A Novel Approach for Tuberous Breast Correction Using Power-Assisted Liposuction, Loops, and Lipofilling (PALLL)

Autologous fat grafting has recently gained popularity in breast and reconstructive procedures.

The aim of this paper was to describe a tricomposite tuberous breast reconstruction that comprises matrix dissociation through extensive tunnelization, tissue recruitment with loops, and autologous fat transfer. This approach, called "matrix modeling," was implemented by the power-assisted liposuction, loops, and lipofilling (PALLL) technique as a method to expand the lower pole, reshape the breast, and increase breast volume.

Between 2014 and 2020, a total of 47 patients underwent tuberous breast correction by combined lipofilling and the use of breast loops. The 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 (mean age, 26 years), 31 had bilateral malformations. 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 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%).

Tricomposite breast reconstruction by PALLL 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.