The Comprehensive Guide to Inverted T Top Surgery: Maintaining Sensation and Volume Medically reviewed by Jennifer Richman on September 15, 2024. Understanding the Inverted T Anchor Top Surgery The inverted T or anchor incision for chest reconstruction or breast reduction, like the buttonhole incision, has the potential to preserve heightened nipple sensation. This is made possible because an inverted T top surgery does not remove all chest tissue, as is the case with the double insicion. Rather, the surgeon leaves behind what we call the pedicle: a portion of tissue that they estimate to contain enough of the original blood and nerve supply to keep the nipple and areola alive. …