I am not sure from your posting whether the proposed liposuction is to be done in the area of the breast as part of the breast reduction or in a completely different area as the thighs or abdomen. Liposuction of the area around the underarm at what we refer to as the "tail of the breast" is often done during a breast reduction in order to create the best shaped breast possible. If there is a chance that liposuction will be needed in this area, I will discuss it with the patient before the surgery and make sure that it is listed as a procedure on the surgical consent. I consider this liposuction to be part of the breast reduction procedure and do it to create the best result possible. If the liposuction is for an area other than related to the breast, necessary is a relative term. If you want liposuction of the hips, for example, it may make alot of sense to do it at the same time as your breast reduction. That way, you have only one postoperative period. There are different risks when you combine more than one procedure at the same time, but if you are healthy and the volume of liposuction and breast reduction are moderate the increase risk should be minimal. However, if you did not request treatment other than to your breasts, then liposuction may not be indicated. This is a question to ask your surgeon. Before you undergo surgery, you should be able to discuss any of your questions and concerns with the doctor performing the procedure. If you do not feel comfortable doing this, this may not be the correct surgeon for you.