Vertical vs. Anchor: Which Should You Choose?

When you choose a breast reduction technique, you often have to decide between two priorities. Do you want the smallest possible scar? Or do you want to avoid a second “touch-up” surgery later?

A classic prospective study from the University of Puerto Rico highlights this exact trade-off. It compared the two most common breast reduction methods: the Vertical (“Lollipop”) pattern and the Wise (“Anchor”) pattern.

The Study: A Fair Comparison

To get a clear answer, researchers designed a randomized study. This removes bias. They followed 208 women undergoing moderate breast reductions (removing about 500g of tissue per breast).

• Group 1: 105 women had the Wise Pattern (Anchor scar).
• Group 2: 103 women had the Vertical Pattern (Lollipop scar).

Crucially, the same plastic surgeon performed all the surgeries to ensure consistency.

The Results: Vertical Wins on Looks

Six months after surgery, the patients rated their satisfaction. The results were clear regarding aesthetics.

• Better Scars: Patients in the Vertical group were significantly happier with their scars compared to the Anchor group.
• Better Shape: Vertical patients gave their “overall aesthetic results” a score of 8 out of 10, compared to just 6 out of 10 for the Anchor group.

If your main goal is a prettier breast with less visible scarring, the Vertical technique is the clear winner.

The Catch: The “Dog-Ear” Problem

However, the Vertical technique had a downside.

Because the Vertical technique does not have a horizontal incision under the breast, it sometimes leaves a small fold of excess skin at the bottom. Surgeons call this a “dog-ear.”

• Vertical Group: 11% of patients needed a minor surgical revision to fix these dog-ears.
• Anchor Group: 0% of patients needed a revision.

What This Means for You

This study reveals a fundamental choice for patients with moderate-sized breasts.

Choose the Vertical (Lollipop) Pattern if:

• You prioritize having minimal scarring.
• You want the best possible aesthetic shape.
• You are willing to accept a small risk (11%) of needing a minor “touch-up” procedure later to trim extra skin.

Choose the Wise (Anchor) Pattern if:

• You want “one and done” surgery with almost zero risk of revision.
• You do not mind having a longer scar that runs underneath the breast fold.

Talk to your surgeon about what matters most to you: the absolute best scar, or the absolute lowest maintenance.

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Reference

[1] Cruz-Korchin, Norma M.D.; Korchin, Leo D.D.S., M.S. “Vertical versus Wise Pattern Breast Reduction: Patient Satisfaction, Revision Rates, and Complications.” Plastic and Reconstructive Surgery 112(6):p 1573-1578, November 2003.