Breast reduction surgery is an out patient procedure performed under a general anesthetic. The incisions for the surgery vary based on your breast size and shape, the size and position of your areolas, the degree of breast sagging, the skin quality and elasticity, and the amount of reduction desired. The incision sites will be discussed during your consult but there are three common incision patterns :

• A circular incision around the areola
• A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease
• An inverted T or anchor-shaped incision pattern

After the incision is made, the nipple is repositioned and if necessary the areola is reduced by removing excess skin at the perimeter. The nipple remains attached to its original blood and nerve supply. Surgical removal of excess fat, glandular tissue and skin will take place. Liposuction is often used to remove excess fat in conjunction with excision techniques. Once underlying breast tissue is reduced the breast is lifted and reshaped. For extremely large, low hanging breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast. This is known as a free nipple graft.

Once the breasts have been reshaped the incisions are brought together. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Sutures or surgical tape is then used to close the skin. The breast reduction surgery generally takes one and a half hours to three hours. Long-acting local anesthetic agents are used to help in the early recovery. With breast reduction surgery restrictive surgical bras are seldom used and drain tubes are often used.