L Scar in Reduction Mammaplasty with Dermal Brassiere

Abstract

In the surgical correction of a ptotic or hypertrophic breast (mastopexy, reduction mammaplasty) the preference for one technique is associated with the choice and experience of the surgeon. The decision as to the type of surgery depends on the anatomic nature, the degree of ptosis, the age of the patient, and, above all, the aesthetic sense of the surgeon. The improvement that the surgeon obtains in shape, volume, and position of the breast must not be compromised by prominent and nonaesthetic scars that alter the final result. Today in mammaplasty, the goal of most surgeons is to give the breast new form, volume, and durable shape with minimal scarring. Starting from these considerations, the author prefers the techniques that involve a vertical or an L scar, which avoid incisions in the so-called hypertrophic areas of the chest (medial and lateral extremities of the submammary fold). The author has used a modification of the Arie technique since 1984 for marked ptosis and hypertrophy. The technique shortens and transforms the long vertical scar into an L-shaped limited scar. The method is based on nipple-areola transposition on a wide superior flap in the new predetermined side (supraareolar dermopexy). The skin of the inferior pole of the breast is deepithelialized to form an inferior dermal or dermo glandular flap for retropectoral dermopexy (dermal brassiere). This flap gives stability to the breast and makes it more durable.