There is a manual technique where surgeons remove tissue after having opened the breast along the tissue lines where surface tissue will be removed as well and lifted.
There is the tumescent technique that is in all actuality, liposuction in a lesser form.
The liposuction technique can also be used with ultrasonic energy but has an increased chance of injury due to burns. Apparently the high frequency waves can over-excite the water molecules (or any fluid) causing them to boil beneath the skin as well as damaging superficial tissues as well. Unfortunately there is also the possibility that blind removal will accidentally disturb or remove milk ducts/glands in such a way that a patient's breast feeding chances are severely decreased.