For breast reduction surgery, I rarely use a full “anchor” scar technique, as my goal is to reduce/lift breast heaviness and reshape the remaining breast tissue while creating the shortest and nicest quality scars possible. Although the anchor incision enables the greatest degree of reduction – for instance from a DDDD cup or larger to a B or C cup – it generally produces a very long scar that extends all the way along the entire fold of the breast (the “inframammary fold”), which is not usually necessary.

In contrast, the “lollipop” scar is used more for a subtle lift of the breast and repositioning of the nipple and areola to a higher position, without significant breast reshaping and a less significant reduction of size. Most women are not good candidates for this incision design.

The “short scar” superomedial pedicle technique that I usually employ has advantages of both techniques, with very few disadvantages. This method often produces a perky and youthful breast shape with pleasing fullness in the cleavage area, a long-lasting result, the most likely recovery of nerve sensation to the nipple, and preservation of the ability to breastfeed.

There is not a one-size-fits-all approach to breast reductions. Each woman who I see in consultation for breast reduction surgery is evaluated independently, on a case-by-case basis. Her symptoms, goals for surgery, body shape, curves, and proportions are evaluated, and the most appropriate procedure to achieve the best results for her is then determined.

I often recommend the addition of liposuction of the “axillary rolls” and the back fat / bra roll region to a breast reduction. Liposuction helps to create the best definition between where the breast ends and the back area begins. An example is visible below:

Liposuction is not covered by insurance, so it may increase the cost of the operation. However, adding liposuction to a breast reduction accentuates the cosmetic outcome of surgery, removes bra roll fat, and reduces the heaviness of the sides of the breasts, all of which can ultimately generate the best possible outcome and enable shorter scars in the inframammary fold.

– Dr. Karen Horton, Board Certified Plastic Surgeon

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