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Aesthetic Plast Surg 2020 04 26;44(2):435-441. Epub 2019 Aug 26.

Plastic, Reconstructive and Aesthetic Surgery Clinic, Istanbul Aydin University Medical Park Hospital, Istanbul, Turkey.

Introduction: Whereas body-contouring surgery after massive weight loss in women receives much attention, little attention has been devoted to accentuating the male physique. Male patients after massive weight loss often suffer from redundant skin and soft tissue in the anterior and lateral chest region, causing various deformities of pseudogynecomastia. The authors present their approach to high-grade pseudogynecomastia correction with preservation of the NAC on an inferior dermoglandular pedicle with transverse scar only closure and without any meaningful liposuction. Read More

Gland Surg 2019 Jun;8(3):287-293

Department of Plastic & Reconstructive Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Surgical correction of gynaecomastia correction sometimes necessitates skin reduction in addition to resection of glandular tissue and liposuction of the fat deposits. Many skin reduction techniques have been described but all suffer from very noticeable and often poor scars that can manifest as hypertrophic or keloid scars in patients with dark skin. Three large gynaecomastia patients undergoing a modification of the Lalonde "no vertical scar" breast reduction technique designed to reduce the extent of scarring were reviewed. Read More

Plast Reconstr Surg Glob Open 2018 Aug 16;6(8):e1912. Epub 2018 Aug 16.

Department of Clinical Sciences, Lund University, Malmö, Sweden.

Background: Arm lymphedema is a well-recognized complication after breast cancer surgery that negatively impacts patients' quality of life, both physiologically and psychologically. Lymph stasis and inflammation result in excess formation of adipose tissue, which makes removal of the deposited subcutaneous fat necessary to eliminate the excess volume. Liposuction, combined with postoperative controlled compression therapy (CCT), is the only treatment that gives complete reduction of the excess volume. Read More

J Plast Reconstr Aesthet Surg 2018 05 31;71(5):691-698. Epub 2018 Jan 31.

Department of Plastic, Reconstructive and Maxillofacial Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.

As older people increasingly care for their body image and remain active longer, the demand for reduction mammaplasty is increasing in this population. Only a few studies of reduction mammaplasty have specifically focussed on the outcomes in elderly women. We developed a new breast reduction technique: the Liposuction-Assisted Four Pedicle-Based Breast Reduction (LAFPBR) that is especially indicated for elderly patients. Read More

Stem Cells Transl Med 2017 08 27;6(8):1666-1672. Epub 2017 Jun 27.

Departments of Plastic Surgery, Odense University Hospital, Odense, Denmark.

Breast cancer-related lymphedema (BCRL) is a debilitating late complication with a lack of treatment opportunities. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with freshly isolated adipose-derived regenerative cells (ADRC) for treating lymphedema with 6 months follow-up. Read More

Lymphat Res Biol 2017 03 30;15(1):87-98. Epub 2017 Jan 30.

1 Department of Clinical Sciences in Malmö, Lund University , Malmö, Sweden .

Abstracts Background: Arm lymphedema after breast cancer surgery affects women both from physical and psychological points of view. Lymphedema leads to adipose tissue deposition. Liposuction and controlled compression therapy (CCT) reduces the lymphedema completely. Read More

Lymphology 2016 Jun;49(2):85-92

The objective of this study was to assess erysipelas incidence before and after liposuction treatment for patients suffering from post-mastectomy lymphedema. A prospective cohort study of 130 patients at Skåne University Hospital in Malmö, Sweden with postmastectomy arm lymphedema, who had poor outcomes from prior conservative treatment and clinical signs of subcutaneous adipose tissue hypertrophy, underwent liposuction between 1993-2012. Pre- and postoperative incident data on erysipelas were available for all of them. Read More

Ann Plast Surg 2016 Dec;77(6):609-614

From the Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, MA.

It is generally claimed that short-scar mammaplasty is limited to small-to-medium reductions. Its use in patients with severe macromastia has been associated with a high rate of complications. This report presents our experience of reduction mammaplasty greater than 1000 g per breast using a short-scar technique. Read More

Aesthetic Plast Surg 2015 Dec 7;39(6):916-21. Epub 2015 Oct 7.

Division of Plastic & Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Unlabelled: Acceptable scar positioning on the anterior male chest is very limited. In Gynecomastia surgery, an obvious areolar incision is the most sensitive indicator of a previous operation; a less apparent scar is indispensable for the patient's psychological satisfaction. Whenever only areolar diameter reduction is required, the circumareolar incision must be performed in a position leaving the least conspicuous scar. Read More

Aesthetic Plast Surg 2011 Jun 26;35(3):402-7. Epub 2010 Oct 26.

Department of Trauma, Plastic, Reconstructive, and Hand Surgery, University Hospital Wuerzburg, Oberduerrbacherstrasse 6, Wuerzburg, Germany.

Background: Breast reduction by liposuction alone is an appealing technique that has failed to gain widespread acceptance. Despite numerous studies on liposuction, the majority of surgeons remain skeptical. This study aimed to review the indication and limitations of this procedure. Read More

Dermatol Surg 2010 Sep 9;36(9):1406-11. Epub 2010 Jul 9.

Department of Dermatology, Erasmus M.C., Rotterdam, The Netherlands.

Background: Liposuction for female breast reduction is a new treatment modality that has many advantages over the generally accepted procedure of excision, which can damage glandular tissue and impair breastfeeding capacity.

Objective: To assess any potential damage to glandular tissue caused by liposuction of the female breast.

Methods: Specimens of the aspirate from 61 consecutive female patients who underwent liposuction of the breast using tumescent local anesthesia (TLA) and powered cannulae (PCs) were sent for histologic evaluation. Read More

Aesthet Surg J 2010 May-Jun;30(3):470-5

Department of Plastic Surgery, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Background: As a consumer-driven industry, cosmetic plastic surgery is subject to ebbs and flows as the economy changes. There have been many predictions about the short, intermediate, and long-term impact on cosmetic plastic surgery as a result of difficulties in the current economic climate, but no studies published in the literature have quantified a direct correlation.

Objectives: The authors investigate a possible correlation between cosmetic surgery volume and the economic trends of the three major US stock market indices. Read More

Int J Surg 2009 Dec 30;7(6):550-8. Epub 2009 Sep 30.

Department of Plastic and Reconstructive Surgery, SpR Plastic Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom.

Introduction And Aim: The National Health Service (NHS) provides treatment free at the point of delivery to patients. Elective medical procedures in England are funded by 149 independent Primary Care Trusts (PCTs), which are each responsible for patients within a defined geographical area. There is wide variation of availability for many treatments, leading to a "postcode lottery" for healthcare provision in England. Read More

J Plast Reconstr Aesthet Surg 2009 Nov 29;62(11):1473-8. Epub 2008 Aug 29.

Department of Plastic and Reconstructive Surgery, St Georges' Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK.

Gynaecomastia reduction surgery is a common male cosmetic procedure. Our clinical experience suggested far lower rates of satisfaction than previously reported. Therefore we evaluated our patient group using a detailed questionnaire designed specifically to assess patient satisfaction with breast attributes and quality-of-life outcome following surgery. Read More

J Laparoendosc Adv Surg Tech A 2008 Jun;18(3):433-7

Department of Surgery, Shuguang Hospital, LuWan District, Shanghai, PR China.

Background: Gynecomastia is an abnormal enlargement of one or both breasts in men. Breast-reduction surgery can help those patients who feel anxious about their abnormal appearance. Surgical treatment of gynecomastia is to excise the excess glandular tissue, which can be performed alone or in conjunction with liposuction. Read More

Ann Plast Surg 2008 Apr;60(4):367-71

Division of Plastic and Reconstructive Surgery, Epidemiology Coordinating and Research Centre, University of Alberta, Edmonton, Alberta, Canada.

Background: The most frequent complication after bilateral reduction mammoplasty (BRM) is the formation of seromas and hematomas. If a group of patients who are at increased risk of seroma and hematoma are identified, the use of drains in this group would be beneficial. We hypothesized that superior pedicle reductions would have increased postoperative drainage. Read More

Ann Plast Surg 2008 Apr;60(4):349-52

Plastic and Reconstructive Surgery of Puerto Rico, San Juan, Puerto Rico.

Since abdominoplasty has been shown to have a positive impact on patient's self-image and quality of life, it is no surprise that the annual number of these procedures performed has continued to increase. Historically, because of concerns with patient safety the majority of these operations have been performed on an inpatient basis. The breast reduction experience has shown that with proper patient selection and operative technique, this procedure can be performed on an outpatient basis without compromising safety. Read More

World J Surg 2008 Jan;32(1):38-44

Department of Plastic and Reconstructive Surgery, University Hospital of Bern, CH-3010, Berne, Switzerland.

Background: Gynecomastia is defined as the benign enlargement of the male breast. Most studies on surgical treatment of gynecomastia show only small series and lack histopathology results. The aim of this study was to analyze the surgical approach in the treatment of gynecomastia and the related outcome over a 10-year period. Read More

Plast Reconstr Surg 2007 Oct;120(5):1095-104; discussion 1105-7

Ulm Klinik Rosengasse and the Plastic Surgery Institute, University of Padova, Italy.

Background: The "minimal scar technique" for breast reduction, developed by Marchac, Lassus, and Lejour, has become an increasingly practiced alternative to standard operative procedures.

Methods: The authors introduced the modified "Lejour technique" in nearly 500 breast reductions in 250 overweight patients (adipose breasts) with a resection weight of more than 700 g. Their technique is a step-wise modification of the following procedures, resulting from their experience with complications and outcomes. Read More

Aesthetic Plast Surg 2006 Sep-Oct;30(5):574-88

Nanavati Hospital and Vasudhan Arjin Cosmetic Surgery and Laser Center, C-212, Lancelot, S.V. Road, Borivali West, Mumbai 400 092, India.

The advent of the tumescent technique in 1987 allowed for safe total corporal contouring as an ambulatory, single-session megaliposuction with the patient under regional anesthesia supplemented by local anesthetic only in selected areas. Safety and aesthetic issues define large-volume liposuction as having a 5,000-ml aspirate, mega-volume liposuction as having an 8,000-ml aspirate, and giganto-volume liposuction as having an aspirate of 12,000 ml or more. Clinically, a total volume comprising 5,000 ml of fat and wetting solution aspirated during the procedure qualifies for megaliposuction/large-volume liposuction. Read More

Dermatology 2006 ;213(2):140-3

Whitehouse Center for Liposuction, Zurich, Switzerland.

Background: Tumescent power liposuction is widely used on various parts of the body for minimal-access lipectomy. The undesired fat deposits are injected with tumescence fluid containing saline, epinephrine, bicarbonate and lidocaine; the latter is used as the only source of pain control. The fat is then removed using vibrating microcannulas. Read More

Plast Reconstr Surg 2005 Aug;116(2):646-53; discussion 654-5

Department of Plastic and Reconstructive Surgery, Addenbrooke University Hospital, Cambridge University Hospital's NHS Trust, Cambridge, United Kingdom.

Background: Ultrasound-assisted liposuction is a technique that is widely used all over the body for minimal access lipectomy. Recently, it has been reported to be especially suitable for the treatment of gynecomastia. To date, however, there is only one published study that specifically addresses ultrasound-assisted liposuction as a treatment modality for gynecomastia. Read More

Plast Reconstr Surg 2005 Jul;116(1):126-31

Department of Plastic Surgery, Christus St. Joseph Hospital, Houston, Texas 77002, USA.

Background: The role of prophylactic antibiotics in reduction mammaplasty remains controversial. However, most surgeons choose to use antibiotics. In addition to cost and potential allergic reactions, unnecessary administration of antibiotics can suppress host natural flora and produce resistant organisms. Read More

Aesthetic Plast Surg 2005 Jan-Feb;29(1):28-31. Epub 2005 Mar 17.

Background: Breast reduction surgery is known to be more effective than medications, diet, or support bras in relieving the suffering from excessively large breasts. Liposuction-only breast reduction, without surgery, is effective for eliminating symptoms and significantly reduces scarring and complications. The procedure allows women to maintain nipple sensation and the ability to breast-feed. Read More

Plast Reconstr Surg 2004 Dec;114(7):1724-33; discussion 1734-6

Department of Plastic Surgery, Nancy Lee and Perry R. Bass Advanced Plastic Surgery and Wound-Healing Laboratory, University of Texas Southwestern Medical Center, Dallas, USA.

The purpose of this survey was to assess the current trends in breast reduction techniques and to compare satisfaction rates and complications associated with traditional incision and limited incision techniques. In September of 2002, a breast reduction survey was sent to 1500 members of the American Society for Aesthetic Plastic Surgery; 554 of the members returned the survey. Questions elicited categorical answers, and the data were evaluated using the chi-square test and the comparison of two proportions. Read More

Aesthet Surg J 2004 May-Jun;24(3):216-23

Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch at Galveston, Galveston, TX, USA.

Background: Gynocomastia is a relatively common condition in men, with a reported overall incidence of 32% to 36% and as high as 65% among adolescent males in some series.

Objective: We reviewed the senior surgeon's experience over the past decade in the surgical treatment of gynecomastia using suction-assisted lipoplasty (SAL) with a cross-chest tunneling technique, performed alone or in combination with direct excision.

Methods: Thirty-four patients with gynecomastia were evaluated and treated surgically at the University of Texas Medical Branch in the past 10 years. Read More

Plast Reconstr Surg 2004 Mar;113(3):992-4

Plastic Surgery Section, Darnall U.S. Army Hospital, Fort Hood, Texas 76544-5063, USA.

This report elucidates the continued and relatively rare problem of congenital symmastia and its surgical repair without concomitant bilateral breast reduction. This case highlights the use of suction-assisted lipectomy techniques to address the excess fat in the presternal web and a periareolar approach for access to the intermammary space. The periareolar incision allows for the use of a concealed approach and the avoidance of a central scar that could result in hypertrophy or keloid formation, especially in this patient who is more prone to hypertrophic scarring. Read More

Plast Reconstr Surg 2003 Jul;112(1):71-82

Department of Plastic and Reconstructive Surgery, Ancona University School of Medicine, Italy.

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. Read More

Plast Reconstr Surg 2003 Jun;111(7):2192-9; discussion 2200-2

Department of Plastic and Reconstructive Surgery, Brugmann University Hospital, Brussels, Belgium.

Since 1989, superior pedicle vertical scar mammaplasty as described by Lejour has been used in the authors' department as the only technique for breast reduction. From 1991 through 1994, a series of 170 consecutive patients (330 breasts) underwent an operation. In these patients, minor complications were observed in 30 percent of the patients and major complications in 15 percent. Read More

Aesthetic Plast Surg 2001 Mar-Apr;25(2):85-8

Department of Plastic and Hand Surgery, University of Freiburg, Hugstetterstrasse 55, 79106 Freiburg, Germany.

As the use of ultrasound-assisted liposuction (UAL) increases, the technique grows more popular in breast surgery, especially in reduction mammaplasty and treatment of gynecomastia. The aim of our study was to investigate the effect of UAL on breast tissue using histological examinations, and analyze the effect of this technique on a cellular level. Biopsies from 10 patients undergoing ultrasonically assisted lipectomy prior to classic reduction mammaplasty were taken from the treated areas of the breast. Read More

Obes Surg 2000 Oct;10(5):451-9

Nutrition Support and Morbid Obesity Clinic, University Hospital of Patras, Rio, Greece.

Background: Dermolipectomies play a major role in the functional and esthetic deformities which result from massive weight loss.

Methods: From June 1994 to June 2000, 148 morbidly obese patients underwent various bariatric surgical procedures. After at least 1 year, 33 patients underwent 51 regional dermolipectomies performed by the same plastic surgeon. Read More

Aesthetic Plast Surg 1999 Sep-Oct;23(5):331-6

Department of Plastic Surgery, Asan Medical Center, Seoul, Korea.

The critical points which should not be overlooked when performing reduction mammaplasty are to minimize scar on the breast and to ensure a sufficient blood supply for the viability of the nipple-areolar complex. Periareolar reduction mammaplasty has been widely used because it left only one scar around the areola. However, with the typical periareolar reduction mammaplasty technique, it is difficult to remove a large amount of breast tissue and mobilize the remaining breast tissue. Read More

Plast Reconstr Surg 1999 Sep;104(3):764-70

Institut Médical Edith Cavell, Brussels, Belgium.

No surgeon likes to face complications. It takes effort to treat them personally and more effort to note, count, analyze, and demonstrate them. The author carefully followed 250 personal consecutive patients (476 breasts) who underwent vertical mammaplasties between 1990 and 1998; studying the complications and their relationship with the types of breasts and patients was very instructive. Read More

Plast Reconstr Surg 1999 Sep;104(3):748-59; discussion 760-3

Mineral Springs Hospital, Banff, Alberta, Canada.

Although the vertical reduction mammaplasty is effective in reducing scarring, the technique has not achieved widespread acceptance in North America. There are several reasons for this. Some believe that the vertical reduction mammaplasty is only applicable to smaller breast reductions and that the learning curve is difficult. Read More

Handchir Mikrochir Plast Chir 1999 Mar;31(2):134-6

Klinik für Plastische Chirurgie, Diakoniewerk Kaiserswerth, Düsseldorf.

In 1991, we started to use a new surgical technique for breast reduction with a single vertical scar incision as developed by Marchac, Lassus, and Lejour. The operative procedure wsa changed step-by-step according to the following significant modifications: Simultaneous liposuction is carried out only in the presence of extensive axillary fatty tissue. The undermining of the glandular tissue is limited to the extension of glandular resection. Read More

Plast Reconstr Surg 1998 Oct;102(5):1698-707

Reconstructive Surgery Institute of Jalisco, Mexico.

Forty-two female patients underwent liposuction of large volumes and extensive abdominoplasty during an 18-month period, with an average follow-up period of 9 months. Fifty-two percent of the patients underwent a third surgical procedure, which was basically aesthetic. The average age was 40 years; weight varied between 51 kg and 113 kg, with only 11 percent of the patients at their ideal weight. Read More

Aesthetic Plast Surg 1998 May-Jun;22(3):159-62

Atlantic Plastic Surgery Associates, Portsmouth, NH 03801, USA.

All breast reductions since 1996 have been performed with only liposuction. Removal of up to 2250 ml per breast has been obtained in 45 patients, without any complications. Significant skin retraction results from a very superficial subcutaneous liposuction, with a significant volume reduction of the gland. Read More

Ann Plast Surg 1995 Sep;35(3):242-8

Department of Plastic Surgery, Rikshospitalet, Norway.

Although liposuction is considered to be a relatively safe procedure, several deaths and nonfatal serious complications such as sepsis, toxic shock syndrome, thromboembolic disease, fat emboli, and adult respiratory distress syndrome have been reported. In the present study, we have investigated a wide variety of components belonging to the coagulation, fibrinolytic, plasma kallikrein-kinin, and complement systems in 22 patients undergoing syringe-assisted liposuction using the superwet or tumescent technique. In spite of a relatively high mean aspirate volume (2,648 ml), only small changes over time well within the normal range were found for the different parameters. Read More

Plast Reconstr Surg 1993 Dec;92(7):1276-84; discussion 1285-9

Department of Surgery, Newton-Wellesley Hospital. Newton Lower Falls, Mass.

Because unsatisfactory scars often result when traditional methods of reduction mammaplasty are performed, techniques that leave less noticeable scars have been advocated recently. One such technique is suction lipectomy, which has been employed previously, but only for patients who have well-located, small nipple-areola complexes and whose hypertrophy is primarily fat. I have found that concern for the size and location of the nipple-areola complex and cause of hypertrophy are unfounded. Read More

Aesthetic Plast Surg 1992 ;16(4):331-5

St. Luke's-Roosevelt Hospital Center, Division of Plastic and Reconstructive Surgery, New York, NY 10019.

The treatment of larger types of gynecomastia is significantly different than that of less severe gynecomastias. Special concerns of the former include areola enlargement, nipple-areola ptosis, and redundant skin. Many procedures have been described to address these issues, none of which is completely satisfactory; these are reviewed here. Read More

Plast Reconstr Surg 1991 Apr;87(4):709-17

Department of Plastic Surgery, Albert Einstein College of Medicine, New York, N.Y.

The use of suction lipectomy to reduce breast volume is described. The technique applies only to a very limited group of patients whose nipple-areola complexes are normally located and whose enlargement is primarily fibrofatty in nature. Suction mammaplasty can be used as a sole technique in congenital asymmetry or in post-reduction enlargement or asymmetry. Read More

Scand J Plast Reconstr Surg Hand Surg 1990 ;24(1):61-5

Department of Plastic Surgery, University Hospital, Uppsala, Sweden.

A retrospective study has been carried out on 149 patients with hypertrophic breasts operated on during the period 1977 to 1979 using Skoog's technique of reduction mammaplasty. Both physical and psychological symptoms were investigated as well as the follow-up results of the operation as a whole, as judged by the patient herself. The observation time was 5 years and the average age of the patients was 39 years. Read More