The two most commonly seen breast reductions differ based on the scar pattern and blood supply to the nipple. There is also a breast reduction done which actually detaches the nipple, called a free nipple graft. This is much less common (I have never done one in 25 years of private practice, and I have done huge breast reductions and lifts).
This is a place where plastic surgeons differ in how they do the surgery, and two surgeons could advise the same patient to do it a different way. Some of this has to do with the training of the surgeon, their comfort at doing the surgery, and other factors. Some doctors do one breast reduction type for some patients, and another for others based on breast size and droop. I do not think anyone is “too big” or “too droopy” to do a short scar lollipop breast reduction. I do not know why the majority of plastic surgeons near me still do an anchor breast reduction, but they do.
That means you can’t convert from a lollipop to anchor or vice versa. So if I am redoing a breast reduction on someone who had an anchor breast reduction in the past, I will redo the anchor.
I call this the lollipop because that is the scar shape- it goes 360 degrees around the areola and then a vertical line to the bottom of the breast. The technique is NOT new. I learned it over 20 years ago from Dr. Elizabeth Hall Findlay at a plastic surgery course. When I saw her results, shorter scar, and better longevity with time, it was a true Aha moment for me. The original description was from LeJour in 1993.
This is the traditional breast reduction I was taught in medical school on forward for years. It is a tried and true technique and works for all sizes and droopiness of breasts. The pedicle blood supply is from inferiorly. My biggest issue with it is
I cannot understand why anyone does the anchor anymore. I think the lollipop vertical breast lift and reduction in superior in every way. I have not found anyone who is too big or droopy to do it. I did an 1800 gram reduction on each breast (3600 grams total), where her breast was almost touching her waist, using a vertical breast reduction.
It has a shorter scar, better shape, lifts the inframammary fold, narrows the breast, better longevity of results. Win. win. win. Our own Plastic Surgery Journal had a journal article about it asking why more people are not doing it. Just come in for a consult and see my photos.
On all counts, I think it is. For sure meet with at least one surgeon who does vertical breast reductions. And do not let anyone convince you that your breasts are “too big” or “too droopy” to do a short scar breast reduction.
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