A Novel Approach for Tuberous Breast Correction Using Power-assisted Liposuction, Loops, and Lipofilling (P.A.L.L.L.)

• Published in: Aesthetic surgery journal Vol. 42; no. 11; pp. NP613 - NP629
• Main Authors: Abboud, Marwan H, Abboud, Nicolas M, El Hajj, Hiba
• Format: Journal Article
• Language: English
• Published: England 13-10-2022
• ISSN: 1090-820X; 1527-330X
• DOI: 10.1093/asj/sjac044

Autologous fat grafting has recently gained popularity in breast and reconstructive procedures.
The authors adopted a tri-composite tuberous breast reconstruction using matrix dissociation through an extensive tunnelization, tissue recruitment using loops and autologous fat transfer. This principle is called "Matrix Modeling" and is applied using the Power-assisted Liposuction Loops and Lipofilling (P.A.L.L.L.) technique. This will expand the lower pole, reshape breast and increase its volume.
Between 2014 and 2020, a total of 47 patients underwent tuberous breast correction by combined lipofilling and the use breast loops. Patient population included patients with unilateral or bilateral tuberous breasts of any stage. Patients who were active smokers, lean, or who desired large breasts, were excluded from the study.
Of the 47 patients, 31 had bilateral malformations. The mean age was 26 years. The mean recruited flap volume was 212 mL. A single session (mean transfer volume, 163 ml) was required in 34 cases (72%). A second session (mean transfer volume, 182 mL) was necessary in the remaining of 28% of cases. Patients were very satisfied in 93% of cases and satisfied in 7% of cases. One infection was observed. The mean operative time was 67 minutes. Imaging performed preoperatively and 1 year postoperatively did not reveal any anomalies other than oil cysts (4%).
Tri-composite breast reconstruction using P.A.L.L.L. is a novel, simple, safe and alternative technique for tuberous breast correction by remodeling the matrix. The aesthetic outcome is natural, implant free, and long lasting.