What are the different options available?
There are two main breast reduction methods. In both types the skin is removed only from the lower part of the breast in order to avoid visible scars above the level of the nipple. The more traditional method of breast reduction leaves an extensive “anchor” scar pattern that includes a scar around the areola, one extending vertically down to the crease under the breast, and a long scar in the crease itself (Figure 1, left). The Lejour or “lollipop” scar method has fewer scars: only around the circumference of the areola and vertically down to the crease under the breast. There is no scar in the crease itself (Figure 1, right). It is also called a vertical reduction. This method can make wide breasts significantly narrower. It also creates more breast projection compared to the anchor pattern method.
Extremely large breasts that fall as low as the beltline may require a free nipple graft procedure. This is a variation of the anchor pattern method where the nipple and areola actually are completely removed from the breast and implanted in the proper location at the end of the procedure. The nipple and areola has a near normal appearance after surgery but sensation is absent. This method is rarely required.