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Mastoplasty in Local Anaesthesia
What is the advantage of additive mastoplasty under local anaesthesia?
The main advantage consists of eliminating the risks related to general anaesthesia.
The wetting solution, used for subcutaneous infiltration, consists of lidocaine, sodium bicarbonate and epinephrine. Antibiotics and non-narcotic analgesics are given pre-operatively, and the patient remains perfectly awake during the operation.
Why do you use anthropometry before surgery?
Anthropometrical analysis is the starting point for surgical planning because it helps me to choose the volume and shape of the prostheses, correlating the mammary region to standardised models.
Is local anaesthesia a painful procedure?
CRYOCAPS are placed over the points where infiltration will be carried out, in order to avoid pain from the needle.
Subcutaneous infiltration is painless, thanks to the pH of the solution, which is compatible with body tissues.
What is the most common incision used?
The infra-mammary incision is indicated in this local procedure, because it provides better and faster exposure of the operative field. The only drawback is a more noticeable scar than that left by the axillary incision, which requires an endoscope and sedation. The peri-aureolar incision can also be used in local mastoplasty with minimal scarring, but increased incidence of nipple paresthesia. The umbilical incision is not used in local additive mastoplasty.
What kinds of mammary implant are used?
Both saline and silicone gel mammary implants can be used.
Where is the implant placed?
The implant is placed below the breast tissue and above the muscular fascia. Subpectoral placement may be chosen in patients with very thin subcutaneous tissue, where more camouflage of the implant is needed.
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