Answer:
Mark Zukowski reported on 50 patients with bilateral breast reductions performed under local anesthesia with intravenous sedation. The average total breast tissue resected was 1372 gm (516 to 2948 gm). The patients were sedated with intravenous midazolam and fentanyl and a local solution of marcaine, lidocaine and 1:200,000 epinepherine was used. Only one patient recalled some significant discomfort. The use of scalpel dissection was recommended over electrocautery. In addition supplementing the injection of local in the deep layers was advised as well.
In a review of 338 consecutive case Buenaventura et al compared the 286 cases done as an outpatient and the 52 cases done as inpatient. There was no significant differences in minor complications such as wound separation, seromas, hypertrophic scars, infection and hypopigmentation. Outpatient surgery resulted in a savings of $1500 to $2500 compared to overnight stay.