Wise-Pattern (Lejour or Anchor) Breast Reduction
The Wise-pattern Breast reduction technique, also known as the Lejour technique, is the original breast reduction surgery procedure. It is also known as the anchor technique as it leaves an anchor-shaped scar. This technique was first developed by Robert Wise in 1956 when he published his experience on refining previous patterns of surgery by designing an incision in the form of a keyhole. The Wise-pattern breast surgery technique is the basis of most, if not all, breast reduction techniques that are being used in the present times. It remains one of the most common styles of incision for breast reduction surgery as it is versatile and can provide predictable outcomes in very large reductions. Thus, it is very useful in patients with large, droopy breasts.
When using this technique, Dr. Agha will remove skin, fat, and tissue from the lower breast area to reduce the mass of the breast. The nipple and areola will be moved to a higher location on the breast, but not removed from the breast mound itself. After the nipple is moved to its new position, the skin above the nipple is brought down and around the breast mass, and then stitched back to close the incisions.
For some patients, Dr. Agha has been employing newer methods of breast surgery that reduce the length of scarring, such as short L-incision or the short inverted T-incision.
Vertical Scar (Lollipop) Breast Reduction
The lollipop, or vertical scar breast surgery, is fast becoming a popular method in the United States. It is mainly used for women who are seeking a smaller reduction in breast size however, and is not preferred for those with greatly oversized breasts.
When employing the lollipop incision technique, a vertical incision is made around the areola and down over the breast. After removing breast tissue and skin, Dr. Agha will then stitch up the incision on the breast. The nipple is moved up in a method similar to that of the anchor procedure, but not more than a few centimeters.
Horizontal Scar Breast Reduction
The horizontal scar breast surgery technique is sometimes employed by surgeons who are looking to create a shorter scar. It is often used when a larger reduction is needed than what the lollipop technique can produce, while avoiding the need for the more involved Wise-pattern technique. However, the horizontal technique can cause what is known as a “flat” or “boxy” look to the breasts. Therefore it is not recommended by Dr. Agha due to these disadvantages, especially in the advent of newer and more effective techniques.
Breast liposuction is often used in combination with other breast reduction methods. Liposuction can also be used alone to decrease the amount of fat from breasts and provide a less-invasive procedure. There is less visible scarring, faster recovery, and fewer complications with breast liposuction than if traditional breast reduction surgery is performed. However, patients must present with certain criteria in order to qualify for best results when employing the liposuction-only technique. Best candidates for liposuction-only surgery are those that have a large proportion of breast fat, but do not have pendulous breasts. Also patients must not have breast tissue that is overly dense or have breasts that are excessively large, since liposuction alone can only produce reductions of approximately 30% to 50%.
Before liposuction-only technique can be considered, along with a thorough evaluation, Dr. Agha will have to determine the elasticity of your skin. This is vital in producing favorable results as the skin will need to have sufficient elasticity or the breast tissue that is left after the procedure may show unfavorable sagging.
As much as it is appealing due to a scar-free result, plastic surgeons are still unconvinced that liposuction alone can solve the problem of extra large breasts. Breast liposuction is often associated with non-drastic results.