Breast reduction with ultrasound-assisted lipoplasty.

Ultrasound-assisted lipoplasty for reduction of fatty breasts and fixation has been found to be a safe technique with promising aesthetic results when it is applied in selected patients and performed by a surgeon with expertise with ultrasound-assisted body contouring. From 1995 to 2000, 120 patients were treated with ultrasound energy to decrease the fatty component of the breast tissue and at the same time to lift the breast mound. Each patient was evaluated preoperatively with mammograms for correct assessment of the nature and consistency of the breast tissue. Only patients with fibrofatty and fatty breast parenchyma were selected for breast reduction and fixation with ultrasound-assisted lipoplasty. Patients with suspect mammograms (calcification) and a strong family history of breast cancer were not considered. All the prescreening and the postoperative long-term mammographic evaluations were conducted by a radiologist with high competence in breast tissue resonance. Patients' age ranged from 17 to 53 years. Total aspirate ranged from 300 to 1200 ml for size, of which 65 percent was supranatant (fat) and 35 percent was infranatant (tumescence solution and blood). Patients were operated on while they were under general anesthesia; more recently, pure tumescent anesthesia was tried with success in minor cases. Breast dimensions were assessed with breast sizers (before and after the operation), and breast measurements were assessed using a classic breast drawing. Minimum follow-up of patients was 4 years. Particular care was given to evaluating long-term breast tissue appearance through mammographic studies and to looking for suspected calcifications. No evidence of a suspect mass or calcifications was found during the 4-year follow-up. The main advantages of the technique are a significant reduction in breast volume (up to three cup sizes), significant breast lift (up to 5 cm), and nearly invisible scars (1.5 cm in length at the inframammary sulcus and at the axilla).