The first standard technique is the anchor technique; in this one the surgeon will cut the skin in three different directions horizontally along the breast crease, vertically from the breast crease to the lower end of the areola and finally a circular incision around the areola itself. The diagram resembles an anchor and it is used in different degrees of breast reduction.

The second technique is the standard keyhole technique; this is the basic technique that is used by several surgeons because it can be used with any needed degree of reduction from mild to severe. The process starts by incising a keyhole incision around the areola, remove the skin and the underlying tissue till the desired size then re – stitch the skin back together with lifting the areola to fit in the circular part of the keyhole diagram.

The previous two techniques leave long scars behind but they are the only ways to deal with severe cases but if the case is mild to moderate then there are other choices with fewer scars that you can choose from.

The third technique is called the periareolar technique but it is commonly known as the doughnut technique. The name comes from the shape of the incision in this technique, the surgeon will use the areola as the center of the doughnut then he will cut a circular strip of skin around it. Then he will remove the desired amount of fat and mammary glands manually and at the end the surgeon will stretch the skin to reach the areola and stitch. In this case stitching is mandatory as we cannot use glue or strips to close such wound. This technique will only leave a scar that is disguised at the rim of the dark areola.

The last technique is the simplest one and it is the only one that leaves minimal scars. In this technique the surgeon will perform a liposuction more than breast reduction. Small incisions will be made at the crease, the arm pit and the areola to enter thin liposuction catheter and remove the excess fat from the designated area before sealing these incisions back.