Dominik L Feinendegen
Posters-Accepted Abstracts: J Clin Exp Dermatol Res
Aim: Over the past few years the vertical scar mammaplasty has become the standard technique for breast reduction and mastopexy. However, because of suturing over the entire length of infraareolar skin unpleasant scars develop. This presentation describes a new technique for improving scars. Materials & Method: Preparing for skin incisions, the key-hole-scheme with a caudal ??drop-form? is drawn on the patient in upward position. After breast reduction/mastopexy with superior pedicle and central mobilisation from the pectoralis fascia, the remaining breast is fixed at the height of the 2nd to 3rd rib. This causes, in the long run, an improved cranial pole filling. After suturing the breast columns and lateral mobilisation of the skin flaps, the areola is transferred and fixed in its new position. The vertical incision line is cleanly adapted layer wise without skin plication. The caudal opening of the dropwise resected skin remains. Depending on the size of this opening wound closure uses a tightly intradermal placement of a ??tabaccopouch? suture. This then is centrally positioned on the pectoralis fascia at the height of the new inframammary fold. The healing then results in a better rounding of the caudal mamma. If there is abundant skin, a double ??tobacco-pouch? suture in 8-form is preferred and brings a more homogeneous distribution of the plicated skin. The eventual healing increasingly smoothes the skin in the inframammary fold. The visible vertical scar remains small and thin. Results: The technique will be explained in detail using case reports and appropriate illustrations and drawings. During the last 10 years 105 patients have been operated with this method (in one center from the same surgeon). In a questionaire 95% of the patients rated the quality of the scar and the form of the breasts as very good to excellent. Conclusion: The single or double ??tabacco-pouch? suture for caudal wound closure in conjunction with a vertical scar technique in mammaplasty brings an aethetically improved scar. The procedure is well suited for small to modest breast reduction/ mastopexy.
