The short answer is shape. An anchor incision gives the best final shape to a breast after a lift or a reduction. It’s the only way that all the breast tissue can be taken off the chest wall, which is one of the most important aspects of the operation. If you look at a young attractive, perky breast, you’ll see no breast tissue sitting on the chest wall below the fold. This not only gives a more attractive shape to the breast, but it also adds length to the torso, giving you better proportions. You will hear some surgeons promoting a vertical scar or lollipop incision. I’ve always found with that approach, you sacrifice the final shape, as it leaves too much breast tissue below the fold, and the length of the breast from the nipple to the fold is too long, giving a bottomed out appearance. It also commonly leaves a dog ear, which then needs to be revised down the track, giving you a scar on the fold. Also, the scar on the fold is the least obvious of all of the scars, so it seems counterintuitive to sacrifice that scar and have not as good final shape.