During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. Because this is a highly personal decision, you’ll want to take time to discuss all of your concerns and desires, including what size and shape you would like your breasts to be.

Show your doctor pictures of breast sizes you like. You should also tell him/her about any medications you currently are taking, and any health conditions you have.

During the consultation, your surgeon will explain the different options available to you. He/she will explain how your age, the size and shape of your breasts, and the condition of your skin may affect the results. He/she will discuss the procedure in detail, explain the risks and limitations, and explain the type of anesthesia that will be used.

The surgeon will then examine and measure your breasts, and photograph them for reference during surgery and afterwards. He/she may also require you to have a mammogram (breast x-ray)

Be sure to ask all the questions you have about the surgery, and ask to see photos of the doctor’s recent patients, before and after surgery. Also ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision. See Questions to ask your dcotor below.

Note: Some insurance companies will pay for breast reduction if it's medically necessary, but they may have specific requirements such as a letter from your surgeon, a referral from your general practitioner, and/or photos or other documentation. Be sure to find out what your insurance company requires if you intend to use insurance to pay for this surgery.

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Most often, the incisions for breast reduction are similar to those used for the "keyhole-anchorbreast lift" technique. This procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Excess glandular tissue, fat, and skin are removed, and the nipple and areola are moved into their new position. The surgeon then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. In some cases, techniques can be used that eliminate the long vertical part of the scar.

In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areolar tissue.)

Liposuction may be also be used in breast reduction. The ultrasound method or liposuction is currently the subject of some controversy due to the possibility of changes in the breast tissue from the ultrasonic waves. The use of standard tumescent liposuction is not quite so problematic. Check with your surgeon at the time of consultation.

The periareolar or doughnut reduction method may also be effective if there is not a large excess of skin. This method has the advantage of hidden scars; however it tends to flatten the breast shape a bit. In general, the more skin that is cut, the more it is possible to shape the breast and therefore, there is a trade-off between the extent of the scars and the extent of the shaping of the breast.Your doctor will discuss the different methods used for breast reduction and describe the technique that is best for you.

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