The anchor reduction technique involves a scar around the nipple that goes up and down the vertical incision and along the IMF, the fold underneath the breast. It is a traditional anchor.
The lollipop reduction technique is also known as the vertical breast reduction. The incision is around the nipple and goes up and down. Both techniques are applications to breast reduction and it is how the skin is excised that differentiates the two.
While some patients are candidates for a lollipop reduction, not everybody is a candidate for a lollipop incision. The treatment option is customized to the patient and depends on how much skin they have as opposed to the amount of breast tissue being removed. The technique is really about the quantity of skin being excised. When a surgeon makes a smaller incision like a lollipop incision, they cannot really remove that much skin. It is used in patients where there is not much skin that needs to be excised.
The lollipop is not limited by the size of the nipple or the size of the breast. The limitation is based on how much skin they have. If there is a lot of skin that the surgeon is trying to remove and he only makes a lollipop incision, all of that skin is going to hang.
Anchor incisions have similar limitations to the lollipop incisions. However this incision is best for women who have a lot of skin and whose breasts are very low and hanging because more skin can be removed.
The long term risks are the same with both anchor and lollipop. If patients gain weight, their breast will get bigger again. If they lose weight, their breast will get smaller again. With either technique, the breast will drop slowly after 5 or 10 years.
There is always a chance a woman may not be able to breastfeed with both techniques. There is also a very small chance of infection. There is a small chance that the incisions can open up. One benefit of lollipop incisions is since a patient does not have a third incision, their chances of wound complications might be slightly less, but the risks are equal with both incision types.
Lollipop reduction takes a little bit longer to perform than the traditional anchor reduction. It also takes a little bit longer for the breasts to settle. Patients need to not be alarmed (around day 3) when they take off their bra and the breasts look like they are all the way up to the chest and the bottom part is flat. This is normal. It takes a couple of months for the breast to settle.
Why? Because the breast is being elevated and the skin is being removed in a V-shape pattern so it pushes the whole breast up. However, the bottom part or the inferior part where the vertical incision is located is almost kind of flat. It looks like the top is very full and the bottom is flat. But because the transverse portion is not being taken out, the results are not visible right away. It takes about a month for it to drop and look nice.
Postop treatment is pretty simple with any type of breast reduction including anchor and lollipop technique. No heavy lifting for six weeks. Depending on their job, a patient can go back to work after a week or two. Most of the time, the stitches are dissolvable so nothing needs to be taken out in a follow-up procedure. After 2 or 3 days, the patient can remove their bra in order to take a shower. After the shower, they have to wear the surgical bra again. There is really not much patients have to do in the way of postop treatment.
The downtime is going to be the same whether they have the anchor or lollipop reduction technique. There is not much complaining about pain following either technique. A lot of women have so much back and neck pain to begin with that they feel relief after their reduction. The weight is taken off and they feel such a difference almost the next day) that the incisions do not bother them much. Patients should walk around the day of the (breast reduction to prevent any blood clots. They can do mild activities like routine cooking and cleaning, but should avoid any heavy duty activity. For about six weeks they should not work out in the gym, but they should keep walking.
Initially with the lollipop, the breasts look higher up. It takes a month or so for them to drop. At first, the anchor sometimes looks a little square when they are swollen but they also round out. The biggest difference when looking at the two breast reductions is that the lollipop probably looks a little fuller and a bit more lifted than the anchor technique.
For both the lollipop and anchor breast reduction, the patient has some initial swelling. It takes about three weeks for the swelling to go down, the bruising to go away, and the breast to settle and kind of round out. A patient needs to give it about two months because their bra size will change from three weeks to six weeks since the swelling continues to go down. After about three weeks when the swelling goes down, the shape starts to form.
Women looking for a breast reduction need to know that it is not a cookie cutter operation. It is not like everybody gets a lollipop or an anchor reduction. It needs to be customized to each individual patient. It all depends on how much skin they have, how much breast tissue needs to be removed, and what they are looking for in order to determine what type of technique to use. They should look for a doctor who will tailor the treatment plan according to the needs of the patient.
Written By Cosmetic Town Editorial Team- MA
Based on an exclusive interview with Dr. Nima Patel in New York, New York