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Liposuction Only Breast Reduction Workup

  • Author: Francesca Romana Grippaudo, MD, PhD; Chief Editor: James Neal Long, MD, FACS  more...
 
Updated: Nov 02, 2015
 

Laboratory Studies

Obtain a CBC count to obtain a hematocrit and a platelet count.

Obtain prothrombin time and activated partial thromboplastin time to check for a coagulopathy when clinical suspicion exists.

Blood sugar should be in the normal range to avoid delayed healing or susceptibility to infections; check as clinically indicated.

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Imaging Studies

An ultrasound scan of both breasts or a mammogram is mandatory to evaluate the percentage of fat tissue in the breast and hence determine eligibility for the procedure.

Sensitivity of mammograms in assessing the glandular-fat tissue ratio in the breast is better than that of ultrasound scan but possibly not as effective as MRI scan.

Mammographic appearance of breast hypertrophy withMammographic appearance of breast hypertrophy with a prevalence of fat tissue over glandular tissue. This mammographic image demonstrates the eligibility of the patient for liposuction of the breast to reduce the hypertrophy.

Obtain a chest radiograph if indicated by examination findings or patient history.

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Other Tests

Obtain photographic documentation to provide to the insurance company for authorization, for comparison of before and after photos to help the patient appreciate the change, and as medicolegal documentation for the surgeon in the event of litigation.

Obtain an ECG as per anesthesia or operating room guidelines.

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Histologic Findings

The aspirate can be sent for pathologic examination to exclude carcinoma or other atypia.

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Contributor Information and Disclosures
Author

Francesca Romana Grippaudo, MD, PhD Assistant Professor, Department of Plastic Surgery, S Andrea Hospital, Faculty of Medicine and Psycology, Sapienza University of Rome, Italy

Francesca Romana Grippaudo, MD, PhD is a member of the following medical societies: International Confederation for Plastic and Reconstructive and Aesthetic Surgery, Italian Society of Plastic Reconstructive Surgery and Aesthetics

Disclosure: Nothing to disclose.

Coauthor(s)

Daniel Christopher Kennedy, MBBS, FRACS Consultant Surgeon, Unit Head Supervisor of Surgical Training, Department of Plastic and Reconstructive Surgery, Mater Public Hospital; Director of Medical Services, Pacific Day Surgery

Daniel Christopher Kennedy, MBBS, FRACS is a member of the following medical societies: Australian Medical Association, Royal Australasian College of Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

James Neal Long, MD, FACS Founder of Magnolia Plastic Surgery; Former Associate Professor of Plastic and Reconstructive Surgery, Division of Plastic Surgery, Children's Hospital and Kirklin Clinics, University of Alabama at Birmingham School of Medicine; Section Chief of Plastic, Reconstructive, Hand, and Microsurgery, Birmingham Veterans Affairs Medical Center

James Neal Long, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, Plastic Surgery Research Council, Sigma Xi, Southeastern Society of Plastic and Reconstructive Surgeons, Southeastern Surgical Congress

Disclosure: Nothing to disclose.

Additional Contributors

Pankaj Tiwari, MD Assistant Professor, Division of Plastic Surgery, Ohio State University College of Medicine

Disclosure: Nothing to disclose.

References
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  3. Lassus C. Breast reduction: evolution of a technique--a single vertical scar. Aesthetic Plast Surg. 1987. 11(2):107-12. [Medline].

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  5. Boni R. Tumescent power liposuction in the treatment of the enlarged male breast. Dermatology. 2006. 213(2):140-3. [Medline].

  6. Hodgson EL, Fruhstorfer BH, Malata CM. Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg. 2005 Aug. 116(2):646-53; discussion 654-5. [Medline].

  7. Rohrich RJ, Ha RY, Kenkel JM. Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg. 2003 Feb. 111(2):909-23; discussion 924-5. [Medline].

  8. Samdal F, Kleppe G, Amland PF, Abyholm F. Surgical treatment of gynaecomastia. Five years' experience with liposuction. Scand J Plast Reconstr Surg Hand Surg. 1994 Jun. 28(2):123-30. [Medline].

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  12. Rohrich RJ, Gosman AA, Brown SA. Current preferences for breast reduction techniques: a survey of board-certified plastic surgeons 2002. Plast Reconstr Surg. 2004 Dec. 114(7):1724-33; discussion 1734-6. [Medline].

  13. Grippaudo FR, Kennedy DC. Liposuction reduction mammaplasty using the tumescent technique. Proceedings of 8° European Congress of IPRAS;. June 22-25, 1997. Lisbon, Portugal. 120.

  14. Abboud MH, Dibo SA. Power-Assisted Liposuction Mammaplasty (PALM): A New Technique for Breast Reduction. Aesthet Surg J. 2015 Jul 24. [Medline].

  15. Wong KY, Malata CM. Conventional versus ultrasound-assisted liposuction in gynaecomastia surgery: a 13-year review. J Plast Reconstr Aesthet Surg. 2014 Jul. 67 (7):921-6. [Medline].

  16. Sadove R. New Observations in Liposuction-Only Breast Reduction. Aesthetic Plast Surg. 2005 Mar 9. [Medline].

  17. McMahan JD, Wolfe JA, Cromer BA, Ruberg RL. Lasting success in teenage reduction mammaplasty. Ann Plast Surg. 1995 Sep. 35(3):227-31. [Medline].

  18. Di Giuseppe A. Breast reduction with ultrasound-assisted lipoplasty. Plast Reconstr Surg. 2003 Jul. 112(1):71-82. [Medline].

  19. Brauman D. Liposuction breast reduction. Plast Reconstr Surg. 2005 Oct. 116(5):1558-9; author reply 1559-61. [Medline].

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The skin is pierced 2 cm above the inframammary fold, in the mid line.
The right breast is infiltrated up to tumescence with solution; the left breast already has been infiltrated.
Appearance of the right breast after a liposuction of 700 mL.
Appearance of both breasts at the end of the procedure. The liposuction of the right breast is 700 mL; the liposuction of the left breast is 600 mL.
At the end of the procedure, elastic tape is used to mould the breast in the new shape and position.
Mammographic appearance of breast hypertrophy with a prevalence of fat tissue over glandular tissue. This mammographic image demonstrates the eligibility of the patient for liposuction of the breast to reduce the hypertrophy.
The material suctioned from the breast appears as a yellow, fatty, bloodless fluid.
A 22-year-old patient, preoperative view. Bra size is 40E. The distance from the jugular notch to the nipple is 33.5 cm on the right breast and 32 cm on the left breast.
Appearance 6 weeks after breast reduction by suction alone; 22-year-old patient. Preoperatively, bra size was 40E. The distance from the jugular notch to the nipple was 33.5 cm on the right breast and 32 cm on the left breast. During the procedure, 800 mL was removed from each breast. Postoperative bra size is 38C. The distance from the jugular notch to the nipple is 29 cm on the right breast and 28 cm on the left breast.
A 22-year-old patient, preoperative view. Bra size is 40E. The distance from the jugular notch to the nipple is 33.5 cm on the right breast and 32 cm on the left breast.
Appearance 6 weeks after breast reduction by suction alone; 22-year-old patient. Preoperatively, bra size was 40E. The distance from the jugular notch to the nipple was 33.5 cm on the right breast and 32 cm on the left breast. During the procedure, 800 mL was removed from each breast. Postoperative bra size is 38C. The distance from the jugular notch to the nipple is 29 cm on the right breast and 28 cm on the left breast.
Right lateral preoperative view; 22-year-old patient. Bra size is 40E. The distance from the jugular notch to the nipple is 33.5 cm on the right breast and 32 cm on the left breast.
Right lateral view 6 weeks after breast reduction by suction alone; 22-year-old patient. Preoperatively, bra size was 40E. The distance from the jugular notch to the nipple was 33.5 cm on the right breast and 32 cm on the left breast. During the procedure, 800 mL was removed from each breast. Postoperative bra size is 38C. The distance from the jugular notch to the nipple is 29 cm on the right breast and 28 cm on the left breast.
A 24-year-old patient, preoperative view. Preoperative bra size is 36DD. The distance from the jugular notch to the nipple is 25.5 cm on the right breast and 24.5 cm on the left breast.
A 24-year-old patient, view 6 weeks postoperatively. Preoperative bra size was 36DD. The distance from the jugular notch to the nipple was 25.5 cm on the right breast and 24.5 cm on the left breast. Postoperative bra size is 36C. The distance from the jugular notch to the nipple is 22 cm on each breast.
A 24-year-old patient, postoperative lateral view at dressing change. Preoperative bra size was 36DD. The distance from the jugular notch to the nipple was 25.5 cm on the right breast and 24.5 cm on the left breast. Postoperative bra size is 36C. The distance from the jugular notch to the nipple is 22 cm on each breast. Note the ecchymosis on the lateral part of the breast.
A 24-year-old patient, postoperative view at first dressing change. Preoperative bra size was 36DD. The distance from the jugular notch to the nipple was 25.5 cm on the right breast and 24.5 cm on the left breast. Postoperative bra size is 36C. The distance from the jugular notch to the nipple is 22 cm on each breast.
A 36-year-old patient, preoperative view. Bra size is 38D. The distance from the jugular notch to the nipple is 31.5 cm on each breast.
A 36-year-old patient, appearance 2 months after breast reduction by suction alone; 570 mL was removed from the right breast and 550 mL from the left breast. The distance from the jugular notch to the nipple is 28 cm on the right breast and 28 cm on the left breast. Preoperatively, bra size was 38D. The distance from the jugular notch to the nipple was 31.5 cm on each breast
A 36-year-old patient, preoperative lateral view. Bra size is 38D. The distance from the jugular notch to the nipple is 31.5 cm on each breast.
A 36-year-old patient, lateral view of the breast 2 months after breast reduction by suction alone; 570 mL was removed from the right breast and 550 mL from the left breast. The distance from the jugular notch to the nipple is 28 cm on the right breast and 28 cm on the left breast. Preoperatively, bra size was 38D. The distance from the jugular notch to the nipple was 31.5 cm on each breast
Female breast, anterior view.
 
 
 
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