Shore University Hospital in Bay Shore, New York.