Bloodless de-epithelialization in reduction mammoplasty with hydrodissection using a digital automatic anesthesia injector: case series

Abstract

De-epithelialization is a technique that thins out the epidermis layer of the skin to resur face defects in a cavity or to implant a flap pedicle subcutaneously, preserving the sub dermal plexus to support the vascularity of the flap. However, in reduction mammoplas ty, de-epithelialization of the pedicle is a time-consuming and tedious step. Although various methods have been proposed to facilitate the completion of this step, a stan dard has not been established. We used a digital automatic injector that could inject a mixture of lidocaine and epinephrine at a constant, adjustable rate without any special effort. With this method, we could inject local anesthetic into the junction of the epi dermis and dermis accurately, which saved time by making dissection easier (hydrodis section) and decreased bleeding during de-epithelialization. Furthermore, we could use less of the lidocaine and epinephrine mixture, thereby reducing its potential side effects.