Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat and skin, and moves the nipple and areola into a new position. He or she then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast.
    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.
    Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the vertical part of the scar. And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.
    After surgery, you’ll be wrapped in an elastic bandage or a surgical bra over gauze dressings.  A small tube may be placed in each breast to drain off blood and fluids for the first day or two.
    You may feel some pain for the first couple of days and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain.
    The bandages will be removed a day or two after surgery, though you’ll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside. Your stitches will be removed in 1-3 weeks.
    If your breast skin is very dry following surgery, you can apply a moisturizer several times a day, but be sure to keep the suture area dry.
    Your first menstruation following surgery may cause your breasts to swell and hurt. You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling. This usually fades over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.
Getting Back To Normal
    Although you may be up and about in a day or two, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for 3-4 weeks.
    Your surgeon will give you detailed instructions for resuming your normal activities. Most women can return to work (if it’s not too strenuous) and social activities in about two weeks. But you’ll have much less stamina for several weeks and should limit your exercises to stretching, bending and swimming until your energy level returns. You’ll also need a good athletic bra for support.
    A small amount of fluid draining from your surgical wound, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, don’t hesitate to call your doctor.