No-Scar Breast Reduction Utilizing Power-Assisted Liposuction Mammaplasty, Loops, and Lipofilling

Background In the context of continuous interest to develop and refine minimally invasive procedures, recent publications reported a scarless approach in breast lifting. Objectives The authors describe a power-assisted lipomodeling technique combined with surgical loops to achieve breast reduction and reshaping with minimal scars. Methods Between 2014 and 2018, a total of 94 patients underwent breast reduction by combined liposuction and loops. Following infiltration of the breasts, liposuction of the outer quadrants and the lower pole was achieved to reduce the breast footprint and the lateral and inferior heaviness of the breast. After multiaxial multiplanar tunnelization, three types of loops were taken around the breast to suspend and elevate the breast skin envelope and parenchyma. Each loop was guided through a 3 mm, three-hole cannula passed through skin stab incisions. The first loop was designed to reduce the breast footprint and enhance the breast projection, whereas the second loop is designed to achieve breast conus remodeling and can be performed three to five times. The third loop was passed circumferentially around the areola and then cephalad along the breast axis and pulled until the desired NAC elevation was reached. Each loop was pulled to achieve the desired breast projection and shape. Results The authors achieved breast reduction with a mean nipple elevation of 7.3 cm, and 88% of patients were satisfied with their breast shape. The total complication rate was 1%, including mild cellulitis in one breast, treated efficiently with oral antibiotics. Conclusions The proposed technique is a novel, simple, and safe alternative to achieve breast reduction and reshaping without a scar.