The size and shape of your breasts and how much reduction you desire are factors that will help your plastic surgeon determine the best technique for you. In some cases it will be possible to avoid the vertical incision that runs from the bottom edge of the areolas to the breast crease or the horizontal incision underneath the breast (typical components of the anchor incision). Rarely, if your breasts are extremely large, the nipples and areolas may have to be completely detached before they are shifted to a higher level. In such a case, you will have made the decision to sacrifice sensation and the possibility of breast-feeding to achieve your desired breast size. Another breast reduction option, which is appropriate only in a select group of women, is liposuction alone.

Liposuction for breast reduction
Breast liposuction may be right for you if you have fatty breasts, need a minor-to-moderate reduction, and do not need to correct sagging. Here are some considerations:

• Results may be acceptable for women who need significant reduction but do not want the scars and loss of sensation and are willing to accept some sagging.
• With the onset of menopause, breast tissue is gradually replaced by fat, so postmenopausal women are among the best candidates for liposuction-only breast reduction.
• Patients with fibrous tissue and minimal fat in their breasts are not good candidates.
• Ptosis (sagging), poor skin condition with little tissue elasticity, and low nipple position are also contraindications.
• Liposuction alone may be used to treat asymmetry up to one cup size.
• Following liposuction of the breast, the elastic qualities of the skin cause it to contract, and subsequent uplifting of the breast contour should occur to some extent.