For patients with moderately good skin tone that have little to no excess skin, and have some glandular tissue not amenable to liposuction, an incision along the border of the areola may be used to remove the glandular tissue in a periareolar fashion. This incision is like a smile along the lower border of the areola. Patients with loose or excess skin may require a free nipple graft procedure with another incision along the lower chest fold, or they may have a pedicled reduction with the incision in the same place.