Suction lipectomy: an excellent adjutant to improve the results of breast reconstruction with RAM flaps.

It has been said about breast reconstruction with implants that a patient should not expect more than a mound that will fill out her brassiere or bathing suit. Autogenous tissue breast reconstruction has changed this. One of the great advantages of autogenous reconstruction over implants is that the breast remains soft, supple, and warm, improving with time as the scars begin to fade and becoming more natural and pendulous. Furthermore, since the new breast is made of fat, we can change its size, enhance its shape, and sculpture it with a suction lipectomy cannula to make it look practically identical to the opposite. We look upon breast reconstruction with rectus abdominis myocutaneous (RAM) flaps as a torsoplasty because of the improvements to the two areas involved: the reconstructed breast and the resulting abdominal lipectomy. This torsoplasty is done in two stages: One is the actual transfer of the rectus abdominis flap in which the skin and fat involved is designed to try to give an aesthetic dermolipectomy but without compromising the vascularity of the flap. Three or four months later, we perform the second-stage torsoplasty where the suction-assisted lipectomy plays a fundamental role and which is the subject of this article.