COSMETIC PROBLEMS OF THE BREAST
11:4 BREAST REDUCTION WITHOUT INCISION: BREAST LIPOSUCTION
Tumescent liposuction of the female breasts:
If percentage of fat is more in comparison to glandular tissue, Liposuction can reduce female breasts by 50% in size depending upon the percentage of fat tissue. It also lifts the breast to significant degree. Reduction in weight of breasts helps to the natural elastic tissue to contract and produce elevation. Thus, liposuction makes breasts smaller and elevated but does not change the shape of the breast. Thus, smaller version of the breasts is produced without surgical scars. At our centre we use powered liposuction method.
Procedure of Liposuction to reduce breast:
Local anaesthetic solution is infiltrated with thinnest needle to minimize pain. Liposuction is done with microcanulae of 1.5mm diameter to 2.7 mm diameter. Then, absorbent pads are placed around the breast. Then, these are fixed with elastic crepe adhesive tape. Breast compression garments are worn to hold the pads in place. The pressure of these garments should be optimum. If compression is less, there is risk of bleeding and if compression is too tight there is experience of pain and difficulty in breathing. Pressure of compression should be adjustable. During initial 15 hours of post liposuction period maximum compression is required to limit post operative haematoma and to reduce bruising. After 15 to 18 hours drainage is reduced and so compression is reduced to moderate level for 48 hours. Then, compression is kept at comfortable level to support the tissue. Very rarely, canula or needle may puncture the lining over the lungs which may cause pneumothorax. Air leaks inside the chest cavity and which may impair breathing. Small scars of liposuction of 3 to 4 millimeter size will reduce within few months. In patient of dark skin, post inflammatory hyper pigmentation develops after surgery which fades away after 2 months. Thus, recovery is rapid, with virtually no scars. Patient can return to work and routine activities within 2-3 days after the surgery.
Who should not undergo this liposuction procedure for breast reduction?
Women who have more glandular tissue than fat (e.g. thin younger women and women who have unusually larger breasts, are not good candidate for liposuction of the breasts. Those who need more than 50 % reduction in size and elevation of breasts, traditional surgical breast reduction is done. If persons has lump in breasts, excessively dense tissue in breast and family history of cancer of breasts, this procedure is not done.
Who is considered good candidate for reduction of breast by liposuction?
Women who have passed through menopause contain larger proportion of fat as compared to teenagers. So, they are good candidates for breast reduction by liposuction. Candidate should have realistic expectations. Overweight young woman (i.e. before menopause) are also good candidate if she wants less than 50% reduction of breast. The proportion of fat in the can be determined by mammograms. Thin young women contain more glandular tissue and least fat. So, they are not candidate for breast reduction by liposuction method. Women who have unrealistic expectation (very perfect breast of a virgin) are not good candidates for breast reduction by this method.
Those who undergo liposuction of belly & thigh area are good candidate for liposuction of breast. They get better results in reshaping breast.