Breast reduction incisions usually follow one of two patterns: a lollipop, around the areola and straight down to the fold, or an anchor, which adds a line along the fold. Liposuction-only reductions leave tiny entry scars. Scars are often red for the first six weeks, then most fade and flatten over months, though they’re permanent.
This guide is part of our breast reduction overview.
Incision types
Surgeons choose breast reduction incisions by how much tissue and skin must go; larger reductions usually need the anchor pattern.
| Incision | Where the scar sits | Usually used for |
|---|---|---|
| Lollipop (vertical) | Around the areola and down the front of the breast to the fold | Small to moderate reductions |
| Anchor (inverted-T, keyhole) | As lollipop, plus a horizontal line in the breast fold | Larger reductions, more loose skin |
| Liposuction only | Small entry points | Selected breasts made mostly of fat, with good skin |
The American Society of Plastic Surgeons (ASPS, US) illustrates the lollipop and keyhole patterns and says the nipple is usually moved while keeping its blood and nerve supply. For very large breasts, a free nipple graft may be used, which leaves the nipple without sensation. The National Health Service (NHS, UK) describes scars around the nipple, often a vertical scar, and sometimes an anchor-shaped scar.
Liposuction alone removes less tissue. In a small 2018 comparative study of young women, liposuction removed an average of 639 g compared with 1,266 g for a standard reduction.
Scar healing
Scars change a lot in breast reduction before and after photos: red for about six weeks, then gradually paler and flatter over many months.
| Time | What scars usually look like |
|---|---|
| Weeks 1 to 6 | Red or discoloured (NHS); stitches usually dissolvable |
| Months 2 to 6 | Gradually softer; may stay pink or darker than surrounding skin |
| Months 6 to 12 and beyond | Most fade and flatten; the NHS says most become largely invisible |
ASPS lists unfavourable scarring, skin discolouration and possible skin loss where incisions meet among the risks. The meeting point of the vertical and horizontal lines in an anchor scar is under the most tension, so it’s the most common spot for slow healing. Thick or noticeable scarring is also listed by the NHS.
Scar care
Protect the incisions, start scar care when advised, avoid sun on new scars and don’t smoke; most product evidence is limited.
- Protect from strain: ASPS advises protecting incisions from excessive force, swelling, abrasion and motion; wear your support bra.
- Silicone gel or sheets: a 2021 Cochrane review of 13 trials found low- to very-low-certainty evidence that silicone sheeting may slightly improve scar appearance and pain.
- Sun protection: keep pink scars covered or use sunscreen.
- No smoking: ASPS says smoking reduces blood flow and impedes wound healing.
At follow-up, I check the junction of the anchor scar most carefully, since it’s where small wound breakdowns tend to show first.
Tattoo cover-up ideas
A breast reduction tattoo can disguise or decorate scars once they’ve fully matured, usually at least a year after surgery.
Popular breast reduction tattoo cover up options:
- Floral or vine designs that follow the curve of the fold scar
- Fine-line designs along the vertical scar
- Medical areola tattooing to blend the scar around the nipple
- Designs placed beside rather than on top of a raised scar
Before any breast reduction tattoo cover, check with your surgeon that the scar is flat, pale and fully healed, and choose an artist experienced with scar tissue. If you tend to form keloids, ask a dermatologist first. For the full recovery picture, see our breast reduction recovery guide, and for results, breast reduction before and after.
Frequently Asked Questions
FAQ
Answers on how visible scars are, which technique scars least, improving scars later and when it is safe to tattoo over them.
How noticeable are breast reduction scars?
They’re clear in the first months, then fade. The NHS says scars may be red for about six weeks and most fade to become largely invisible. The fold scar is usually hidden by a bra; the vertical and areola scars are on the front of the breast.
Which breast reduction leaves the smallest scar?
Liposuction-only reduction leaves the smallest scars but removes less tissue and doesn’t lift much. The lollipop pattern avoids the fold scar. Larger reductions usually need the anchor pattern to remove enough skin.
Can scars be improved later?
Often, yes. Options include silicone products, steroid injections for raised scars, laser treatment or a small scar revision once the scar has matured. Your surgeon will suggest what suits your scar after several months.
How long should I wait before tattooing over scars?
Most people wait at least a year, until the scar is flat, pale and no longer itchy. Ask your surgeon to confirm it has matured, and choose a tattoo artist experienced with scar tissue.
If you’d like to see where your incisions would be before deciding, you can book a consultation with Metropole Clinic by ABmedi. For techniques, insurance and costs, return to our breast reduction hub.
This article is for general education and does not replace a personal medical consultation.
References
Show sources
- Breast reduction: procedure. American Society of Plastic Surgeons (ASPS, US). Accessed 2026. plasticsurgery.org
- Breast reduction (female). National Health Service (NHS, UK). Reviewed 2023. nhs.uk
- Breast reduction: safety. American Society of Plastic Surgeons (ASPS, US). Accessed 2026. plasticsurgery.org
- Jiang Q, et al. Silicone gel sheeting for treating hypertrophic scars. Cochrane Database Syst Rev. 2021. cochrane.org
- Liposuction reduction alone versus inferior pedicle mammoplasty in young females: a comparative study. Egypt J Plast Reconstr Surg. 2018;42(2):331-335. ejprs.journals.ekb.eg
- Breast reduction: preparation and recovery. American Society of Plastic Surgeons (ASPS, US). Accessed 2026. plasticsurgery.org
