Breast reduction techniques are categorized by the type of skin incisions used and the position of the breast tissue and gland that will form the new breast. The technique most commonly used by surgeons is a combination of a modified Wise Pattern skin incision combined with an inferior pedicle of breast tissue and gland.
The diagram below shows the basis of this technique. The dotted lines indicate where the skin incisions are made. This is called the modified Wise pattern. The area in light green color, located on the sides, is where there will be a removal of breast tissue and gland to reduce the size of the breast. The area in blue color is the breast tissue and gland which remains intact and is left over to form the new breast. This is called an inferior pedicle because the base of the tissue is located at the inferior (or lower) aspect of the breast. Note that the nipple and areola is never removed. It is simply moved up to the new position.
This diagram below shows what happens during surgery. The incisions are made on the skin. The excess breast tissue and gland is removed and the breast size is reduced. The nipple is not removed, but rather is moved upward to its new and higher position. The incisions are then closed. Not only is the size of the breast reduced, but the breast is also given a more "perky" shape along with smaller and more asthetically sized nipples and areola.
Dr. Diaz is an experienced breast reduction surgeon. He was invited by Dr. Drew to perform a breast reduction on national television. Click on the video below to see an overview of breast reduction surgery.
Photo credit: https://medlineplus.gov/ency/presentations/100189_2.htm