20 yrs old and would prefer not to have the risks and scars of a traditional reduction.Tumescent liposuction breast reduction?

Question

I am quite young - and would prefer not to have the risks and scars of a traditional breast reduction. However, I have DD cup breasts, which are heavy, embarassing and uncomfortable. I am quite young (20) and am thin elsewhere. Is there a way to tell how much of a reduction I might be able to achieve through liposuction? My ideal would be a B-C cup. Thanks in advance!

Jonathan J. Staiano, FRCS (Plast) · Answer

Dear LaraJane,

	 

	Liposuction is an appealing method for breast reduction because of the small scars involved.  However, you should be aware that it will not tighten the skin envelope and lift the breast in the same way that a formal breast reduction would.  Often patients with larger breasts have a degree of droop and to remove breast volume by liposuction alone will only create more of a droop as the breasts will be more empty.

	I feel that it is best used for older patients who are not concerned about the cosmetic appearance of the breasts and want the breasts to be less heavy for comfort.  They do not necessarily mind having a significant droop as this can always be corrected by wearing a bra.

	Although a breast reduction gives more scars than just liposuction, the final result will, cosmetically, be better.  Find a plastic surgeon and go through some before and after photos.  Good luck.

James Knoetgen, III, MD · Answer

Hello LaraJane, thanks for your question. Liposuction breast reduction is an attractive technique because it leaves very small scars. It is best for breasts that contain more fat than breast tissue and are not very saggy.

	I have performed liposuction breast reductions on women your age and they were all satisfied with the results, but they were only reduced about one or two cup sizes because their breasts were very dense. 

	Since you're 20 years old, your breasts are probably pretty dense and contain more breast tissue than fat, so it may not be able to reduce you all the way from a DD to a B-C. A vertical breast reduction will give you a "lollipop" shaped scar and will be able to reduce you more than a liposuction reduction.

	I suggest you consult with a board certified plastic surgeon and wish you all the best!

Marialyn Sardo, MD · Answer

It would be difficult to go from a DD to a B-C with liposuction alone. Also, being a young woman, the breast tissue would most likely be more fibrous and glandular and not contain as much fat. This would make it harder to remove much tissue. You may be able to have a reduction with a vertical scar and circumareolar scar only thereby eliminating the scar under the breast

Mary C. Herte, MD · Answer

hi LaraJane:  Breast liposuction to reduce breast size is a very attractive concept and anyone would prefer no scars to any scars if the result were the same.  however as has been said, liposuction does not give any uplift to the breast (nipple position may actually drop due to deflation of the breast without skin tightening) and the amount of reduction is limited, ordinarily to one or 2 cup sizes. (and most large breasted women are under-estimating their cup size when i examine them...).

	but the most critical limiting factor is that liposuction only removes fat.  Breast tissue itself is not removed by the liposuction process.  that makes it a poor option for young women who had rapid breast growth made up of firm breast tissue.  if an examination were possible, i would expect that, based on the fact that you are quite thin, your breasts are comprised primarily of firm breast tissue that is not amenable to liposuction removal. Because liposuction removes only fat, liposuction is most effective in women whose  breast texture is primarily fatty tissue.

	check with your board certified plastic surgeon to see if you are even a candidate for breast liposuction and to find out what compromise to your final result you will have to make to avoid the typical skin reduction scars that breast reduction ordinarily requires.  with surgical reduction, most patients can enjoy a significant size decrease (up to 50% in volume), elevation of the nipple to a more youthful level and tightening of the skin to give a more uplifted and less droopy appearance.

	Our breast reduction patients belong to one of the happiest groups of patients in all of plastic surgery....scars and all!!!

	Best of luck to you! Dr. H

Robert L. Kraft, MD, FACS · Answer

There is a lot of hype about breast reduction by liposuction, led heavily by non plastic surgeons.  This procedure is amenable to a very small percentage of patients seeking breast reduction, perhaps from C to B cup with minimal ptosis.  It is unsuitable for the degree of reduction you require and would result in sagging and misplacement of the nipple areolae complex.  Breast reduction, when performed by a plastic surgeon with expertise, has one of the highest satisfaction rates of any procedure and the scarring, which will fade with time, is a reasonable tradeoff for the benefits of the procedure.

Steven Wallach, MD · Answer

Liposuction is not the best way to accomplish a breast reduction in most patients. In patients that have fatty breasts the volume can certtainly be reduced, but in all likelihood the skin will not tighten. Also raising a significantly sagging nipple areola complex requires skin resection and movement of the nipple areola using a scalpel.

Steven Schuster, MD, FACS · Answer

I am asked several times a year to treat a patient for a breast reduction by liposuction instead of surgery.  I am able to do this in a small percentage of patients, maybe once or twice a year. These patients are usually teens, with very large breasts in an otherwise thin body frame. They have both breast tissue and fat in the breast and usually have very little drooping.  In almost all cases I will remove 600-700 cc or grams to reduce the size about 2 cup sizes.  I always advise them they will probably need a standard vertical reduction sometime in the future if they want more reduction or a higher smaller perkier breast.  Not all plastic surgeons will do breast liposuction so interview several to see if you are a candidate.  Good luck, Dr. Schuster in Boca Raton Florida.

Robin T.W. Yuan, MD · Answer

You can only reduce the fat content of the breast with liposuction so your hypertrophy should be mainly fat and not glandular.  SInce liposuction reduction is predominantly a passive decompression type of procedure, there is not much shaping that can be done if the skin is also loose. Ideally, the breast should look normal, just larger and lower, without the nipples pointing down or too bottom heavy.

	Robin T.W. Yuan, M.D

Tom J. Pousti, MD · Answer

Thank you for the question.

	Unfortunately without direct examination is not possible to give you good advice.  There are many variables involved including the amount of adipose tissue versus breast tissue in your breasts,  the quality of skin elasticity that is present,  the degree of ptosis (drooping) present as well as your overall goals in regards to breast size and shape. As you know, cup size varies depending on the bra manufacturer making cup size  discussions an inaccurate  way to communicate goals. 

	It would behoove you to be examined in person by a well experienced board-certified plastic surgeon.

	I hope this helps.

Scott L. Replogle, MD (retired) · Answer

"Tumescent" is a term for the injection fluid before liposuction that numbs the tissues (the procedure can be done under local anesthesia) and constricts small blood vessels so there is little or no blood loss with the liposuction. 

	Liposuction of the breast is not a breast reduction. It does not remove breast tissue. All it does is to reduce the fat content of the breast. This has little effect on the weight of the breast as fat is quite light compared to breast tissue. The other problem is knowing how much of the breast is fat and how much is glandular breast tissue. There is no simple test for this but like other parts of the body, if there isn't an excess of fat cells, not much can be accomplished by liposuction alone. In my experience it's hard to judge how much volume decrease will be accomplished by liposuction of the breast and it's usually in the 1/2 to 1 cup size range with no change in the position and basic shape of the breast (as it is for the skin in other areas of liposuction). 

	There are a few cases where this amount of volume decrease and the uncertainty of the amount of volume decrease is acceptable but not generally in young patients who tend to have more glandular breast tissue and not in those who want more than a cup size decrease or a specific end result size. The nipple-areola position cannot be too low as it will not be elevated by liposuction. 

	I would advise a properly done breast reduction with a circumareolar and vertical incision (lollipop incisioni) that will allow for proper reduction, lifing, shaping, and balancing the breasts. The scar tradeoff is usually quite well tolerated by those who really need a significant reduction of the breast.

20 yrs old and would prefer not to have the risks and scars of a traditional reduction.Tumescent liposuction breast reduction?

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