The advantages of prior tumescence (manually or mechanically using a pump) are impressive. There is less bleeding. The gland is lifted from the fascia of pectoralis major. As a result, dissection is simple because the correct layer is easily located and time is saved. Wound healing is faster.
Initially, the incision area is infiltrated to deep into the muscle fascia. Then by pulling up the mammary gland with the left hand, tumescence is continued in the prefascial, parasternal, and lateral regions in the whole of the dissection area. As an operating surgeon, one detects how the gland becomes detached from the muscle fascia and can predissect the subsequent dissection boundaries and layers with the tumescence needle. As a result, much time is saved in the dissection process since this
a e dissection can generally be carried out using the finger as a blunt instrument, in the correct layer and completely without bleeding. For this reason it is important that the surgeon performing the operation carries out the tumescence him/herself and does not leave it to his assistant.
■ Approximately 100 ml of tumescence solution is infiltrated on each side, depending on the size of the breast. In the process, the complete mammary gland is lifted up from the pectoral muscle.
On the basis of a clinical trial, which involved the introduction of breast implants with and without tumescence (n = 100), we have shown that postoperative swelling and pain are reduced and that the healing process is accelerated.
Liberal preoperative tumescence of the operation site may be confusing for inexperienced surgeons since it results in an increase in the breast volume.
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