Multiple techniques have been advocated for breast reduction. Unfortunately, traditional procedures for breast reduction have led to significant breast scarring. In an effort to address this problem, techniques that result in less noticeable scars have been suggested recently. One such technique is liposuction of the breast, which achieves mild to moderate reduction in breast size with minimal scarring. Liposuction has been used in conjunction with traditional methods of breast reduction for thinning flaps and pedicles, removing and contouring laterally located fat and bulges in the axilla.1-3 In 1991, Matarasso and Curtiss introduced the use of liposuction alone as a breast reduction modality, but the technique was applicable only to women with well placed nipple-areola complex and predominantly fatty breasts.4 A year later, Curtiss went one step further stating that women with breast ptosis, large areola and firm parenchyma could also be successfully treated by suction alone.5 In addition, Gray updated his experience with 204 women undergoing liposuction breast reduction,6 and recently Moskovitz, Muskin and Baxt reported the first outcome study for liposuction as a primary method of breast reduction surgery.7 In this article, we will outline our approach to liposuction as a sole method for breast reduction. In addition, we’ll also discuss the pre- and post-operative considerations you’ll need to keep in mind. Technique A pre-operative mammogram is of utmost importance in order to screen for breast cancer and to assess breast fat-parenchyma content. We routinely employ intravenous conscious sedation for most of our patients undergoing cosmetic surgical procedures, utilizing a certified ambulatory surgical suite. The patient is marked in an upright position to ensure symmetrical evaluation with the natural gravitational pulling of the breast tissue. Access incisions are made in the periareolar, inframammary or axillary folds. We use a 3-mm to 4-mm cannula attached to a 60-ml syringe, and the dissection is carried out in a spoke-wheel pattern. The cannula port is maintained in a downward direction, and the patient is periodically elevated to a semi-sitting position to evaluate symmetry and desired outcome. Wounds are closed with a single absorbable suture. The patient wears a vest garment for approximately 4 weeks following the procedure, and most return to work within a few days. We recommend a post-operative mammogram 6 months after the procedure. Liposuction vs. Traditional Reduction Techniques Although multiple techniques have been advocated to reduce large breasts, traditional methods are all associated with extensive procedures and significant breast scarring. The efficacy of the liposuction technique for breast reduction has been well established,4-7 and it compares to that of traditional open techniques in the proper patient subset. Different surgical techniques may be indicated according to the breast volume. Our experience has been that the liposuction technique can achieve mild to moderate reduction in breast size with minimal scarring. (See figures 1 and 2.) This reduction ranges from 0.5 to 1.5 cup sizes. On the other hand, moderate to extremely large breasts may be best treated by traditional procedures. The correction of the nipple-areola complex by liposuction alone has been a great discussion point. In our male patients with gynecomastia who have been treated with liposuction, the nipple-areola complex rises afterward. This effect is mainly due to the reduction of breast tissue, reduction in gravitational breast tissue pulling and fibrosis formation. In females this effect is less evident, but certainly with liposuction alone significant elevation of the nipple-areola complex is possible. (See figure 2.) We prefer females with adequate nipple-areola complex height or with mild ptosis, in order to achieve optimal results. There is a subset of patients mainly concerned with excess breast size and weight who are seeking surgical intervention in order to ameliorate neck and back pain and who have minimal concern with nipple position or overall cosmesis following the breast reduction. Liposuction as the sole modality for breast reduction in this subset of patients has proven to be effective, with a lower rate of complications, a higher level of patient satisfaction, a significant quicker return to normal activities, and with noticeable savings in operating room costs. It was once believed that liposuction breast reduction could be successfully performed only in fatty breasts. Although suction removes fat more easily than parenchyma, with the right technique and adequate cannulas and sizes, liposuction can satisfactorily reduces the size of firm breasts that have a major parenchymal component. The average breast reduction in patients with firm breasts ranges from 0.5 to 1 cup size. Possible Complications Complications of traditional breast reduction techniques are significant, ranging from 29%8 to 50%9 as compared with a less than 1% complication rate with liposuction breast reduction. These complications include infection, hematoma, seroma, dehiscence, fat necrosis, and skin loss.9 Moreover, patients may complain of poor shape, extensive or painful scars, numbness, and inability to breast-feed.6 Ideal Method for the Right Patient Liposuction allows us to reduce breast mass with little downtime, minimal scarring and a low rate of complications. In conclusion, for a select subset of patients, liposuction of the breast can achieve mild to moderate reduction in breast size with minimal scarring and satisfactory cosmesis.
Exploring Aesthetic Interventions: Using Liposuction for Breast Reduction
Multiple techniques have been advocated for breast reduction. Unfortunately, traditional procedures for breast reduction have led to significant breast scarring. In an effort to address this problem, techniques that result in less noticeable scars have been suggested recently. One such technique is liposuction of the breast, which achieves mild to moderate reduction in breast size with minimal scarring. Liposuction has been used in conjunction with traditional methods of breast reduction for thinning flaps and pedicles, removing and contouring laterally located fat and bulges in the axilla.1-3 In 1991, Matarasso and Curtiss introduced the use of liposuction alone as a breast reduction modality, but the technique was applicable only to women with well placed nipple-areola complex and predominantly fatty breasts.4 A year later, Curtiss went one step further stating that women with breast ptosis, large areola and firm parenchyma could also be successfully treated by suction alone.5 In addition, Gray updated his experience with 204 women undergoing liposuction breast reduction,6 and recently Moskovitz, Muskin and Baxt reported the first outcome study for liposuction as a primary method of breast reduction surgery.7 In this article, we will outline our approach to liposuction as a sole method for breast reduction. In addition, we’ll also discuss the pre- and post-operative considerations you’ll need to keep in mind. Technique A pre-operative mammogram is of utmost importance in order to screen for breast cancer and to assess breast fat-parenchyma content. We routinely employ intravenous conscious sedation for most of our patients undergoing cosmetic surgical procedures, utilizing a certified ambulatory surgical suite. The patient is marked in an upright position to ensure symmetrical evaluation with the natural gravitational pulling of the breast tissue. Access incisions are made in the periareolar, inframammary or axillary folds. We use a 3-mm to 4-mm cannula attached to a 60-ml syringe, and the dissection is carried out in a spoke-wheel pattern. The cannula port is maintained in a downward direction, and the patient is periodically elevated to a semi-sitting position to evaluate symmetry and desired outcome. Wounds are closed with a single absorbable suture. The patient wears a vest garment for approximately 4 weeks following the procedure, and most return to work within a few days. We recommend a post-operative mammogram 6 months after the procedure. Liposuction vs. Traditional Reduction Techniques Although multiple techniques have been advocated to reduce large breasts, traditional methods are all associated with extensive procedures and significant breast scarring. The efficacy of the liposuction technique for breast reduction has been well established,4-7 and it compares to that of traditional open techniques in the proper patient subset. Different surgical techniques may be indicated according to the breast volume. Our experience has been that the liposuction technique can achieve mild to moderate reduction in breast size with minimal scarring. (See figures 1 and 2.) This reduction ranges from 0.5 to 1.5 cup sizes. On the other hand, moderate to extremely large breasts may be best treated by traditional procedures. The correction of the nipple-areola complex by liposuction alone has been a great discussion point. In our male patients with gynecomastia who have been treated with liposuction, the nipple-areola complex rises afterward. This effect is mainly due to the reduction of breast tissue, reduction in gravitational breast tissue pulling and fibrosis formation. In females this effect is less evident, but certainly with liposuction alone significant elevation of the nipple-areola complex is possible. (See figure 2.) We prefer females with adequate nipple-areola complex height or with mild ptosis, in order to achieve optimal results. There is a subset of patients mainly concerned with excess breast size and weight who are seeking surgical intervention in order to ameliorate neck and back pain and who have minimal concern with nipple position or overall cosmesis following the breast reduction. Liposuction as the sole modality for breast reduction in this subset of patients has proven to be effective, with a lower rate of complications, a higher level of patient satisfaction, a significant quicker return to normal activities, and with noticeable savings in operating room costs. It was once believed that liposuction breast reduction could be successfully performed only in fatty breasts. Although suction removes fat more easily than parenchyma, with the right technique and adequate cannulas and sizes, liposuction can satisfactorily reduces the size of firm breasts that have a major parenchymal component. The average breast reduction in patients with firm breasts ranges from 0.5 to 1 cup size. Possible Complications Complications of traditional breast reduction techniques are significant, ranging from 29%8 to 50%9 as compared with a less than 1% complication rate with liposuction breast reduction. These complications include infection, hematoma, seroma, dehiscence, fat necrosis, and skin loss.9 Moreover, patients may complain of poor shape, extensive or painful scars, numbness, and inability to breast-feed.6 Ideal Method for the Right Patient Liposuction allows us to reduce breast mass with little downtime, minimal scarring and a low rate of complications. In conclusion, for a select subset of patients, liposuction of the breast can achieve mild to moderate reduction in breast size with minimal scarring and satisfactory cosmesis.
Multiple techniques have been advocated for breast reduction. Unfortunately, traditional procedures for breast reduction have led to significant breast scarring. In an effort to address this problem, techniques that result in less noticeable scars have been suggested recently. One such technique is liposuction of the breast, which achieves mild to moderate reduction in breast size with minimal scarring. Liposuction has been used in conjunction with traditional methods of breast reduction for thinning flaps and pedicles, removing and contouring laterally located fat and bulges in the axilla.1-3 In 1991, Matarasso and Curtiss introduced the use of liposuction alone as a breast reduction modality, but the technique was applicable only to women with well placed nipple-areola complex and predominantly fatty breasts.4 A year later, Curtiss went one step further stating that women with breast ptosis, large areola and firm parenchyma could also be successfully treated by suction alone.5 In addition, Gray updated his experience with 204 women undergoing liposuction breast reduction,6 and recently Moskovitz, Muskin and Baxt reported the first outcome study for liposuction as a primary method of breast reduction surgery.7 In this article, we will outline our approach to liposuction as a sole method for breast reduction. In addition, we’ll also discuss the pre- and post-operative considerations you’ll need to keep in mind. Technique A pre-operative mammogram is of utmost importance in order to screen for breast cancer and to assess breast fat-parenchyma content. We routinely employ intravenous conscious sedation for most of our patients undergoing cosmetic surgical procedures, utilizing a certified ambulatory surgical suite. The patient is marked in an upright position to ensure symmetrical evaluation with the natural gravitational pulling of the breast tissue. Access incisions are made in the periareolar, inframammary or axillary folds. We use a 3-mm to 4-mm cannula attached to a 60-ml syringe, and the dissection is carried out in a spoke-wheel pattern. The cannula port is maintained in a downward direction, and the patient is periodically elevated to a semi-sitting position to evaluate symmetry and desired outcome. Wounds are closed with a single absorbable suture. The patient wears a vest garment for approximately 4 weeks following the procedure, and most return to work within a few days. We recommend a post-operative mammogram 6 months after the procedure. Liposuction vs. Traditional Reduction Techniques Although multiple techniques have been advocated to reduce large breasts, traditional methods are all associated with extensive procedures and significant breast scarring. The efficacy of the liposuction technique for breast reduction has been well established,4-7 and it compares to that of traditional open techniques in the proper patient subset. Different surgical techniques may be indicated according to the breast volume. Our experience has been that the liposuction technique can achieve mild to moderate reduction in breast size with minimal scarring. (See figures 1 and 2.) This reduction ranges from 0.5 to 1.5 cup sizes. On the other hand, moderate to extremely large breasts may be best treated by traditional procedures. The correction of the nipple-areola complex by liposuction alone has been a great discussion point. In our male patients with gynecomastia who have been treated with liposuction, the nipple-areola complex rises afterward. This effect is mainly due to the reduction of breast tissue, reduction in gravitational breast tissue pulling and fibrosis formation. In females this effect is less evident, but certainly with liposuction alone significant elevation of the nipple-areola complex is possible. (See figure 2.) We prefer females with adequate nipple-areola complex height or with mild ptosis, in order to achieve optimal results. There is a subset of patients mainly concerned with excess breast size and weight who are seeking surgical intervention in order to ameliorate neck and back pain and who have minimal concern with nipple position or overall cosmesis following the breast reduction. Liposuction as the sole modality for breast reduction in this subset of patients has proven to be effective, with a lower rate of complications, a higher level of patient satisfaction, a significant quicker return to normal activities, and with noticeable savings in operating room costs. It was once believed that liposuction breast reduction could be successfully performed only in fatty breasts. Although suction removes fat more easily than parenchyma, with the right technique and adequate cannulas and sizes, liposuction can satisfactorily reduces the size of firm breasts that have a major parenchymal component. The average breast reduction in patients with firm breasts ranges from 0.5 to 1 cup size. Possible Complications Complications of traditional breast reduction techniques are significant, ranging from 29%8 to 50%9 as compared with a less than 1% complication rate with liposuction breast reduction. These complications include infection, hematoma, seroma, dehiscence, fat necrosis, and skin loss.9 Moreover, patients may complain of poor shape, extensive or painful scars, numbness, and inability to breast-feed.6 Ideal Method for the Right Patient Liposuction allows us to reduce breast mass with little downtime, minimal scarring and a low rate of complications. In conclusion, for a select subset of patients, liposuction of the breast can achieve mild to moderate reduction in breast size with minimal scarring and satisfactory cosmesis.
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