LAS VEGAS Liposuction can be an effective alternative to breast reduction surgery in select patients, according to a presentation at an international symposium on cosmetic and laser surgery.
Traditional breast reduction can require significant postoperative recovery and cause unnatural-looking breast lift, Dr. Cameron Rokhsar said. In addition, many patients are left with an inverted T scar. In contrast, liposuction with local anesthesia does not lift the breast and often leaves only small scars, said Dr. Rokhsar, a dermatologist in private practice in New York City.
Liposuction is a common cosmetic procedure in the United States. "The procedure has evolved from one under general anesthesia with massive blood loss to an outpatient procedure with minimal blood loss," Dr. Rokhsar said.
The fat removal technique became "extremely safe" with the advent of the tumescent technique, he added. For example, a survey of 66 physician members of the American Society of Dermatologic Surgery found that there were no deaths among 15,336 patients they treated with tumescent liposuction (Dermatol. Surg. 1995;21:45962).
After baseline mammography, Dr. Rokhsar measures breast size through water displacement and makes radial markings. Cannulas are introduced through two tiny holes to remove the fat from the breast. The process can suction up to 50%70% of breast fat. In an unpublished study of 30 of Dr. Rokhsar's patients, this procedure reduced breast size by an average of one cup size. A follow-up mammography is performed at 6 months as a new baseline reference.
"The patient can sit up afterwardit is a very simple procedure," said Dr. Rokhsar, who is also on the dermatology faculty at Albert Einstein College of Medicine in New York.
Liposuction is contraindicated for a breast composed primarily of glandular tissue versus fat, Dr. Rokhsar said.
Patients with nipple ptosis, a family history of breast cancer, or patients looking for significant breast lift are generally not candidates for breast liposuction, he added.