Common Types of Breast Reduction Techniques

Breast reduction surgery, also known as reduction mammoplasty, removes excess glandular tissue, fat, and sagging or stretched skin in order to reduce the size and weight of the breasts. Breast reduction procedures can effectively reduce back pain and discomfort many women with overly large breasts suffer from on a daily basis. Aesthetically, breast reductions can transform the appearance of the breasts to make them smaller, firmer, more symmetrical, and youthful looking. The areolas or nipples can also be reduced in size or positioned to sit higher on the newly perkier breasts.

There are three common techniques for breast reduction surgery: Liposuction, Vertical (Lollipop) breast reduction, and Inverted T (Anchor) breast reduction. While an in-person consultation with a board certified plastic surgeon is the best way to determine which technique is best for you, understanding each technique is a great way to prepare for a consultation.

The following types of breast reduction surgery are the most commonly practiced methods:

Liposuction for Breast Reduction 

Liposuction is a quicker, less invasive procedure for breast reduction that offers lasting results with minimal scarring. Liposuction is an option if you are seeking nominal to moderate changes in breast size, if your breast tissue is mostly fatty tissue, and if you have good skin elasticity.

While breast size is reduced with liposuction, the overall shape and contour of the breast, including the position of the areola and nipple, will remain the same. If you are seeking a lift, modification to breast shape or symmetry, one of the surgical options below may be best.

Vertical (Lollipop) Breast Reduction

The lollipop breast reduction requires two incisions. One is at the edge of the areola, and the other runs from the lower edge of the areola to the crease beneath the breast. While there is more scarring with this procedure than with liposuction, scars are located beneath the breast and generally concealed by clothing or the shape of the breast itself.

A vertical incision breast reduction is ideal for those who need a mild to moderate reduction in breast size, or for those with noticeable sagging who would like more significant reshaping and lifting of the breast tissue. This method allows for the removal of not only fat tissue, but glandular tissue as well. The breast is made narrower, lifted and restructured so that the areola and nipple are moved to a natural looking.

Inverted T (Anchor) Breast Reduction

The Inverted T breast reduction incurs the same two incisions as the vertical incision breast reduction, but with one additional incision that follows the crease underneath the breast. While there will be more scarring with this method, scars are concealed by the shape of the breast itself, bras and bikini tops.

An anchor, or inverted T breast reduction allows for greater tissue removal and more extensive reshaping. This method is thus ideal for those with significant sagging or in need of a considerable reduction in breast size. However, this method also requires the longest downtime.

Which Breast Reduction Method Is Best?

There is no singular best method of breast reduction. Each patient will require a different method depending on their individual needs and goals. The best technique for each patient depends on their initial breast anatomy, the amount of tissue that needs to be removed, and their desired end result in terms of aesthetic appearance.

An in-person consultation with your plastic surgeon will guide you to the best decision. During a consultation the surgeon may discuss the following:

• What is your current breast anatomy? (size, shape, type of tissue)
• Which type of tissue is to be removed? (fatty, glandular)
• How much of a reduction in size do you need?
• Do you want to reduce the size or shape of the areola or nipple?
• Do you wish to correct asymmetry in the breasts?
• Are you seeking a reshaping or lifting of the breasts?
• What final outcome (aesthetically and physically) are you hoping for?

If shape and lift are priorities, the surgeon may suggest combining breast reduction surgery with a lift procedure or liposuction or breast implants.

Breast Reduction with Breast Lift or Breast Implants

It’s important for many patients to understand that breast reduction is different from a breast lift. Many breast reduction patients carry the majority of their breast volume in the lower half of their breasts and can only achieve adequate cleavage (upper pole fullness) with a strong bra.  Combining a breast reduction with a breast lift or breast augmentation may be the best choice if you desire more cleavage or greater upper pole fullness.

In a breast lift, sagging breasts are lifted and low pointing nipples are lifted or placed higher on the breast. Implants add volume and reshape the breast providing more upper pole fullness.

A breast lift can be done using either the vertical or inverted T method of breast reduction surgery. Depending upon your specific anatomy and desired results, your doctor may do this procedure in one stage or two. One stage means your breast reduction and implant surgery will be performed at the same time. Sometimes, it’s better to do this as a two stage procedure. This allows you to heal from your breast reduction surgery before adding volume with an implant, which potentially stretches the skin.

Your ideal breast size and shape will dictate the path you choose with your doctor. Consultations are most beneficial when patients have taken the time to think through their desired outcome and have a general understanding of their options.

Dr. McGee has been practicing plastic surgery for more than 18 years in all areas of the field, including cosmetic surgery and reconstructive breast and facial surgery. Dr. McGee is board certified by the American Board of Plastic Surgery and the American Board of Surgery. He has numerous hospital affiliations in the Round Rock and greater Austin areas and is a member of the American Society of plastic Surgeons, American Society for Aesthetic Plastic Surgery, American College of Surgeons and Austin Smiles.