Q: Dear Dr. Eppley, do you perform scarless breast reduction? If so how is it done and how small and what shape will my breasts be afterwards?
A: There is no such thing as true scarless breast reduction. The only ‘scarless’ method of breast reduction is liposuction. This can remove some volume of breast tissue but it can not improve any shape features of the breast. It can not lift or tighten skin, reduce the size of the areola, elevate the position of the nipple-areolar complex, nor give the breast a rounder or even a more conical shape. For most breast reduction patients, these changes are just as important as the amount of breast tissue removed. Liposuction of the breast, in fact, can even make the shape and the sagging of the breast worse. As you reduce the breast volume, but do not change the skin that contains it, the breast will sag worse. At the least, the amount of breast sagging will certainly not improve.
There is a very limited role for liposuction or scarless breast reduction for a few select patients. But they have to have large breasts which sit adequately high on the chest wall, have a good nipple position and fairly tight breast skin. Most women with large breasts that want a reduction do not have these breast shape features. This is why the traditional method of breast reduction with scars is needed.
Dr. Barry Eppley