The Surgeon Minute

Breast Reduction Balancing Act: Scars vs. Results

Breast Reduction Balancing Act: Scars vs. Results

Breast reduction surgery provides relief from physical and social discomfort, dramatically changing the way women with oversized breasts look and feel. Post-breast reduction surgery, women find themselves enjoying the many benefits of having breasts that are in proportion to the rest of their body as they lead a healthier, more comfortable life.

According to board certified plastic surgeon Dr. Stafford R. Broumand of New York City, the highest degree of patient satisfaction is achieved with breast reduction surgery. “It’s an incredibly wonderful surgery that gives a outcome which makes our patients the happiest,” shares Broumand. “We’ve taken a patient who has been troubled by back pain, bra strap pain, neck pain – they have been self-conscious of their breasts, they don’t fit into clothes – and we’ve made them more proportional.”

Reasons to Consider a Breast Reduction

Many women who undergo breast reduction surgery do so for medical reasons. Painful bra strap marks and skin rashes are common among large-chested women. The added stress of a heavy breast on the body can lead to back, neck and shoulder pain. Women experiencing these negative side effects often find themselves unable to participate in certain forms of exercise and other physical activities that amplify the physical discomfort.

Breast reduction before and after.

Problems with Oversized Breasts:

  • Back pain
  • Bra strap pain
  • Neck pain
  • Self-esteem issues
  • Difficulty fitting into clothing

Women also seek breast reduction surgery for aesthetic reasons. Large breasts can attract negative attention, making a woman feel uncomfortable with her appearance in social situations. Breasts that are out of proportion with the shape of a woman’s body make it difficult to find clothing to fit and flatter her figure. In addition, the weight of a heavy chest causes it to droop at a faster rate. Misshapen, saggy breasts leave many women self conscious of their appearance when the clothing comes off.

Three Breast Reduction Incision Options

During breast reduction surgery, fat and breast tissue are removed and the remaining breast is lifted and reshaped to create a smaller, firmer, perkier breast. Dr. Broumand begins each consultation by explaining the three different breast reduction incision options. They range from a small circular scar, to a circular scar with a vertical component, to a more extensive anchor-shaped scar.

Breast reduction incisions.


Incision Placement Options:

  • Benelli (Donut): Circular incision around areola only
  • Lollipop: Circular incision with a vertical component from areola to fold
  • Anchor: Circular incision, vertical component and a third incision placed in the fold


Of the three options, the Benelli Lift, also known as a periareolar incision or a donut mastopexy, offers the least amount of visible scarring but delivers the smallest degree of change. Two circle incision are made, a small circle incision close to the areola, and a larger circle incision further away from the areola. The donut-shaped piece of skin between the circles is removed along with excess breast tissue, and the outer circle is drawn inward using a purse-string suturing technique.

While this is a good option for women who are looking for a small degree of improvement, women who have very large chests are not always a candidate for a Benelli Lift.


The second option, Dr. Broumand’s preferred breast reduction method, is the Lollipop incision. The lollipop incision places less tension on the circular portion of the incision around the areola, as most of the lift is achieved through the vertical scar component. With less tension on the circular component of the incision, the scar tends to heal better and remain less noticeable around the areola. The vertical incision begins at the bottom of the circular scar and extends straight down to the fold beneath the breast.   

“The vertical limb of the lollipop incision heals incredibly well. In reality, if a patient looks at their breast pre-operatively, and then with a faint or almost hidden lollipop incision post-operatively the trade-off is not proportional,” explains Broumand. “They want to have the smaller breasts, the scar is minimal and so the scarring to them is almost a non-event.”


An anchor incision combines the lollipop lift with a third incision placed in the fold beneath the breast. While more incision offers a greater opportunity for reshaping of the breast, Broumand finds the added flexibility in the operating room doesn’t always outweigh the negative potential for extensive visible scars.

“Early on in my practice I did an anchor incision on a very fair skinned patient, and the scar thickened,” explains Broumand.  “It just tormented me and our patient. So we thought, we’ve got to come up with a better way of doing this surgery. That’s where the lollipop incision came in, to reduce that amount of scarring underneath the breast.”

Breast reduction results - Dr. Broumand.

The Goldilocks of Breast Lift Surgery

No one wants to go through breast reduction surgery and recovery only find themselves faced with too little improvement or excessive scarring. Breast reduction surgery is a balancing act between achieving enough lift while minimizing the scars.  It’s important to choose a board certified plastic surgeon to guide you through the decision making process so that together you can decide which procedure is just right for you.  

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