Take a semi-recumbent position, perform routine anesthesia on the incision, cut the skin under the skin along the incision mark line, perform total breast anesthesia on the gland surface through the incision with the prepared anesthetic, and then peel off the skin flap around the gland surface until it reaches the breast base 1-2cm, and determine the direction and size of gland resection according to the size of giant breasts. Among my 36 cases, 33 cases were treated with spindle-shaped wedge resection of upper, lower, left and right mammary glands, 2 cases were treated with isosceles triangular spindle-shaped wedge resection of upper, left and right mammary glands, and 1 case was treated with spindle-shaped wedge gland resection of upper and lower mammary glands. When the gland is removed, it should be cut radially from the base to the areola. The upper point is 2cm away from the skin incision, avoiding the glandular tissue under the nipple areola, and the lower point keeps the posterior tissue of the breast about 1cm. Each excised gland should be symmetrical and similar in size. The spindle incision of gland is closed and sutured first, and then folded and sutured from the base of breast to areola. There is no need to remove the skin by leaving negative pressure drainage at the lower breast fold. The incision and areola were closed and sutured layer by layer.

Postoperative treatment: negative pressure drainage should be removed within 48 hours according to the drainage volume. Double breasts were bandaged under pressure for 7 days, antibiotics were applied for 5 days, and the incision was taken out 10 days. 1, infection. Because aseptic operation is not strict, or improper operation causes great trauma, reducing the blood supply and anti-infection ability of tissues, infection may occur.

2. hematoma. It is mainly caused by excessive excision of glandular tissue, too large separation range, incomplete hemostasis and no incision edge during suture.

3, nipple or areola necrosis. This is one of the most serious sequelae, mainly because of rough operation, which destroyed the blood supply around the areola.

4. Lactation function is impaired. The breast tissue such as glands and ducts removed during operation is too large, which leads to the imperfection or complete damage of the lactation tissue of the breast and affects the lactation function of the breast.

5, slow wound healing, scar hyperplasia, etc. Breast reduction surgery is a traumatic operation. If the incision is infected, it will easily lead to the sequelae of scar hyperplasia.

6, breast asymmetry. In order to prevent this problem, it is necessary to observe the breasts on both sides during the operation and make appropriate adjustments to coordinate the two sides. Pay attention to the shaping of both sides when sewing to avoid asymmetry. As a common complication, it is usually difficult to stop bleeding because of the removal of breast tissue. Preparing electrocoagulation for hemostasis during operation can reduce the occurrence of bleeding complications.

Purple blisters and scattered local necrosis are common in nipple and areola skin, which may be caused by poor blood supply. Pay attention to the skin flap thickness, breast separation range and resection range during operation to avoid necrosis.

The formation of excessive scar at the incision is related to the individual differences of patients and the degree of tissue damage caused by doctor's operation. Prevention is to minimize tissue damage during surgery; The redundant flap should be cut off properly and sutured without tension to reduce the scar of incision.

The asymmetry of breast size is mostly caused by uneven resection of breast tissue or adipose tissue on both sides. During the operation, the operator should try to remove the same amount of tissue.