Our Summary

This research paper looks at a technique used in breast removal and breast reconstruction surgeries, known as the tumescent technique. The technique is commonly used to help reduce blood loss during surgery. However, there have been concerns that it could increase the risk of skin death (necrosis) after surgery.

To explore this, the researchers looked at a range of past studies on the topic. They found that surgeries that used the tumescent technique did indeed have higher rates of skin death. However, there was no link between this technique and increased rates of blood accumulation (hematoma) or infection.

In simpler terms, the study suggests that while the tumescent technique can help reduce blood loss during breast surgery, it may also raise the risk of skin death afterwards.

FAQs

  1. What is the tumescent technique used in breast removal and reconstruction surgeries?
  2. Does the tumescent technique increase the risk of skin death (necrosis) after surgery?
  3. Is there a link between the tumescent technique and increased rates of blood accumulation or infection?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mastectomy is to discuss the potential risks and benefits of using the tumescent technique during the surgery. It’s important for the patient to understand that while the technique can help reduce blood loss, there is a higher risk of skin death afterwards. The doctor may recommend additional precautions or follow-up care to minimize this risk and ensure the best possible outcome for the patient.

Suitable For

Patients who are typically recommended mastectomy include those with:

  1. Breast cancer that cannot be treated with other methods such as lumpectomy or radiation therapy.
  2. Genetic mutations such as BRCA1 or BRCA2 that significantly increase the risk of developing breast cancer.
  3. Previous radiation therapy to the chest area, which may increase the risk of developing a second primary cancer in the breast.
  4. Severe breast abnormalities or deformities that cannot be corrected with other methods.
  5. Recurrence of breast cancer after previous treatment.
  6. Desire for risk reduction in high-risk individuals, such as those with a strong family history of breast cancer.

Ultimately, the decision to undergo a mastectomy is a personal one that should be made in consultation with a healthcare provider and based on individual circumstances and preferences.

Timeline

Before mastectomy:

  1. Patient receives a breast cancer diagnosis and discusses treatment options with their healthcare team.
  2. Patient decides to undergo a mastectomy as part of their treatment plan.
  3. Patient meets with a surgeon to discuss the procedure, potential risks, and the use of techniques such as the tumescent technique to reduce blood loss during surgery.
  4. Patient undergoes pre-operative testing and preparation for the surgery.

After mastectomy:

  1. Patient undergoes the mastectomy surgery using the tumescent technique to reduce blood loss.
  2. Patient is monitored in the recovery room and then transferred to a hospital room for post-operative care.
  3. Patient may experience pain, swelling, and discomfort in the days following surgery.
  4. Patient receives instructions on wound care, pain management, and follow-up appointments.
  5. Patient may begin the process of breast reconstruction if desired.
  6. Patient may experience skin death (necrosis) as a potential complication of the tumescent technique used during surgery.
  7. Patient continues to follow up with their healthcare team for monitoring and support throughout their recovery process.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the tumescent technique in mastectomy surgery?
  2. How common is skin death (necrosis) after mastectomy surgery using the tumescent technique?
  3. Are there any alternative techniques that can be used to reduce blood loss during mastectomy surgery without increasing the risk of skin death?
  4. How will the use of the tumescent technique impact my recovery time and overall outcome of the surgery?
  5. What steps will be taken to minimize the risk of skin death and other complications during and after mastectomy surgery using the tumescent technique?
  6. How experienced are you in using the tumescent technique for mastectomy surgery, and what is your success rate with this technique?
  7. Are there any specific factors about my health or anatomy that may increase the risk of complications with the tumescent technique during mastectomy surgery?
  8. What should I expect in terms of scarring and overall aesthetic results with the use of the tumescent technique in mastectomy surgery?
  9. How will the use of the tumescent technique affect my options for breast reconstruction after mastectomy?
  10. Are there any additional precautions or measures I should take before or after mastectomy surgery using the tumescent technique to reduce the risk of complications?

Reference

Authors: Siotos C, Aston JW, Euhus DM, Seal SM, Manahan MA, Rosson GD. Journal: Plast Reconstr Surg. 2019 Jan;143(1):39-48. doi: 10.1097/PRS.0000000000005100. PMID: 30589774