There are variations in the techniques of breast reduction surgery depending on your size & shape of your breast as well as desired amount of reduction. The common techniques are-

The inferior pedicle technique, sometimes also known as a keyhole, inverted-T, or “Wise pattern” reduction, involves an anchor-shaped incision, which circles the areola. The incision extends downward, following the natural curve of the breast. Excess glandular tissue, fat, and skin are removed. Next, the nipple and areola are moved into their new higher position. A drawback of this technique is sometimes “square” looking breasts, but this is a common option for women with the largest, droopiest breasts. Inferior pedicle techniques can also be performed through shorter scar incisions in some patients.

The vertical scar techniques are gaining popularity in the United States as well as India due to their shorter scarring and projecting shape post-surgery. These types of procedures can involve the use of superior, inferior, medial or laterally based pedicles to the NAC. As compared to traditional incisions, they may have a limited or absent horizontal component. These procedures are best suited to smaller reductions with less excess skin to limit the scar length. Advantages include increased projection by the gathering of tissue medially, shorter scar length, and quicker surgery times. This technique keeps its results the best in the long term. The breast is reduced through removal of the lateral and inferior tissues, leaving the upper pole mostly untouched. We are performing breast reduction through this technique in most of our patients.

The liposuction-only technique is used for women with breasts that are not quite as large as with the other procedures or where there skin is not much hanging or in patients who are anesthesia risks for longer procedures. For the best outcomes, women who choose this procedure have fatty, non-dense breast tissue with good skin and little ptosis (droop). As few women with larger breasts possess those characteristics, the widespread use of this technique may be limited. The result is not as drastic as the other techniques, but it involves a quicker healing time and little scarring. This is the preferred technique for most of the un-married girls with heavy breasts.

The free nipple graft technique is used primarily for high-risk patients of ischemia to the NAC to reduce the chance of sloughing it postoperatively. Typical candidates would include diabetics, smokers, longer breasts approaching 20 cm from the IMF to the nipple, and breasts with significantly larger than normal resection requirements. In this procedure, the areola and nipple are completely removed for relocation and replaced as a skin graft higher on the breast. In these cases, sensation from the areola area will be lost and it eliminates the ability for lactation. This technique is sometimes used during surgery or postoperatively if the NAC viability is questionable. By eliminating the requirement for a pedicle, this procedure allows significantly greater amounts of tissue to be removed safely.