A/Prof Damian Marucci cosmetic plastic reconstructive surgeon

What are the incisions like for a breast reduction?

Sydney Kogarah Miranda breast reduction

Women who have very large breasts sometimes experience symptoms like back, shoulder, and neck pain. It can also be challenging for them to find clothes that fit well. In order to address these problems, some women choose to have a surgical breast reduction. This is a procedure to remove excess tissue from the breast, leaving behind a breast that’s more proportional to the patient’s overall body frame. Studies have shown that this can help to relieve symptoms like back pain.

All surgical procedures result in scars. A/Prof Marucci’s patients often wonder what their scars will look like after a breast reduction. There are two major types of incisions that are commonly used for breast reduction, which are usually known as the “inverted anchor” incision and the “lollipop” incision. What is each one like? Which one will be used in your case?

Lollipop incision for breast reduction

The lollipop incision is one option for breast reduction, but is typically used for small reductions/ breast lift surgery. One part of the incision is made all the way around the areola, which is the dark circle surrounding the nipple. There’s another incision extending directly downward from the edge of this circle to the inframammary crease, which is the point where the breast meets the chest wall. During the procedure, extra incisions will be made outside of these, and the skin in between will be removed.

After healing, you’ll have a scar around your areola with another part extending downward, so the scar looks like a lollipop. The areola will be smaller than it was before the surgery.

The lollipop incision allows the surgeon to access the breast tissue, so that fat and glandular tissue from inside the breast can be removed. The incision around the areola is necessary, because the nipple generally needs to be repositioned higher on the chest wall to provide a good cosmetic result. This incision type works well for many patients, providing a good balance between surgical access to the breast and minimising the resulting scars. However, for most patients requiring a significant breast reduction, the lollipop incision doesn’t allow for the removal of enough excess tissue.

Inverted anchor incision for breast reduction

For most patients needing a breast reduction, the inverted anchor incision (or “Wise pattern”) is preferred. It’s the same as the lollipop incision, except there’s an extra incision along the inframammary crease. This will usually be fairly well hidden after the surgery. (In fact, an incision along the inframammary crease is very common in breast augmentation as well.)

The inverted anchor incision allows the most access to the breast tissue, and allows the surgeon to remove tissue from both the upper and lower parts of the breast. It also allows for greater removal of excess sagging skin. For those who have quite a bit of excess tissue, the inverted anchor incision generally allows the surgeon to create the most natural-looking and balanced breast shape.

Can you have a breast reduction without the vertical scar?

Whether the inverted anchor or the lollipop incision is used, the most visible part of the scar is usually the vertical part that extends downward from the areola. Some patients wonder whether it’s possible to avoid this part of the incision.

In some cases, the incision can be made just around the areola – this is sometimes called the “doughnut” incision. Another larger circular incision is made outside of this, and the tissue removal takes place between them. The resulting scar consists only of the circular part around the areola, which is generally fairly discreet because the color change at the edge of the areola disguises it.

However, this incision only allows for a relatively small amount of tissue removal. Most women who choose to have a breast reduction need more tissue removed than the doughnut incision allows. Even though the scar is smaller, the overall result will not be as good, because the surgeon isn’t able to remove enough tissue in a balanced way.

Sydney Kogarah Miranda breast reduction

If you’re considering a breast reduction and you’re wondering what type of scar you could expect, your next step is a consultation with a qualified plastic surgeon. If you’re in the greater Sydney area, please schedule a consultation with A/Prof Marucci in our Kogarah or Miranda rooms. After examining you and learning more about your goals for your appearance, he’ll be able to let you know which incision type he recommends in your case and why. If you choose to have the procedure, you’ll know that you’re in the highly trained hands of an Associate Professor of Surgery at the University of Sydney. Simply contact our front desk to book your appointment.

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