Breast reduction with ultrasound-assisted liposuction

Abstract

The number of breast reduction procedures performed in the United States continues to rise and the trend in plastic surgery, indeed in surgery as a whole, has been reduction in the size of skin incisions used to perform procedures. Patients with large breasts can have any of the following issues such as neck, back, and shoulder pain; intertrigo; postural imbalances; and difficulty with social situations and purchase of clothes. However, they continue to ask for minimally invasive procedures as they do not desire unwanted scars of traditional reduction mammaplasty. An example of this paradigm shift to minimally invasive surgery is utilization of the endoscope for what were previously open procedures. The trend in surgery of the breast has been similar, as exemplified by the shorter scar techniques of Marchac [1], Lejour [2], and others, by the periareolar techniques such as those used by Goes [3] and Benelli [4], and by the use of the endoscope in breast augmentation and reconstruction. Liposuction of the breast for purpose of breast reduction, by itself and as an adjunctive procedure, has been advocated by others [5-7], but carrying out this procedure has oft en been difficult and bloody, especially in younger patients whose breasts commonly contain higher proportion of breast tissue. Lejour has shown in her unique studies on composition of breast tissue that even the so called dense breast is at least 50% fatty tissue, so if this could easily and reliably be removed, small to moderate reductions could be accomplished with small incision ports alone, or perhaps with only a periareolartype incision [8]. Larger breasts may become amenable to shorter scar techniques aft er reduction with ultrasound- assisted lipoplasty (UAL) as shown by Goes [9]. © 2009 Springer-Verlag Berlin Heidelberg.