The most common method of carrying out a breast reduction consists of three incisions.
One incision encircles the areola, the second incision runs vertically downwards from the lower edge of the areola to the inframammary fold and the third incision runs horizontally under the breast in the natural fold.
Once your plastic surgeon has removed the surplus skin, fat and gland tissue, the nipples are re-sited in the position agreed prior to the operation. At the same time the areola is generally reduced in size.
Skin which was previously positioned above the areola is drawn downwards and sutured to give an aesthetically attractive breast shape.
The nipples themselves remain attached to the underlying mammary gland tissue, whereby feeling in the nipples and the ability to breastfeed are usually retained.
There are a range of options to be considered when planning the incisions for a breast reduction. The size and shape of the breast, the size of the areola and the extent of slack skin are all factors determining the choice of incision. Any asymmetry in the breasts can be balanced out by the various incision methods.
In some cases it may be possible to avoid the horizontal incision in the inframammary fold.
In such cases the skin is puckered below the vertical scar, resulting in a weal for approx. 6 - 12 weeks. If this excess skin has not disappeared after 3 months, a scar correction can be carried out under local anaesthetic as an out-patient procedure.
Your plastic surgeon will discuss the various options with you and recommend the method which is most suitable for you.