The Tumescent Technique for Bloodless Breast Reduction

Abstract

M Beveridge, M Bell. The tumescent technique for bloodless breast reduction. Can J Plast Surg 1994;2(3):121-124. The tumescent technique for reduction mammaplasty provides a safe, reliable and inexpensive way to reduce intraoperative blood loss in reduction mammaplasty. The results of a study involving 64 consecutive patients operated on by the same surgeon are presented. Initial subjective experience with the infiltration of large volumes of very dilute anaesthetic solution deep in the breast along the planned incision lines suggested that the technique significantly reduced blood loss. To confirm this. 23 consecutive cases were operated upon without infiltration and the next 20 cases were done with infiltration of 250 mL of 0.1 % lidocaine with 1:1,000,000 adrenaline. Preoperative hemoglobin was compared with that obtained at an office visit on the seventh postoperative day. The difference in the drop in hemoglobin observed in the two groups was significant at the P<0.02 level; however, the difference was most pronounced in the group in whom a smaller volume of tissue was removed. Accordingly in the next phase of the study the volume of solution to be injected was calculated in relation to body weight. When 10 mL/kg body weight of solution was injected there was dramatically less bloodloss compared with the control group (P<0.01). Patients experienced no ill effects attributable to the injection: there were no significant postoperative hematomas nor any adverse effect on wound healing.