■ Using his/her right hand, the assistant holds the sharp four-pronged retractor under traction on the upper incision margin in such a way that the operating surgeon can carry out the dissection along the mammary gland in the direction of the pectoralis major fascia cleanly and without bleeding using surgical tweezers and Metzenbaum dissecting scissors. Owing to the tumescence this is largely free from bleeding. The excess tumescence solution flows back out again. If there are small amounts of bleeding, the sites can be coagulated using bipolar tweezers.
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