Your degree of droopiness will determine the type of scar pattern. There is essentially always a circular scar around the areola and a vertical scar down to the fold beneath the breast to allow access for reducing and shaping the breast. A "vertical" only or "lollipop" scar is a possibility without the scar along the fold if there is not excessive lower breast skin to remove.

Published on Jul 11, 2012

It ultimately depends on how small you would like to be and how much extra skin has to be removed. One possibility is liposuction only, but this option is best for patients under 30 with no droop and a small size change. The other is a lollipop incision, which avoids the scar underneath. These things would be determined at your consultation.

Published on Jul 11, 2012

The scar pattern for breast reduction (or mastopexy/lift for that matter) depends upon the anatomic starting point. Patients with very limited sagging/ptosis may be candidates for a circum-areolar or donut lift; however, this is not an option in the case of reduction. Moderate degrees of ptosis or sagging can be addressed via a vertical reduction that results in a "lollipop" incision or a circum-areolar incision plus a vertical limb. For patients with more significant ptosis or sagging, an anchor scar is often necessary to address the laxity in all dimensions and more effectively reshape the breasts.

Ultimately, this decision is based on exam. Without photos, at the least, there is very little that can be said in your particular situation.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

It is possible but the anchor incision exists and is most commonly used because it works. It allows the surgeon to reduce the breasts, to shape the breasts, and to match the breast best from one side to the other.

Published on Jul 11, 2012

Yes, there is a technique known as vertical scar reduction. However, everything depends upon how large you are.

Published on Jul 11, 2012

This is a very common question, and a very common concern. On very few instances, a mini lift can be done using just the areola, but most patients do not qualify for this. As with any surgery, if there is extra skin that needs to be removed, the exchange is a scar. I would recommend an in-person consultation with a board-certified plastic surgeon to go over your concerns and see what your options are. Best of luck!

Published on Jul 11, 2012

I can sometimes do a breast reduction with liposuction only. I try to limit the amount of the incisions, but it really depends on how low your breasts are, the amount of tissue removed and how up you want your breasts to be. You can image your breasts to get an idea of how they will look after the reduction.

Published on Jul 11, 2012

There are some patients that are candidates to just do liposuction of the breast. That requires the skin to constrict on its own. This is usually not a great option for those who have lost elasticity to their skin. There are other techniques that are like a lollipop. There are pros and cons of each incision you make. The lollipop scar generally leaves too long of an incision from the nipple to the inframamary crease. To tighten the skin you need to take some out in the anchor scar usually. You should go and meet with a board-certified plastic surgeon for a physical exam. The best would be to see a to tighten the skin you need to take some out in the anchor scar usually. You should go and meet with a board-certified plastic surgeon for a physical exam member of the American Society for Aesthetic Plastic Surgery as they do most of their work in cosmetic surgery. Good luck

Published on Jul 11, 2012

All patients and all surgeons want to limit scarring. The reason surgeons use the anchor scar is that they believe it creates the best shape and long lasting results. I am one of those. But there are others who prefer the lollipop incision. In my opinion breasts reduced with a lollipop incision often look too pointy, a notable percentage need a second procedure to revise the scar, and even though the scar is shorter, the scar itself isn't as good because uneven lengths of skin are sewn together which often results in some puckering.

There is a reduction that can be done with a scar just around the areola, but that only works for breasts that barely need a reduction.

I often do breast reduction with liposuction alone, which requires only two very small and totally hidden incisions. There are two drawbacks: if a patient needs a lift then it won't work and since liposuction only removes fat, it doesn't get an an adequate reduction in a highly glandular breast.

Published on Jul 11, 2012

It is possible to eliminate the scar under the breast in certain individuals, however, the vertical scar and the scar around the areola cannot be avoided.

Published on Jul 11, 2012

Thank you for your question. Breast reduction surgery is one of the most patient pleasing operations that we do.
In general, breast reduction surgery involves the anchor incision BUT every patient differs with how much breast tissue needs to be removed, etc. so it will best to visit with a well experienced plastic surgeon in your area so that he/she can perform a physical examination and discuss your goals in person. Best wishes.

Published on Jul 11, 2012

Great question. Yes, there are several different types of breast reduction procedures. The vertical and spare reduction will allow you to avoid the anchor type incision. Depending on how much of a reduction you need, your incision will either be down your breasts or down your breast and curved laterally toward the side of your breasts.

Published on Jul 11, 2012

Its possible in some cases to do a reduction with liposuction alone. However, the amount of tissue being removed is more limited and there is no lift with liposuction alone, so if you are sagging, you will still sag. There are minimal scars with liposuction but this is used in relatively limited cases. Without photos its difficult to give you the best advice.

Published on Jul 11, 2012

To limit the scarring from a breast reduction and avoid an incision on the bottom of the breast, a lollipop approach might be an option, it depends on your size, shape, and anatomy. Or, sometimes liposuction alone can reduce the breast but it will not provide much of a lift. Seek the opinion of a board certified plastic surgeon to find out what it best for your anatomy.

Published on Jul 11, 2012

Yes. However the answer depends on the degree of ptosis (sagging) associated with the breast hypertrophy. If there is minimal to no ptosis, a breast reduction can be achieved with very small incisions using liposuction. With increasing degrees of hypertrophy and ptosis, options for a crescent, "donut" or "lollipop" incision become more likely. Advanced ptosis and hypertrophy are commonly treated using the anchor lift

Published on Jul 11, 2012

Thank you for the question, it is possible to have the vertical or lollipop lift or a combination of Ultrasonic liposuction with a lift around your areola. You would have to have an examination to discuss these options with a board-certified plastic surgeon.

Published on Jul 11, 2012