Most breast reductions and breast lifts are done with a pattern called an inverted "T" or anchor scar. This places an incision around the areola, one vertically downward and one in the breast fold.
In most cases the scar can be limited to around the nipple-areola complex, or add a short vertical scar going down from the areola. This technique eliminates the incision under the breast.
In our practice we have used the vertical scar pattern (around the nipple-areola and up and down) for most breast reductions with great success.