For breast reduction, making a three-dimensional pyramid-shape tissue design and using these pyramids as the base for the new breasts is called "Dance of the Pyramids," under the scope of the Avsar technique. A customized design/drawing for the patient is made before the surgery.
During the surgery, four breast tissue pyramids are planned and created in the breast structure. The upper pyramid (pedicle) carries the nipple/areola structure and is known as the pyramid that provides the upper volume for the breast, and it acts as a lift while preventing future sagging problems. The lower pyramid represents the sagging part of the old breast and does interfere the new breast. The lower pyramid is also removed during surgery and is sent for pathological examination. The right and left two pyramids are also very important: They move from left and right in the center during breast reduction and represent the bottom pole of the breast and support the breast from underneath. The new breast structure—that is, the neo-breast—has a healthy and firm structure with the joining 3 pyramids. The success of the surgery depends on how good these pyramids are designed.
When the three-dimensional design, the right technique, and the experience come together, it will be possible to reduce very large breasts to the patient’s desired size and make them firmer. In this technique, the breasts are reduced to an ideal size while excess tissues extending to under the arms disappear with the movement of the side pyramids to the center.