Lollipop Incision

Female To Male (FTM) & Female To Nonbinary (FTN) Reconstruction Chest Surgery

The lollipop incision is appropriate for patients who are on the cusp of qualifying for a Periareolar approach, but who have a small amount of skin excess located at the inferior chest wall. This approach involves a scar around the nipple and straight down (in the shape of a lollipop)and allows for a small amount of skin excision from the inferior chest. This approach may be preferred over patients who would otherwise be candidates for the Double Incision, but prefer the vertical orientation of the scar over the inferior horizontal scar.

How the Procedure is Performed

First, the nipple areola is resized and reshaped as in the Periareolar approach, with an outer circular incision outside the areola to allow for a small amount of skin excision. In addition, a vertical elliptical skin excision pattern is created between the inferior aspect of the areola and the inferior chest border to allow for additional skin excision located at the inferior chest. The breast tissue is then removed through the inferior chest incisions. The inferior vertical incisions are closed together, and the outer circular incision is closed around the new smaller areola.

Indications for the Lollipop Incision

Nipple ptosis less than 1 cm
Small to moderate amount of skin excess located at the inferior chest wall
Desire for a vertical scar over a horizontal inferior scar

Downsides to the Lollipop Incision

The downside to this approach is the presence of a vertical scar which is not located in the natural anatomic border of the chest wall. The scar length is ultimately shorter than that of a Double Incision, which may be preferable to some patients.

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