Tumescent Local Anaesthetic and Modified lateral pillar to chest wall suture tightening technique for day stay breast reduction: 500 consecutive breast reductions

SDCC 

Objectives: We use superomedial pedicle technique at our centre and propose deep lateral pillar suture to narrow the breast and achieve good projection and not to leave extra skin inferiorly to avoid bottoming out. Using diluted LA infiltration reduces the bleeding and thus reduces operative time and overall complication rates.

Introduction: Symptomatic enlarged breasts are both a physical and mental debilitating condition for the young female. Common physical symptoms associated with this condition are bra strap marks, skin rash and neck/shoulder/back pain. Breast reduction surgery offer relief to these symptoms and also significantly improves the self-esteem and reduces the emotional stress.
Several breast reduction techniques have been described; commonly used ones are inferior pedicle and superomedial pedicle technique.

Materials / method: The aim of the study was to review all breast reductions carried out between March 2018 to March 2023. All cases are performed under GA combined with diluted LA infiltration at the incision line and in the breast parenchyma. We use superomedial pedicle technique at our centre and propose deep lateral pillar suture to narrow the breast and achieve good projection and not to leave extra skin inferiorly to avoid bottoming out.

Results: 500 cases were performed at the ASC as a day case procedure from March 2018 to March 2023. The mean age was 39 years.
488 cases had superomedial pedicle with wise pattern reduction and 12 patients needed breast amputation with free nipple areola graft. The mean weight of reduction was 650 gm per breast and largest reduction was 4kg for each breast.
The surgery time ranged from 25-60 min. The follow up period ranged from 6-24 months. Most patients were satisfied with the outcome. 12 cases has post operative hematoma requiring evacuation. 14 % of cases had some minor suture line delayed healing / breakdown.

Conclusion: Breast reduction is a safe day case procedure with minimal complications and aesthetically pleasing outcome. Using diluted LA infiltration reduces the bleeding and thus reduces operative time and overall complication rates.

Aesthetic

PSTM 2024