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Infiltration of Epinephrine in Reduction Mammaplasty: A Systematic Review of the Literature

Hardwicke, Joseph T. Ph.D., M.R.C.S.; Jordan, Robert W. M.R.C.S.; Skillman, Joanna M. F.R.C.S.(Plast.)

Plastic and Reconstructive Surgery: October 2012 - Volume 130 - Issue 4 - p 773–778
doi: 10.1097/PRS.0b013e318262f085
Breast: Original Articles

Background: Evidence of the benefit of dilute epinephrine infiltration before reduction mammaplasty is provided by several controlled trials. Despite variation in operative technique and data collection, a reduction in intraoperative blood loss has been shown. The aim of this review of the literature is to weigh the available evidence with respect to reducing blood loss during surgery and other outcome measures such as postoperative drainage.

Methods: Two researchers independently selected articles for review, and data were extracted from each primary article and used for statistical and descriptive comparisons.

Results: A meta-analysis of operative blood loss showed a highly significant drop in operative blood loss in breasts infiltrated with epinephrine and a reduction in the need for blood transfusion. Operative time, postoperative drainage, and complications were not significantly affected by epinephrine infiltration.

Conclusion: The authors’ recommendation would be for the use of dilute epinephrine infiltration before reduction mammaplasty.


Coventry, United Kingdom

From the Department of Plastic Surgery, University Hospitals of Coventry and Warwickshire NHS Trust.

Received for publication March 24, 2012; accepted April 17, 2012.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. No outside funding was received.

Joseph T. Hardwicke, Ph.D., M.R.C.S., Department of Plastic Surgery, University Hospitals of Coventry and Warwickshire NHS Trust, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom,

©2012American Society of Plastic Surgeons