Abstract
Background
Symptoms of axillary accessory breasts (AABs) vary among patients. Mildly protruding AABs do not require skin excision, whereas severely protruding AABs might. We report a novel technique that includes mammary gland excision followed 6 months later by second-look redundant skin excision, if necessary.
Objectives
We aimed to evaluate the efficacy of this two-step surgical approach and compared it with one-step en bloc resection in severely protruding AAB patients.
Methods
This retrospective study included 834 women who underwent AAB excision during 2017–2019. AABs were classified according to their external appearance: protruding, palpable accessory breast at an obtuse angle (class I) or an acute angle with accompanying skinfold (class II). Class II was further divided according to the excision technique: one-step en bloc resection (n = 36) or two-step resection (n = 42). Patients completed post hoc satisfaction surveys evaluating appearance, axillary pain, and scar, 6 months postoperatively.
Results
There were 204 class II patients and 168 patients who underwent a two-step approach; 42/168 underwent second-look skin excision, and 126/168 underwent one-step gland excision exclusively. The remaining 36 patients underwent one-step resection. Scars measured 4.3 cm in the second-look group versus 6.4 cm in the one-step group (P < 0.000). Overall satisfaction scores were higher in the second-look group versus the one-step group (13.6 vs. 12.3, respectively; P < 0.000).
Conclusions
For severely protruding AABs, mammary gland excision with skin preservation comprises the first operation, and second-look skin excision can be considered 6 months later. This procedure avoids overtreatment and potentially increases patient satisfaction compared with one-step en bloc excision.
Level of evidence IV
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Acknowledgements
The author thanks Sa Rang Kim, Beom Seok Oh, and Young Hyun Lee from the Research Center of Damsoyu Hospital for assisting with the statistical analysis and organizing the data in this manuscript. We also thank Nancy Schatken, BS, MT (ASCP), and Jane Charbonneau, DVM, from Edanz Group (www.edanzediting.com/ac), for editing a draft of this manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board of Damsoyu Hospital (DSY-2019-005).
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Written informed consent was gathered from all patients included in this study.
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Lee, S.R. Efficacy of Two-Step Surgery on Severely Protruding Axillary Accessory Breast: First-Step Mammary Gland Excision Followed by Second-Look Redundant Skin Excision. Aesth Plast Surg 44, 677–686 (2020). https://doi.org/10.1007/s00266-020-01649-7
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DOI: https://doi.org/10.1007/s00266-020-01649-7