Abstract
Background
Macromastia frequently affects females and can be upsetting. The main objective of any reduction procedure is to reduce the hypertrophic breast while maintaining a healthy nipple-areola complex, making reduction mammoplasty one of the most often done aesthetic procedures. To accomplish this, the skin envelope must be appropriately re-draped in order to achieve projected elevated, symmetrical breasts, scarcely perceptible scars, and lasting results.
Methods
Twenty-five patients who were candidates for wise-pattern reduction mammoplasty were included in the study. Two techniques of skin re-draping and closure were assessed; for each patient, both breasts were closed in two directions of closure either areola first closure (traditional technique) versus areola last (retrograde closure). Comparison between the differences in the intraoperative length of the wound was compared.
Results
The direction of skin closure starting from the periphery and ending with areola closure as a last step has a statistically significant impact on reducing the length of the scar with no increasing incidence of early wound dehiscence. The average length of the horizontal wound was 25.17 ± 2.21 cm versus 20.25 ± 1.59 cm in the traditional method and retrograde method respectively.
Conclusions
Refinement during the final step of the skin closure including the direction of skin closure and excision of excess skin through a circum-areolar wound to avoid dog ears will affect the final length of the scar. Changing the direction of skin closure from the areola first closure to the areola last closure although a simple step but effective.
Level of evidence: Level IV, therapeutic study.
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Ali, R.A., Makarem, K. & Noaman, A. Retrograde skin tailoring in wise-pattern reduction mammoplasty closure. Eur J Plast Surg 46, 1039–1048 (2023). https://doi.org/10.1007/s00238-023-02135-4
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DOI: https://doi.org/10.1007/s00238-023-02135-4