Hematoma following reduction mammaplasty can be a serious complication. Intra-operative hypotension and post-operative hypertension may promote in hematoma development.

We reviewed patients who underwent reduction mammaplasty from 2001 to 2004. A hematoma was defined as a collection that required operative exploration. A non-hematoma cohort of 20 was randomly selected for statistical comparison. The operation was divided into three equal phases and mean blood pressure (BP) for each period recorded. The phases were defined as shaping, hemostasis, and closure. Perioperative and demographic data were collected.

538 wise pattern inferior pedicle reductions and 8 hematomas (1.5%) were identified. Mean age was 41 years and mean BMI was 30. Mean operative time 2 hours. Average resection was 788 grams(R) and 771 grams(L). Analysis demonstrated BP during hemostasis phase was significantly lower in the hematoma group. (p<0.004) Post-operative BP was significantly higher in the hematoma group. (p<0.007) The mean “swing” of systolic BP from the hemostatic phase to post-op was significantly larger in the hematoma group. (p<0.001)

Hypotension during the hemostasis, post-operative hypertension, and large BP fluctuations were all significant in our series. Normotensive hemostasis and tight post-operative BP management may decrease the development of hematoma following reduction mammaplasty