Northern Virginia – Fairfax and Manassas
By: George Bitar, M.D. and Larry Lickstein, M.D.
Board Certified Plastic Surgeons
A breast reduction by liposuction serves a woman’s goal to have her breasts reduced without the scars of a “regular” breast reduction, with a quicker operation, and less healing time. Since women are reluctant to have a “regular” breast reduction because of scarring, a liposuction breast reduction is a good alternative. These women suffer from all the problems that other heavy-breasted women have including the neck pain, back pain, shoulder pain and shoulder grooving. They also are dissatisfied with their body image and may be unable to wear the clothes that they desire because of their enlarged breasts. These factors may hinder a woman with large breast from participating in sports, playing a more active social role, and simply enjoying life to the fullest.
We perform a regular breast reduction with a technique that is with predictable results and a very low complication rate. The regular breast reduction leaves a scar that is shaped like a lollipop around the areola and the mid-lower breast plus horizontal scars extending the length of the lower crease of the breast. The resultant scar looks like an anchor (See Section on Regular Breast Reduction). This method accomplishes two goals: The first is the decrease in breast volume. The second goal is a breast lift and removal of excess skin. The problem to some people is accepting the scar. A breast reduction by liposuction is an ideal operation for a heavy-breasted woman who wants volume removed from her breasts, but does not want to have the scars, and wants “less of an operation” with less chance of complications. This technique has its limitations and cannot accomplish the lifting effect that a regular breast reduction can accomplish by removing the skin of the lower portion of the breast (and thus leaving scars). It also cannot guarantee the removal of the huge volume that a regular breast reduction can accomplish.
Preparing for Surgery
An initial consultation is set-up where we will discuss the breast reduction procedure and whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery. You are asked to stop smoking, if you are a smoker, two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.
The Breast Reduction by Liposuction Procedure
The procedure is relatively simple and straightforward. A patient, who is deemed a good candidate for this procedure, is given antibiotics, and anesthetized in the operating room. The breasts are injected with tumescent solution to give some pain relief and decrease the bleeding during surgery. Then 2 small incisions are made in each breast, about 3 millimeters each, and liposuction is performed to remove the desired amount. When sufficient fat is removed, the incisions are closed and the patient is awakened.
Benefits of this Breast Reduction by Liposuction Technique
- Avoidance of the anchor incision scar. Instead, two small incisions are made under the crease of each breast to perform the liposuction
- The time it takes to perform the surgery varies according to the size of the breasts. On average, a regular breast reduction operation may take 2-3 hours. A breast reduction by liposuction may take half an hour to an hour.
- The pain may be less than a regular breast reduction due to less scarring.
- The recovery time is lessened because of less surgery performed, so a patient should recover in a few days.
- Symmetry between the two breasts is well preserved by liposuctioning the exact same amount from either breast.
- The nerves and blood vessels are well preserved.
- The lift that is created by a regular breast reduction cannot be achieved by liposuction alone since the excess skin is not removed. As a result, the volume may be reduced, but the shape of the breast may either be less full, or sagging as a result of fat removal, depending on the skin quality. The nipple may rise a little with liposuction alone, but the lift achieved is not as significant as the regular breast reduction technique.
- The breast consists of breast tissue and fat. Only fat is removed with liposuction and not breast tissue as would be the case with regular breast reduction, since the breast tissue as well as the fat would be cut away. As a woman gets older, the breast tissue gets replaced with fat, so, the older the woman, the more that can be removed from her breast with liposuction alone. In other words, a woman in her twenties who would like to go down three sizes may not be a good candidate for liposuction breast reduction, since she may not have that much fat in her breast.
How We Minimize Complications of Breast Reductions:
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible , anticipating problems or set-backs, and addressing them before they happen. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class hospital with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.
Bleeding with any form of liposuction is rare. Before liposuctioning the breast, we inject tumescent solution that will constrict the blood vessels and minimize the bleeding. The bleeding from this operation with this technique has been minimal.
Infection with liposuction is rare. The most important step in avoiding infections, in our opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, our patients are prescribed a one-week course of antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a breast reduction by liposuction has been zero.
Since with a breast reduction by liposuction there is no skin removal or breast tissue manipulation other than suctioning fat out of the breast, open wounds are extremely rare.
Ability to Breastfeed
Women are sometimes concerned that if they get a breast reduction that they will not be able to breastfeed afterwards. With liposuction alone, the risk of losing ability to breast feed is minimal.
Loss of Nipple Sensation or nipple / Areolar skin
With liposuction alone, this risk is minimal.
Our office will provide you with a detailed post-operative instruction sheet that will be individualized to your needs. We usually see patients the day after surgery in one of our offices to make sure that everything is O.K., and that you are healing as planned. Multiple visits in the year after the procedure will ensure the best outcome possible.
For more information about this procedure contact us, call our office and speak to our friendly staff member at 703-206-0506.
Information on this web site is for information only. Do not use the information to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.