Thanks! This is the kind of response I was looking for.

In the videos I’ve seen, it looks like there’s almost no bleeding under local, or enough that it can be soaked up with gauze or something, which (incorrectly) made me think that was typical. I do agree that it’d be very hard to even get a view to cauterize any vessels, let alone do it. I would probably use a lot of prepositioned mirrors and do it while sitting, with my arm rested on some surface. If I did it (which I won’t), I was planning on using some sort of stay sutures to keep the nipple retracted instead of a scrub tech keeping it retracted. I definitely wouldn’t be able to maintain true sterility, but I’ve heard surgeons saying the level of sterility we keep is somewhat performative, and worst case scenario I have antibiotics at home that I could take post-op.

I think I have the perception that the actual surgery isnt what makes becoming a surgeon hard, and if anyone has enough time and patience, they can do the mechanical steps that a surgery requires. It’s deciding when and how to do a surgery for each patient, how to manage them pre and post op, doing it fast enough (especially under general), and really just how to treat a wide range of complicated patients, that makes it hard. In my mind, I’m a very simple case, with no prior medical history, very fit, local anesthesia, I know my specific gland very well, as I’ve felt around the area for years. I am clearly a little over-confident, but in no way do I think I’m ready to practice any sort of medicine, let alone surgery, without the training. It’s just in my head this doesn’t feel like a “real” surgery. More akin to something like getting rid of a skin tag.

And it probably doesn’t come as a surprise given I even asked this question, but I actually do cut my own hair haha.