Breast Reduction Incisions : Anchor, Lollipop, or Donut?

Choosing the Right Incision for Your Breast Reduction (Reduction Mammoplasty)

For people considering reduction surgery (Reduction Mammoplasty), one of the critical decisions is selecting the appropriate breast reduction incisions. This choice not only impacts the procedure’s outcome but also determines the extent and appearance of post-surgical scarring. Three primary incision techniques are commonly employed: the anchor incision, the lollipop incision, and the donut incision. Each approach offers distinct advantages and considerations, making it crucial to become familiar with their nuances to make a decision aligned with your goals and preferences.

Sydney Specialist Plastic Surgeon Dr Jake Lim has many years of experience performing breast reduction – reduction mammoplasty surgery and other breast procedures.

Download Dr Lim’s Breast Reduction Surgery Guide

Breast Reduction (Reduction Mammoplasty) Incisions

Breast reduction surgery, also known as reduction mammoplasty, is a surgical procedure designed to remove excess breast tissue and skin, alleviating the physical burden associated with overly large breasts. During the operation, the plastic surgeon carefully eliminates the breast tissue to achieve a more proportionate shape while addressing any asymmetry or sagging concerns.

To facilitate this, incisions are necessary to access the underlying breast tissue and reshape the breasts. The incision pattern chosen by your plastic surgeon is influenced by many factors, including your breast size, skin elasticity, and desired outcome. The three primary incision techniques are as follows:

1. Anchor Incision

The anchor incision, also referred to as the inverted-T or Wise pattern incision, is a widely employed technique in breast reduction surgery. It involves three distinct incisions:

A circular incision around the areola (the pigmented skin surrounding the nipple)
A vertical incision from the bottom of the areola to the inframammary fold (the crease beneath the breast)
A horizontal incision along the inframammary fold

This incision pattern resembles an anchor or inverted-T shape, hence its name. The anchor incision is particularly used for women with overly large breasts, as it provides your plastic surgeon with ample access to remove substantial amounts of tissue and reshape the breast effectively.

2. Lollipop Incision

The lollipop incision, also known as the vertical incision, is a less invasive approach compared to the anchor incision. It involves two incisions:

A circular incision around the areola
A vertical incision from the bottom of the areola to the inframammary fold

This incision pattern resembles the shape of a lollipop, giving it its descriptive name. The lollipop incision is often recommended for women with moderate breast size or those seeking a more subtle reduction. It typically results in a shorter scar than the anchor incision, making it a preferred choice for women who prioritise reducing visible scarring.

3. Donut Incision

The donut incision, also referred to as the periareolar incision, is the least invasive of the three techniques. It involves a single circular incision around the areola, with no additional vertical or horizontal incisions.

This incision pattern is primarily suitable for women seeking a minor breast reduction or those with smaller breasts. While the donut incision offers the advantage of reduced scarring, it may not be appropriate for more extensive breast reductions, as it limits your plastic surgeon’s ability to remove considerable amounts of tissue or reshape the breast extensively.

Breast Reduction Patient 10 — Front View

Factors Influencing Incision Choice

When determining the most suitable incision pattern for your breast reduction (reduction mammoplasty), many factors come into play. Your plastic surgeon will carefully evaluate these considerations to ensure an optimal outcome and reduce potential risks or complications.

Breast Size and Tissue Volume

One of the primary factors influencing incision choice is the size of your breasts and the amount of tissue that needs to be removed. Women with significantly large breasts may require the anchor incision to facilitate extensive tissue removal and reshaping. Conversely, those with moderate or smaller breast sizes may be better candidates for the lollipop or donut incisions, respectively.

Skin Elasticity and Breast Ptosis

The elasticity of your skin and the degree of breast sagging (ptosis) are important in determining the appropriate incision pattern. Women with good skin elasticity and reduced sagging may be suitable candidates for the donut or lollipop incisions, as these techniques can effectively reshape the breasts without the need for extensive skin removal. However, those with significant breast ptosis or poor skin elasticity may require the anchor incision to achieve optimal breast reshaping and lift.

Desired Outcome and Aesthetic Preferences

Your personal goals and aesthetic preferences are equally important considerations when choosing the incision pattern. If reducing visible scarring is a top priority, the donut or lollipop incisions may be preferable, as they result in shorter or more discreet scars. However, if achieving a considerable breast reduction and lift is the primary objective, the anchor incision may be the most appropriate choice, despite the potential for more extensive scarring.

Surgeon’s Expertise and Recommendations

The expertise and recommendations of your plastic surgeon are also important in determining the most suitable incision pattern. Dr Jake Lim will evaluate your unique anatomy, breast characteristics, and desired outcomes to provide personalised guidance on the incision technique that offers the best balance of safety, effectiveness, and aesthetic appeal.

Incision Techniques Comparison

To better understand the nuances of each incision technique, here is a comparative analysis of their advantages, disadvantages, and potential outcomes.

Aspect	Anchor	Lollipop	Donut
——–	——–	———-	——-
Pros	• Allows extensive tissue removal and breast reshaping • Optimal for addressing significant ptosis (sagging) • Facilitates symmetry correction in cases of significant breast asymmetry	• Less visible scarring than anchor incision • Suitable for moderate breast reduction • Balances reshaping access and scarring reduction	• Most discreet scarring (circular around areola) • Suitable for minor breast reduction • Reduced surgical trauma and shorter recovery period
Cons	• Extensive scarring, including horizontal scar along inframammary fold • Longer recovery period • Increased risk of complications (e.g., wound healing issues, sensitivity changes)	• May not suit very large breasts or severe ptosis • Potential for residual sagging or asymmetry if reduction is extensive • Risk of visible vertical scar	• Limited access for extensive tissue removal or reshaping • Potential for residual sagging or asymmetry if reduction is more than minor • Risk of nipple/areola sensitivity changes or malposition
Best suited for	Women with significantly large breasts or severe ptosis requiring extensive reshaping	Those seeking moderate reduction or with good skin elasticity	Women seeking minor reduction or those with smaller breast sizes

Preparing for Your Breast Reduction (Reduction Mammoplasty) Consultation

To ensure a productive consultation with Dr Jake Lim, it’s essential to prepare thoroughly. Here are some helpful tips:

1. Understand Your Goals and Priorities

Before your consultation, take the time to reflect on your specific goals for the breast reduction surgery. Are you primarily seeking relief from physical discomfort caused by large breasts, or is achieving a more proportionate breast shape your primary motivation? Additionally, consider your priorities regarding scarring visibility and the extent of breast reshaping desired.

2. Gather Relevant Medical Information

Prepare a comprehensive medical history, including any previous breast surgeries, medications, or underlying health conditions that may impact the surgical outcome. Provide your plastic surgeon with detailed information about your breast concerns, such as asymmetry, sagging, or discomfort, as these factors can influence the incision choice.

3. Discuss Lifestyle and Recovery Considerations

Be prepared to discuss your lifestyle and recovery expectations with your surgeon. Factors such as your physical activity level, work demands, and ability to take time off for recovery can influence the incision technique recommended. Additionally, discuss your support system and post-operative care arrangements, as these can impact your healing process.

4. Bring Visual References

Bring along visual references, such as photographs or illustrations, to help communicate your desired breast shape and size to your plastic surgeon. This can aid in aligning expectations and ensuring a shared understanding of the intended outcome.

5. Ask Questions and Voice Concerns

Don’t hesitate to ask questions and voice any concerns you may have during the consultation. Dr Lim is patient, understanding, and willing to provide comprehensive explanations to address your queries and alleviate any apprehensions.

FAQs about Breast Reduction (Reduction Mammoplasty) Incisions

How long does the recovery process typically take?

The recovery timeline for breast reduction – reduction mammoplasty surgery can vary depending on your individual circumstances. Generally, you may expect to return to light activities within 1-2 weeks, but make sure to avoid strenuous exercises or heavy lifting for at least 4-6 weeks. Full recovery, including the settling of swelling and scars, may take several months.

Will I still be able to breastfeed after a breast reduction?

After breast reduction (reduction mammoplasty), there is a possibility that your ability to produce milk may be affected. The extent of this impact depends on the surgical technique used and the amount of tissue removed. If breastfeeding is important to you, discuss this concern with your plastic surgeon beforehand.

How much pain should I expect during recovery?

Pain levels can vary from person to person, but most patients describe the discomfort as moderate and manageable. You’ll likely experience the most significant pain in the first few days following surgery, which can be controlled with prescribed pain medication. As you heal, the discomfort should gradually subside. Some patients report feeling tightness, soreness, or a burning sensation in their breasts, which is normal and typically resolves within a few weeks. If you experience severe or worsening pain, contact your plastic surgeon immediately.

Will my breasts continue to change after surgery?

Your breasts may continue to change after surgery due to factors such as ageing, weight fluctuations, hormonal changes, and pregnancy. While breast reduction can provide long-lasting results, it doesn’t halt the natural ageing process or prevent future changes in breast tissue. To maintain your results, it’s advisable to maintain a stable weight and follow a healthy lifestyle. If you’re planning to become pregnant or lose a significant amount of weight, you may want to discuss the timing of your surgery with your surgeon.

How soon can I resume intimate activities after breast reduction surgery?

The timeline for resuming intimate activities varies, but most surgeons recommend waiting at least 3-4 weeks after your procedure. This allows time for initial healing and reduces the risk of complications. Listen to your body and follow your surgeon’s specific guidelines. Some patients may need to wait longer, especially if they experience prolonged swelling or discomfort. When you do resume intimate activities, be gentle and communicate openly with your partner about any concerns or discomfort you may have.

Are there non-surgical alternatives to breast reduction?

Breast reduction surgery is the most effective way to considerably reduce breast size. Some non-surgical options might provide relief for mild cases. These include:

Supportive bras: Professionally fitted, high-quality sports bras or specialised reduction bras can help alleviate discomfort and provide better support.
Physical therapy: Exercises targeting the back, neck, and shoulder muscles can help improve posture and reduce pain associated with large breasts.
Weight loss: If you’re overweight, losing weight may lead to a reduction in breast size, although results vary.
Alternative therapies: Some people find relief through acupuncture, massage, or chiropractic treatments.

Keep in mind that these alternatives typically offer temporary relief and may not address physical or emotional concerns related to very large breasts.

Breast Reduction (Reduction Mammoplasty) Incisions: Anchor, Lollipop, or Donut?