Double Dermal Keyhole Pattern

  • Elie Frederic Harouche

The double dermal pattern was first described in 1995 [1] and is based on the traditional keyhole pattern with some modifications. Historically, the keyhole pattern has been a reliable, consistent technique with reproducible and predictable good results for breast reduction [2–5]. However, some drawbacks are well known and have been well documented. In particular, an area of weakness — the inverted Th— has been troublesome and frustrating for many surgeons and patients [6]. Because of its placement, the weight of the breast, and various local wound factors, the inverted Thhas been the site of early postoperative dehiscences and later of widening of the scars [7]. Many attempts have been made to minimize the size of the incision with multiple reduction mammaplasty designs. Trials of periareolar incisions with or without a short vertical limb have been somewhat successful [8–11]. Nevertheless, the results are not always predictable and certainly not always reproducible, especially in large reduction mammoplasties. The best reduction mamma-plasty closure, however, remains elusive.


Breast Reduction Dermal Layer Reduction Mammaplasty Lateral Triangle Periareolar Incision 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Elie Frederic Harouche
    • 1
  1. 1.Columbia University College of Physicians and SurgeonsNew YorkUSA

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