Is There Any Way For a Surgeon to Avoid Cutting Blood Supply During Repeat Reduction?

I'm having repeat reduction and do not have records of prior reduction in 1978. I had recent consult with PS who indicates that she can remove at least 500g per breast and would use same reduction pattern as was used in first reduction. How will she know where blood supply is? Are there any techniques that help surgeons identify blood supply so as not to cut them? I have posted pics on recent review under Bellasma.

Doctor Answers 2

Revisionary breast reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Many years have passed since the first reduction - its unlikely that the blood supply to your nipple/areolar complex is relying on the original pedicle created by the first surgeon. For revisionary reductions, I favor using the 'central pedicle' or 'central mound technique' which essentially attempts to preserve as much central blood supply as possible. I also try to undermine the skin flaps minimally. If most of the excess weight is in the lower pole of your breast, then this approach works well, in my experience.

Repeat Breast Reduction Concerns?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question and pictures.
The concern with repeat breast reduction surgery is related to blood flow to the remaining tissue;  if too much tissue is removed in one operation the blood flow to the remaining tissue (including nipple/areola)  may be compromised.   Part of the tissue that is left in place is called the “pedicle"; this segment of tissue is responsible for delivering the blood supply to the nipple/areola tissue.   Must be taken during repeat breast reduction surgery to avoid cutting the  pedicle that is responsible for “delivering” blood flow to the nipple/areola complexes.  If this does occur,  tissue necrosis may result.

Generally speaking, I would expect much of the blood flow to the breasts  and breast skin to have  been reestablished after 30 years.  
I hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.