**2. Indications**

Our procedure preserves maximal venous and arterial blood supply to the breast and NAC by basing the NAC on the central, lateral, and superior pedicles. Resected parenchymal tissue is minimized and parenchymal transposition is expedited with the use of power-assisted liposuction as the main tool for decreasing breast volume. Sturdy sutures from the dermis to the chest wall enable glandular suspension, keeping upper-pole fullness and recreating the inframammary fold. Because the PALM technique preserves blood supply to the breast and NAC, this technique can be safely performed for patients with gigantomastia, breast hypertrophy, and severely ptotic breasts (NAC elevation up to 28 cm). In our experience, the resection pattern relies on the planned NAC elevation. When the planned NAC elevation is less than 10 cm, vertical wound closure is planned preoperatively. For NAC elevations more

*Power-Assisted Liposuction Mammaplasty (PALM): A Short Scar Mammaplasty… DOI: http://dx.doi.org/10.5772/intechopen.98816*

than 10 cm, a short T or J wound-closure pattern is decided intraoperatively after elevation of the NAC to the desired position and redraping the parenchymal tissues.
