Sub-muscular Breast Augmentation Using Tumescent Local Anesthesia
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Tumescent local anesthesia (TLA) consists of infiltration of saline solution with lidocaine and epinephrine into the tissues to obtain regional anesthesia and vasoconstriction. The use of TLA in augmentation mammoplasty has been described for sub-glandular positioning. We describe a modified TLA technique for primary sub-muscular breast augmentation reporting our experience during the past 7 years.
From 2010 to 2017, 300 patients underwent bilateral primary sub-muscular breast augmentation under TLA and conscious sedation. The tumescent solution was prepared with 25 mL of 2% lidocaine, 8 mEq of sodium bicarbonate, and 1 mL of epinephrine (1 mg/1 mL) in 1000 mL of 0.9% saline solution. Firstly, the solution was infiltrated between the pectoral fascia and the mammary gland, secondarily, during surgery, under the pectoralis major muscle.
The average amount of tumescent solution infiltrated while performing TLA was 740 mL per breast. No signs of adrenaline or lidocaine toxicity were reported and conversion to general anesthesia was never required. In all patients, no pain nor discomfort was reported during the pre-operating infiltration and surgical procedure. We reported a major complication rate of 3.3% (4 hematomas and 6 seromas) and a minor complication rate of 6.0% (8 implant dislocation and 10 dystrophic scars formation).
TLA represents a safe and efficacious technique for performing breast augmentation surgery with sub-muscular implant positioning. This technique guarantees good pain control during and after surgery and has low incidence of postoperative side effects. Patients subjected to sub-muscular breast augmentation with TLA were satisfied.
Level of Evidence IV
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KeywordsBreast augmentation Sub-muscular Tumescent local anesthesia Breast implants
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- 16.Klein JA (1990) Tumescent technique for regional anesthesia permits lidocaine doses of 35 mg/kg for liposuction. J Dermal Surg Oncol 16:248Y263Google Scholar
- 17.Klein JA (1988) Anesthesia for liposuction in dermatologic surgery. J Dermal Surg Oncol 14:1124Y1132Google Scholar
- 18.Maxwell GP, Gabriel A (2009) Breast reconstruction. In: Aston SJ, Steinbrech DS, Walden JL (eds) Chapter 57, Aesthetic plastic surgery. Elsevier, PhiladelphiaGoogle Scholar
- 19.Namias A, Kaplan B (1998) Tumescent anesthesia for dermatologic surgery. Cosmetic and noncosmetic procedures. Dermatol Surg 24:755Y758Google Scholar
- 24.Cigna E, Tarallo M, Bistoni G, Anniboletti T, Trignano E, Tortorelli G, Scuderi N (2009) Evaluation of polyurethane dressing with ibuprofen in the management of split-thickness skin graft donor sites. Vivo. 23(6):983–986Google Scholar
- 25.Peled IJ (2002) Tumescence in augmentation mammaplasty. Plast Reconstr Surg 110(1366–1367):13Google Scholar