As with other procedures, a breast reduction begins with sedation prior to any incisions. There are multiple options for incision sites that are generally determined by patient preference and recommendations by the surgeon.

After the incisions come the most critical steps: removal of excess skin and breast tissue while reshaping the remaining portions. It is often necessary to reposition the patient’s areolas and nipples to a higher point on the breast. In most cases, this is done without stripping original blood and nerve tissues; however, some cases call for what is called a free nipple graft. This relatively rare procedure is performed only if the patient’s nipples and areolas sit too far down and must be transplanted to a higher point to maintain an aesthetically pleasing position.

Once the removal and reshaping process is finished, the incisions are then closed with deep-tissue sutures and skin tape or adhesives.