Large breasts, known medically as macromastia, cause a lot of musculoskeletal symptoms such as back and neck pain as well as grooves in the shoulder skin from the bra straps. Breast reduction surgery is tremendously effective at both lifting the large breast as well as making it smaller. Such surgery, however, is a significant operation that results in a lot of scars located mainly on the lower pole of the breast.
Some patients have asked me if liposuction could be used for reducing the large breast instead of a large open operation. Since the breast is full of fatty tissue that is capable of being suctioned out, this is not an unreasonable question. Such a concept has also been touted by some international plastic surgeons.
The problem with liposuction for breast reduction is that is can do nothing for the large amount of hanging skin or the low sitting nipple. Removing fat, deflating the balloon if you will, will only make the skin become more loose and hang down further. So the breast may be reduced in actual size or volume but it will certainly not look better and many of the problems caused by large breasts are the result of their sag not just their weight.
That being said, there are some uses of liposuction in breast reduction. In large breasts that have reasonably tight skin, good breast shape, and a fairly well-positioned nipple , liposuction can be used to make a modest change in breast size. Perhaps ½ a cup size reduction may be able to be achieved. This would save substantial breast scars but a dramatic downsizing of the breast will not be achieved. Liposuction is also very useful in reducing the side of chest next to the breast which is often quite full as well. Contrary to the perception of many patients, breast reduction surgery will not make this area smaller. Liposuction must be done in addition to breast reduction surgery to get improvement that far to the side and back.
While most breast reduction surgeries in the U.S. are covered by health insurance, liposuction methods that may be used for it will not be. If liposuction is used for any part of the breast reduction, those costs will be the patient’s responsibility.
Dr. Barry Eppley
Indianapolis, Indiana