Breast Reduction with Tumescent Liposuction

Abstract

Purpose: Conventional breast reduction is technically difficult, produces scarring, and may result in loss of nipple sensation, possible necrosis of the areolar complex, or both. Our objective was to develop tumescent liposuction as an alternative. Materials and Methods: Patient selection was important. Patients should have large breasts but not severe ptosis. After volumetric measurement, the breasts were infused with tumescent solution. Approximately one half of the breast volume was removed with suction lipectomy by using the Giorgio Fisher cannulas. More tissue was removed from the lateral quadrants than from the medial quadrants. During the removal of the last JOO mL, the underdermis was abraded with the 2.5-mm Giorgio Fisher cannula. This loosened the dermal plexus throughout the breast area up to the clavicle. The breasts were supported during the postoperative period with Reston foam and binders. With this technique, the breasts were reduced and elevated during the postoperative period. Results: A 2.5- to 5-cm elevation of the areolar complex followed this liposculpting. No cases of loss of sensation or nipple necrosis developed. Breast reduction and areolar complex elevation were possible with superficial and deep liposculpting of the adult breast in cases of grades I and II ptosis. Conclusion: Breast reduction by liposuction provides a scarless alternative to conventional methods. It is especially useful in adolescent gigantomastia before there is significant breast ptosis.