Contouring the Inferior Pole of the Breast in Vertical Mammaplasty: Suction-Assisted Lipectomy versus Direct Defatting

Abstract

Precise contouring of the inframammary fold is essential in vertical mammaplasty to avoid persistent dog-ears and revision surgery. This report presents the adjunctive use of suction-assisted lipectomy to shape the inferior pole of the breast in vertical reduction mammaplasty. A total of 117 patients underwent a modified superomedial pedicle vertical breast reduction. In group I (n = 45), the lower pole shaping was achieved with direct defatting. Based on contour problems leading to revisions, group II (n = 72) comprised the later experience whereby the inferior pole and inferolateral aspect of the breast was approached with liposuction. The rest of the procedure was similar. Revisions and complications were analyzed retrospectively. The demographics were similar in terms of age (38 ± 13 years versus 37 ± 12 years; p > 0.05), body mass index (31.8 ± 5.2 versus 32.1 ± 4.8; p > 0.05), and the amount of breast reduction (713 ± 341 g versus 668 ± 455 g on the right side and 704 ± 347 g versus 649 ± 450 g on the left side; p > 0.05). Group II patients required revision surgery significantly less than group I patients (22.2 percent versus 5.5 percent; p < 0.05). However, the complication rates were similar (15.6 percent versus 12.5 percent; p > 0.05). In a practice setting with a broad spectrum of patient profiles, adjunctive use of liposuction in vertical breast reduction accomplishes effective contouring of the lower pole of the breast and reduces the revision rates significantly with a low complication rate. This is particularly helpful in large breasts with an ill-defined lateral border. It is emphasized that liposuction is used for contouring purposes and not for volume reduction.