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Table of Contents
Breast Revision
Suture: 3-0 vicryl for closing capsule or deep layer, 3-0 monocryl, 4-0 monocryl Dressing: Dermabond, steristrip over tails, Bra
Breast Reduction
Dr. Wong wants you to print out AP pre-operative photo and tape it up in the OR. Remember to take it down at the end of the case or you will be fired.
pre-op mark sternal notch, breast merridian can use draped ruler over neck. Imf and then pitanguy point for nipple placement. Uses tumesence 1mg epi in 1L NS
There was a superior medial powder-coat bilateral breast reduction. Unfortunately, I've learned today that the patient had a hematoma. The side that I had the steps to this operation are to first mark out to your pedicle and to de-ep that area. Of note, she does want you to print out the sheet of the patient's breasts pre-op to hang in the operating room. Once your pedicle is de-ep you can then cut your pedicle out going straight down to the chest wall if possible.
Next, you will make your triangular mastectomy superior flap about two centimeters thick and then cut out the rest of the remaining breast. Before cutting she does inject with tumescence, but this is really epinephrin one milligram of epinephrine in a bag of saline. She injects about six syringes worth or about 360 CCs per side. She does not use any local anesthetic in this, so she can use it later.