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The Sitting, Oblique, Supine (SOS) Marking Technique for Mastopexy and Breast Reduction

  • Fahmy S. Fahmy

Macromastia can cause considerable emotional and physical stress. The problem of macromastia has been the subject of the efforts of many plastic surgeons since late nineteenth century. In United States alone nearly 40,000 women undergo breast reduction each year [1].

Breast reduction presents both artistic and technical challenges. The surgery aims to reduce the vertical and horizontal planes, shape the parenchyma, reposition the nipple—areola complex, and resect redundant skin. The surgery on paired organs has the added challenge of symmetry. The added effect of recumbence alters the shape and position of the breast. The classic breast shape, as we know it, exists in the erect posture. Much of the outcome of our work as plastic surgeons is determined by preoperative planning and designing. The availability of numerous marking techniques of breast reduction and mastopexy and the abundance of further modifications over the last decennia are clear indications that none of these techniques have proved to be ideal.

The majority aim to achieve some degree of precision in determining the angle between the two vertical limbs. This ultimately affects the amount of tissue resected and the postoperative shape. Few, if any, of such techniques have gained total popularity or acceptance by the plastic surgeons. The freehand marking technique is probably the most widely used technique. Devices as templates [2, 3] shaped wires, goniometers, and geometrical techniques have also been recommended [4–9]. Some of these devices have stood the test of time; others have been modified or abandoned.

Keywords

Plastic Surgeon Breast Reduction Inframammary Fold Sternal Notch Oblique Position 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Goldwyn RM, Courtiss EH: Reduction mammaplasty by the inferior pedicle (pyramidal) technique. In: Goldwyn RM (ed), Reduction Mammaplasty. Boston, Little, Brown & Co. 1990, pp 255–266Google Scholar
  2. 2.
    Wise RJ: A preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg 1956;17(5): 367–375CrossRefGoogle Scholar
  3. 3.
    Palumbo SK, Shifren J, Rhee C: Modifications of the Lejour vertical mammaplasty: analysis of results in 100 consecutive patients. Ann Plast Surg 1998;40(4): 354–359CrossRefPubMedGoogle Scholar
  4. 4.
    Courtiss EH, Goldwyn RM: Reduction mammaplasty by the inferior pedicle technique. An alternative to free nipple and areolar grafing for severe macromastia or extreme ptosis. Plast Reconstr Surg 1977;59(4):500–507CrossRefPubMedGoogle Scholar
  5. 5.
    Kavka S: A simple device for marking the areola in vertical mammaplasty. Plast Reconstr Surg 1999;103(7):2087PubMedGoogle Scholar
  6. 6.
    Mendez-Fernandez MA: An easy-to-make, easy-to-use device for preoperative marking for reduction mammo-plasty and mastopexy. Ann Plast Surg 1991;26(6): 602–603CrossRefPubMedGoogle Scholar
  7. 7.
    Lazarus D: A new template-goniometer for marking the wise keyhole pattern of reduction mammaplasty. Plast Reconstr Surg 1998;101(1):171–173CrossRefPubMedGoogle Scholar
  8. 8.
    Beer GM, Morgenthaler W, Spicher I, Meyer VE: Modifications in vertical scar reduction. Br J Plast Surg 2001;54(4):341–347CrossRefPubMedGoogle Scholar
  9. 9.
    Paloma V, Samper A, Sanz J: A simple device for marking the areola in Lejour's mammaplasty. Plast Reconstr Surg 1998;103(7):2134–2135Google Scholar
  10. 10.
    McKissock PK: Reduction mammaplasty by the vertical bipedicle flap technique. Clin Plast Surg 1976;3(2): 309–320PubMedGoogle Scholar
  11. 11.
    Gasperoni C, Salgarello M: Preoperative breast marking in reductio0n mammaplasty. Ann Plast Surg 1987;19(4): 306–311CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Fahmy S. Fahmy
    • 1
  1. 1.Department of Plastic SurgeryCountess of Chester HospitalChesterUK

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