Although several techniques are employed during the procedure, the most common technique is performed through a keyhole-shaped incision along the natural contours of the breast. The incision is made to outline the area where breast skin will be removed, and define a new location for the nipple. When the tissue has been removed, nipple and areola are moved to a higher position. Then the skin surrounding the areola is brought down and together to reshape the breast. Sutures are usually terminated in a vertical line around the areola, extending downwards the nipple. The inverted “T” scar is avoided except for very large breasts.
For some patients, particularly those with relatively smaller breasts and minimal sagging, modified techniques which require smaller incisions can be used. One of these techniques is called ‘periareolar mastopexy’ in which circular incisions are made around the areola, and a circular strip of skin is removed.