Reduction mammaplasty and mastopexy are two distinct yet interrelated procedures that share many points in common. Both operations result in lifting of the nipple and areola, reduction of the breast skin envelope, and generally an overall improvement in the shape of the breast. As a result, these goals are accomplished for both procedures using similar operative strategies. While recognizing these similarities, it is important to note that the major focus of breast reduction is to reduce the volume of the breast, whereas mastopexy is generally intended to lift and reshape the breast with little or no breast volume change. Typically, the aesthetic concerns in mastopexy are generally more demanding than those in breast reduction. Understanding the basic elements of each procedure is key to developing a successful operative plan that provides the best results possible and yet minimizes potential complications.

Many different and varied techniques for breast reduction have been described. Several of these procedures have come to be known simply on the basis of the name of the physician who described the operation. In addition, many of these procedures have variably overlapping technical details, all of which can create confusion when attempting to evaluate published results. To assist in organizing and evaluating the multiple techniques of breast reduction, it is helpful to realize that any procedure designed to accomplish breast reduction must consist of the following four interrelated elements: preserving the nipple-areola complex (NAC) blood supply, removing the redundant parenchyma, removing excess skin, and shaping the breast. Understanding how the technical details of each individual procedure satisfy these four cardinal elements allows us to group the various procedures to be grouped. For instance, the superior pedicle procedures can be contrasted with the inferior pedicle procedures. With this as an organizational framework, direct comparison of the different techniques is facilitated and results in a better understanding of these various operations.