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Before and after breast reduction using ultrasound assisted liposuction (UAL) in a 24 year old woman with macromastia and breast asymmetry. Her breasts were heavy and dense; she indeed was a typical candidate for a breast reduction by excisional methods (the usual technique of reduction mammoplasty).

However, she felt very strongly that she wanted to avoid scars on her breasts, given her personal history of forming keloid scars. She had researched liposuction and wanted to investigate having a breast reduction using liposuction as her preferred technique.
Breast tissue is heavy and dense, and usually requires additional energy in the form of ultrasound to adequately remove breast tissue, as for gynecomastia correction surgery (male breast tissue removal). Ultrasonic liposuction, or UAL was a reasonable option for this patient. Three incisions were planned for each breast – one in the armpit area and two under the breasts. These are visible as dark healing incisions in some of the after images.

She was fully educated about the potential risks (thermal injury as the liposuction wand heats up, 3-4 millimeter long scars under her breasts from the cannula insertion sites, inability to remove as much breast tissue as compared to traditional breast reductions) and potential benefits of UAL-based breast reduction (avoidance of the lollipop scar and inframammary fold scar under her breasts, possibly decreased downtime).

Ultrasonic liposuction removed over a liter of fat and breast tissue from both breasts. This is often less than a traditional breast reduction. Another major difference in this technique is that the breasts are only “debulked” of fat, but rearrangement of breast tissue is not possible. Therefore, the appearance of the breasts can be as like after significant weight loss, with a deflated and possibly droopy appearance.

Postoperatively, she had swelling and bruising that required tight wrapping with an ACE wrap. Early follow up photos are shown 6 weeks after surgery. She thankfully did not develop keloid scars at the liposuction incision sites and she was very happy with her decision to have surgery.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton