What is Breast Liposuction?
Breast liposuction is a cosmetic surgery procedure that reduces the size and weight of large, massive breasts, helping to create a more aesthetically pleasing breast contour that is better proportioned to a patient’s body. By removing excess breast tissue, fat, and sagging, stretched skin, a cosmetic surgeon can make the breasts smaller, lighter, and firmer and improve breast symmetry and drop sagging. Although breast reduction is often performed to address medical issues, patients who do not have the symptoms of macromastia but are unhappy with the size of their breasts can still pursue breast reduction as an aesthetic procedure.
Patients choosing to undergo breast reduction surgery for cosmetic reasons may cite any number of factors, including social stigmas and wardrobe concerns. While many patients want breast reduction to alleviate physical symptoms such as back, neck, or shoulder pain, shoulder grooves, or discomfort while exercising, you should not overlook the cosmetic benefits of breast reduction:
- Your breast will be lifted and firmer, helping you look more youthful
- Bras will fit more comfortably and attractively
- With better-proportioned breasts, your overall silhouette will be more balanced and attractive.
- Stretched areola and large nipples can be reduced during the same procedure, helping you look better in and out of clothing.
- Swimsuits, sports bras, and form-fitting clothes will look and feel better, helping boost your confidence during activity.
Women with large pendulous breasts suffer from neck pain, back pain, shoulder pain, and discomfort from bra straps. The weight of the breasts can cause a previously straight back to assume a more forward-leaning position. Participation in swimming or other sporting activities is often limited because of the large breast size. Well-fitting clothing is difficult to find, and wearing large-size clothing is often the only alternative.
The most common method of breast reduction is excision, and several such surgical techniques are available where general anesthesia is usually needed. However, complications such as post-operative pain, severe scarring, necrosis of the nipple-areolar complex, and prolonged healing times are typical, leading to long down recovery time. Breast reduction using local tumescent anesthesia (TLA) could drop most of these complications by liposuction.
Breast Liposuction Benefits
A caring surgeon understands that women find their breasts as an essential component of their femininity. Most techniques can induce extensive, disfiguring scars that can be emotionally traumatic. All surgical reduction methods may entail significant complications. Women may still be distressed by well-healed scars from traditional procedures, even with ideal symmetry. With liposuction, from thirty to fifty percent of breast volume can be removed with good elevation, along with the reduction of the size of the areola without post-surgical wound side effects or the disfiguring inverted T-shaped scar Prof. Moawad added.
Breast Liposuction Right Candidate
Overly large breasts can cause health and emotional problems. In addition to self-image issues, you may also experience physical pain and discomfort. The weight of excess breast tissue can impair your ability to lead an active life. The emotional embarrassment and self-consciousness often associated with having large pendulous breasts can be as crucial as physical discomfort and pain.
You may be a candidate for breast reduction surgery if:
- You are physically healthy
- You have realistic expectations
- You don’t smoke
- You are bothered by feeling that your breasts are too large
- You have breasts that limit your physical activity
- You experience back, neck, and shoulder pain caused by the weight of your breasts
- You have shoulder indentations from bra straps
- You have skin irritation beneath the breast crease
Not A Candidate for Breast Liposuction
Patients were excluded from the procedure for the following reasons: a personal history of breast cancer, a mammogram with a suspicious mass, abnormal pre-operative lab results, and an absence of medical clearance by the individual physician.
Indications for Breast Liposuction
- Refusal of breast reduction by excision
- Women who will accept a reduction of 50 % or less
- Women >45 years of age
- Previously unoperated large breasts
- Large breasts after surgical reduction
- Asymmetry in volume in unoperated breasts
- Asymmetry in volume after surgical reduction
- Patients who are poor candidates for general anesthesia
Contraindications for Breast liposuction
- A personal history of breast cancer
- Pendulous breast with minimal fat content
- Unrealistic expectations
- Undiagnosed breast mass
- Young women with low BMI
- Women who want a reduction of >50 % (unless
- postmenopausal)
- Women who want a breast lift rather than a reduction
- Family history of breast cancer (relative
- contraindication)
- Fibro-glandular breasts (relative contraindication)
Breast Liposuction Consultation
During a consultation with Prof. Moawad, exact measurements of your breast volume are taken to determine the amount of fat to be removed. A mammogram (as a baseline investigation for follow-up) is needed. You are provided with specific pre-operative and post-operative instructions by our professional staff at MSI. You’ll be asked several questions about your health, desires, and lifestyle. The success and safety of your breast reduction procedure highly depend on your complete candidness during your consultation.
During your breast liposuction consultation, be prepared to discuss:
- Why do you want the surgery, expectations, and desired outcome?
- Medical conditions, drug allergies, and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco, and drugs
- Previous surgeries
- Family history of breast cancer and results of any mammograms or previous biopsies
Breast Liposuction cosmetic surgeon will also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine your breasts and take detailed measurements of their size and shape, skin quality, placement of your nipples, and areola.
- Take photographs for your medical record.
- Discuss your options and recommend a course of treatment
- Discuss the outcomes of your breast reduction procedure and any risks or potential complications
- Discuss the use of anesthesia during your process for breast reduction
Breast Liposuction Selection Criteria
In general, the content of fat in the breast increases with age. Women over 45 years of age often have high breast fat content. They are, therefore, good candidates for breast liposuction as this technique reduces breast volume by diminishing the fat amount only. The risk of skin irregularities increases with the amount of fat removed, but for most women, especially those over 60 years of age, the reduction in weight and volume is more important than the risk of these irregularities occurring. The higher concentration of fat in older women’s breasts allows the surgeon to predict the amount of fat that I can remove accurately.
The breasts of most younger women contain more glandular tissue and less fat, limiting the amount of fat that can be aspirated in these women and reducing the risk of over-reduction. I can use the body mass index (BMI) to indicate the amount of fat in the breasts in younger women. A low BMI in patients with
large breasts indicates a low percentage of fat in the breasts.
Conversely, a high BMI indicates a high percentage of fat in the breasts, especially if the patient has subcutaneous fat in the flank areas and abdomen. However, patients with fat deposits in the extremities do not necessarily have a high-fat percentage in the breasts. THEREFORE, the BMI cannot be used as an absolute selection criterion; it can be used, however, as one of the selection criteria in younger women. In older women, breasts are generally fatty, independent of their BMI.
Except for postmenopausal women, patients who desire more than a 50 % reduction in breast size are not good candidates for breast liposuction. Moderate lifting and conservation of the original shape of the breasts are realistic goals; however, patients who are more concerned about breast lifting than volume reduction should not have breast liposuction.
What are the Risks of Breast Liposuction?
Breast liposuction for reducing female breast size allows significant breast reduction with no scarring and without risk of general anesthesia. Patients have minimal post-operative pain and rapid post-operative recovery, and in most cases, you can resume regular activity at once. The decision to have breast liposuction reduction surgery is highly personal.
You will have to decide if the benefits will achieve your goals and if the risks of breast reduction surgery and potential complications are acceptable. Your cosmetic surgeon and cosmetic surgery staff will explain the risks associated with breast liposuction.
You will be asked to sign consent forms to fully understand the breast liposuction you will undergo and any risks or potential complications. The practice of medicine and surgery is not an exact science. Although satisfactory results are expected, there is no guarantee. In some situations, it may not be possible to achieve the best results with a single breast liposuction procedure, and another surgery may be necessary.
Where Breast Liposuction Be Done?
I may perform breast liposuction in the MSI office-based surgical facility. The assistant staff will fully attend to your comfort and safety. It’s vital to address all your questions directly about breast liposuction. It is natural to feel anxiety, whether excitement for the expected outcome or pre-operative stress. Discuss these feelings with your cosmetic surgeon.
Your doctor will give you specific instructions on caring for yourself and minimizing breast liposuction risks. Following your physician’s instructions is key to the success of your surgery. Surgical incisions mustn’t be subjected to excessive force, abrasion, or motion during healing.
How Should I Prepare for Liposuction Breast?
After researching the basics of breast liposuction, many patients want to know what to expect before surgery. Before breast liposuction reduction surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
- Stop smoking well in advance of breast reduction surgery
- Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
- What to do on the day of surgery
- Post-operative care and follow-up
What are the Steps for Breast Liposuction?
How I Do Breast Liposuction
Antibiotics were administered for seven days, starting on the evening before the scheduled working day.
I made preoperative markings with the patient upright. I drew the outer contours along the inframammary crease and the upper side of the breasts. If the axillary extension of the breast was to be treated, this area was also marked. I drew the final markings perpendicular to the axis of the breast in a circular pattern.
The skin was first anesthetized with the tumescent solution to create multiple intradermal blebs. Spinal needles were then inserted through the blebs to infiltrate the breast tissue with a tumescent solution. The volume of the tumescent solution used was approximately 150–200 % of the breast volume.
Breast liposuction is enhanced. For example, a 1,000 mL breast would require a volume of 1,500–2,000 mL Infiltration; 30 min was allowed for equilibration and absorption of the tumescent solution by the breast tissue. Maximum vasoconstriction and anesthesia were reached during this phase. If necessary, a second infiltration was performed to reach full tumescence. I prefer to use external ultrasound energy for 15 minutes for each breast.
Incisions for cannula entrance were made lateral and medial in the inframammary crease. Suction was performed with a powered cannula, stabilizing the breast with the non-dominant hand. A fan-like pattern was followed, rather than a conventional crisscross pattern, beginning in the deepest layers of the breast where the most fat is present. All layers of the breast were suctioned to create optimal contraction of tissue. The areas of the breast that had the most glandular tissue (i.e., subareolar and upper lateral quadrant) were spared from aggressive suction.
The suction of the first breast was completed before beginning the suction of the second breast. Suction was stopped when fat was easily aspirated from the breast, and I reached the target volume. I collected the aspirated fat from each breast in separate containers. If the axillary tail was aspirated, I also used a separate container. With the patient upright, a small incision was made at the lowest point of each breast. A cannula was inserted into the incision, and I completed a few strokes. This maneuver optimized postoperative drainage. The breast was covered with an absorbent dressing and compression garment, with a supportive binder for extra compression to minimize.
Breast Liposuction Recovery?
Many patients have questions about recovery from breast liposuction. When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. You may wear an elastic bandage or support bra to minimize swelling and support the breasts as they heal. You will be given specific instructions for breast reduction recovery that may include:
- How to care for your breasts following breast liposuction
- Medications to apply or take orally to aid healing and reduce the risk of infection
- Specific concerns to look for at the surgical site or in your general health
- When to follow up with your cosmetic surgeon
Be sure to ask your cosmetic surgeon specific questions about breast liposuction recovery.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery? When will they be removed?
- Are stitches removed? When?
- When can I resume regular activity and exercise?
- When do I return for follow-up care?
After the operation, a supportive binder was applied for 48 h, and patients were instructed to continuously wear a compression garment, apart from during showering, for two weeks. They could choose to wear a sports bra for two additional weeks. Showering was allowed the morning of the day after the breast liposuction. There were no restrictions on light daily activities, which I could perform on the first day after the procedure. Patients who performed heavy physical work were told to refrain from doing so for one week after the procedure. Sporting activities were to be resumed gradually.
Breast Liposuction Results
Most patients achieve about 50% breast reduction and considerate breast lift with an average of 3cm in 6 months. After breast reduction, you can expect to enjoy smaller, lighter breasts for a lifetime, so long as you keep a stable weight and do not have any more children. However, nothing can stop the normal aging process. Eventually, your breasts will begin to sag once again, although not as severely as they might have before breast reduction.
Also, future pregnancies are likely to change the shape, size, and appearance of your breasts, reversing some of the positive changes made during breast reduction. If you plan to have more children, talk to your cosmetic surgeon. They can help you weigh the pros and cons of having surgery or wait until you have finished having children.
Can I Breastfeed After Having Breast Liposuction?
Yes. There is minimal trauma to glandular breast tissue, as apparent by the healthy appearance of post-liposuction mammography. Breast reduction by tumescent liposuction is not expected to interfere with lactation following pregnancies.
Life After Breast Liposuction
After about 2-3 months, your results will be in place, and you can shop for new bras with confidence. However, you may notice subtle changes for the first 6 to 12 months.
My thoughts on Breast liposuction
I believe breast liposuction can be effectively used to treat the effects of excess breast size and weight. Common complaints such as neck pain, back pain, shoulder pain, intertrigo, and shoulder ruts, can be lessened or eliminated by a breast liposuction approach. Furthermore, the breast liposuction reduction method requires a short recovery time with minimal postoperative care. No drains are used, and no sutures need to be removed. The complication rate is low, and the patient satisfaction rate is high. The efficacy of liposuction breast reduction compared to that traditional open techniques, and the complication rate is lower.
Candidates for liposuction breast reduction must be primarily concerned with breast weight and size. All patients must also understand that the glandular portion of their breast may limit the effectiveness of liposuction breast reduction. Patients who complain of breast ptosis should be referred for traditional breast reduction.
As a primary method of breast reduction, liposuction has not been widely adopted by plastic surgeons partly because the acceptance of liposuction as a breast reduction modality requires a shift in plastic surgery philosophy. What if, however, some patients do not care about nipple position and breast form?
What if a population of women desire a straightforward breast weight reduction and would choose to forego optimal breast form and nipple position if they could achieve rapid recovery with no scars? These are the questions that plastic surgeons must ask, and the answers to these questions form the basis of a shift in breast reduction philosophy.
Women who currently seek breast reduction surgery have accepted that traditional surgery will require certain scars and postoperative sequelae. Most of these women will be happy with their outcome because they understand the risks and benefits of the surgery. I believe that many women desire treatment for their breast hypertrophy but will not consent to traditional plastic surgical care and therefore have never sought the input of a plastic surgeon.
Breast Liposuction reduction does not provide the same global improvement to the breast that traditional surgery does, and it is not meant for all women. Forty years ago, there was no option for removing breast weight without incisions, so it only made sense that the incisions be placed strategically to improve breast form. Today, however, liposuction allows us to reduce breast mass through tiny apertures that leave no significant scars.
The high satisfaction rates found in breast liposuction are mainly attributable to the careful application of this method for those women who were confident that their complaints were based on breast weight and not ptosis. In conclusion, breast liposuction breast reduction gives patients and surgeons a practical choice in managing breast hypertrophy with little downtime, minimal scarring, and high patient satisfaction.
The cup size of the bra is an inaccurate indicator of breast size. The brand determines the patient’s bra size, the material (elastic or nonelastic), and personal comfort (i.e., broad, tight, or very tight). Treatment of the subaxillary fat changes the circumference of the breast, consequently influencing the cup size. Some patients will wear the same bra following the procedure,
often finding that the fit will be more comfortable.
