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FACE
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BREAST
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LIPOSUCTION
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ABDOMEN
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LIMBS
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A serious complication after breast reduction is loss of the blood supply to the nipple. This can happen for many reasons. If the nipple is moved a large distance the pedicle may not carry enough blood and in older patients, or those with diabetes, the blood supply is poor to begin with.
- In the hours after surgery the blood supply of the nipple is checked regularly and if it appears darker then surgery may be needed to help restore the blood supply. It has been shown that when the blood supply of the nipple only comes through the pedicle there is often an actual increase in the flow of blood which may continue for several days.
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- The first thing that is done is to release the stitches around the nipple. This helps to prevent kinks in the veins and arteries of the nipple. If this does not work and the blood supply gets worse the surgeon may decide to re-open the breast. The surgeon can check that the pedicle carrying the blood supply to the nipple is not kinked.
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- Sometimes during surgery it is obvious that the blood supply to the nipple is poor and in these cases the surgeon may change from a pedicle type operation to a free nipple graft.
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- Assessment of blood supply to the nipple is usually not difficult However in some cases, especially in those with darkly pigmented areolas, it is hard to assess the blood supply. In these cases surgeons sometimes recommend other methods such as fluorescein or Doppler flowmetry to check the blood supply.
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- If the nipple blood supply is seriously damaged, all or part of the nipple may die. Reconstruction of the nipple is then needed.
- Scand J Plast Reconstr Surg Hand Surg 1991;25(1):41-5
Skin circulation in the nipple after reduction mammaplasty with a bipedicle vertical dermal flap.
Perbeck L, Proano E, Maattanen H.
Department of Surgery, Karolinska Institute, Huddinge University Hospital, Sweden.
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