Breast reduction surgery, which usually takes from three to five hours, is performed in a hospital or surgical center. An overnight stay is not usually required. The surgery commonly involves three incisions. After the surgeon removes excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areolas may be reduced in size. Skin that was located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour under the arm.

• Your surgeon will use a surgical marker on your skin to indicate where the incisions will be. These markings are especially important, because your breasts change shape once you are lying on your back on the operating table.
• Most surgeons prefer general anesthesia for this procedure. A few may perform breast reduction with intravenous sedation, also known as “twilight sedation.”
• Your incision pattern will depend on the size of your breasts, how much your breasts sag and where your nipple-areola complex is positioned. With each technique the areolas can be made smaller if they’re too large. An areolatome, more commonly known as a “cookie cutter,” is used as a circular template to make the new areola size. The cookie cutter diameter ranges from thirty-eight to forty-five millimeters. Here are some commonly used incision patterns:
  • Microincisions are used for breasts that are fatty (not fibrous) and not sagging. Liposuction is used to decrease breast size. Small incisions allow the liposuction cannula (tube) to enter the breast.
  • A donut incision, or periareolar incision, is made solely around the border of the areolas.
  • A keyhole incision, also known as a lollipop incision, is made around the border of the areolas and vertically down from the areolas to the breast crease.
  • An anchor incision, the most common technique used by plastic surgeons, involves three distinct cuts. One incision is made around the border of the areolas; the second extends down vertically from the areolas to the breast crease and merges with a third incision along the breast crease.
• Your surgeon will remove excess breast skin and fat with a scalpel and/or cautery instrument based on the size breast you desire. If your breasts are asymmetrical (or uneven), the surgeon may remove more tissue from one breast than the other. He or she will then reshape the remaining skin and fat to create a more youthful breast shape and move the nipple-areola complex to a higher position.
• In most cases, drains will be placed in the breasts to collect excess fluid.
• Breast incisions are then closed with sutures that go from the deep tissue layers to the more superficial layers (the skin).The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, as well as to make your surgical experience as easy and comfortable as possible.