Before operation the doctor takes some specific measurements while patient is awake. These measurements are taken in sitting position and are important to decide the amount of excision to be done. The operation is done under general anesthesia. The excess skin, underlying fat and glands are removed and nipple and areola are replaced in new position. Sometimes extra fat around breast and near arm pit is removed by liposuction. The incisions are stitched there after. To avoid deposition of excess fluid and blood , a small tube is removed from both the breasts.