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An infiltration technique for reduction mammaplasty: results in 192 consecutive breasts
J M O'Donoghue1, N D Chaubal, R M Haywood
1Department of Plastic Surgery, Stoke Mandeville NHS Trust Hospital, Aylesbury, Bucks, United Kingdom.
Acta Chirurgiae Plasticae
|April 1, 2000
Summary
Local anesthetic infiltration with adrenaline is safe for reduction mammaplasty. A dilute, large-volume tumescent technique in the retroglandular space minimizes blood loss and complications, potentially eliminating the need for drains.
Area of Science:
- Plastic Surgery
- Surgical Techniques
- Anesthesiology
Background:
- Local anesthetic infiltration with adrenaline is recognized as safe for reduction mammaplasty.
- Current infiltration techniques lack clarity regarding optimal application.
- Effective methods must respect breast neurovascular anatomy.
Purpose of the Study:
- To describe and evaluate a specific local anesthetic infiltration technique for reduction mammaplasty.
- To assess the safety and efficacy of a dilute, large-volume tumescent technique in the retroglandular space prior to surgery.
Main Methods:
- A large volume (400 ml) of dilute local anesthetic (lignocaine and adrenaline) was infiltrated into the retroglandular space 15 minutes before surgery.
- The technique was applied to 96 consecutive patients undergoing reduction mammaplasty using an inferior pedicle method.
- This method is considered a variation of the tumescent technique used in liposuction.
Main Results:
- The breast complication rate was 9.36%, and the patient complication rate was 19.79%.
- Postoperative blood loss was minimal, ranging from 0 to 305 ml (mean 56.03 ml).
- The procedure facilitated an almost bloodless dissection.
Conclusions:
- The described tumescent local anesthetic infiltration technique is safe and effective for reduction mammaplasty.
- This method leads to significantly reduced postoperative blood loss.
- The technique may allow for the omission of drains in most cases.