Electrocautery Dissection and Blunt Dissection for Breast Implants

asked 2 years ago by Tammi79 in AZ
Latest answer by Steven Wallach, MD
Question viewed 1,342 times
Tags: breasts, pain, reduce

What percentage of doctors use electocautery dissection and blunt dissection for breast implants? How much is the pain reduced using electrocautery dissection?

11 answers to Electrocautery Dissection and Blunt Dissection for Breast Implants

Dissection techniques

The most important thing about the dissection is to remain as bloodless as possible with whichever technique you use. I think electrocautery works best.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast Augmentation Technique

There have been a number of studies about the complication rates and speed of recovery relating to peri-operative factors in breast augmentation. Complication and reoperation rates have significantly fallen with careful discussion of patient desires, use of patient centered measurements in choosing an implant and careful surgical technique, including the method of dissection of the pocket. By doing these things, reoperation rates are about 2%, not the reported 15-20% seen in most studies.... more

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Electrocautery dissection and blunt dissection for Breast Implants

Great technique question, more like a first year plastic surgery resident type question. As seen in these previous postings the electro cautery dissection is far above any blunt finger or instrument dissection. The recovery, degree of swelling, amount of black and blue (ecchymosis), potential hematoma are much less with the cautery. When we see post augmentation patient I almost can guess the surgeon if from my area who uses blunt dissection. Thanks for a great question.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Electrocautery versus blunt dissection for breast augmentation with implants

This varies tremendously with each surgeon and with each approach. For example probably 90% of TUBA procedures are done primarily with blunt dissection. Whereas the breast crease approach can be accomplished via a variety of techniques. Electrocautery can also be delivered using bipolar forceps which is a more direct and locatlized application of the energy.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Blunt vs. Cautery Dissection for Breast Augmentation

Hi there- I also feel strongly that precise cautery dissection has lowered my complication rates and simplified recovery for my patients. I do not think that the procedure takes any longer either. This is a no brainer. As for your question about how many surgeons do which, I could not say, but I think time will strengthen the knowledge base and more surgeons will use cautery only technique.

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Cautery vs blunt dissection

rate and careful dissection that is used in breast surgery, there is a decreased incidence of pain, swelling and post-op bleeding. This is one reason I am not a fan of TUBA surgery. Dr Edwards

Michael C. Edwards, MD
Las Vegas Plastic Surgeon

www.medwardsmd.com

Another vote for cautery rather than blunt dissection for breast augmentation

Blunt dissection, by definition, involves ripping the tissues apart blindly while cautery dissection is done under direct vision with precision. Since it also controls bleeding there is less bruising. All of this means faster recovery with less discomfort, though I remain skeptical about the "24 hour return to normal activities" that some claim.

Richard Baxter, MD
Seattle Plastic Surgeon

Both work and pain is an individual issue

I use both blunt, sharp and electrocautery dissection. I don't find it makes a difference in patient pain. What works for me is the use of a long term anesthetic placed in the pocket prior to inserting the implant. My patients have very few complaints of pain.

William B. Rosenblatt, MD
New York Plastic Surgeon

Dissection for breast implants

Hi Njgirl, Most surgeons use electrocautery dissection, as it leads to less pain and a more bloodless field. It also leads to less trauma to the tissues and therefore less postoperative swelling and bruising. Good question and good luck! Dr. Singer

Elan B. Singer, MD
Manhattan Plastic Surgeon

HUGE Reduction in Breast Augmentation Pain by avoiding Blunt Dissection.

I TOTALLY agree with Dr. Rand. The prime standard bearer for precise pocket dissection with cautery rather than blunt dissection has been Dr. John Tebbetts of Dallas who suffered the scorn of many of our colleagues for his opinions. Myself and many other Plastic surgeons think very highly of him. Those who abandoned blunt dissection and adopted his techniques have greatly improved the quality of our results and our patients' satisfaction. Aside from increased speed (resulting in bleeding... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Making the breast implant pockets

Ever since I went to almost exclusively using electrocautery rather than blunt finger dissection, my patients have reported much less pain and I have seen much less swelling and virtually no bruising.