Deepithelialization in Breast Reduction: A Simple Technique

In all cases of breast reduction, deepithelializing has to be done more or less around the areola. The deepitheli-alized areola, according to the technique, may or may not stay connected to the neighboring skin by one or two dermal glandular pedicles. Usually, this deepitheli-alization is performed using a knife.

With a knife, this deepithelialization may be excellent but sometimes may be irregular, too superficial, or too deep, particularly in the hands of a beginner. An identical layer thickness of the dermis has to be saved when the knife technique is used and this is difficult for beginners to learn because a cleavage plane does not exist in this procedure.

Consequently, being too superficial, in the immediate postoperative period or later, may result in a scar of poor quality. Months postoperatively, sebaceous cysts may appear or the scar is uneven. Localized infections may be present and frequently many sebaceous glands may have been included in the scar. Such unpleasant events should be avoided even if they are not serious. When performed too deep, the blood supply of the areola as well as the venous drainage may be hindered and necrosis of the areola may happen, either partially or totally.