An oncoplastic technique to reduce the formation of lateral 'dog-ears' after mastectomy
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BioMed Central
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An oncoplastic technique to reduce the formation of lateral 'dog-ears' after mastectomy Haresh Devalia†1, Anushka Chaudhry†1, Richard M Rainsbury†2, Neda Minakaran†1 and Dibyesh Banerjee*1 Address: 1St George's Hospital, Blackshaw Road, London, UK and 2Royal Hampshire County Hospital, Winchester, Hants, UK Email: Haresh Devalia - [email protected]; Anushka Chaudhry - [email protected]; Richard M Rainsbury - [email protected]; Neda Minakaran - [email protected]; Dibyesh Banerjee* - [email protected] * Corresponding author †Equal contributors
Published: 17 December 2007 International Seminars in Surgical Oncology 2007, 4:29
doi:10.1186/1477-7800-4-29
Received: 7 October 2007 Accepted: 17 December 2007
This article is available from: http://www.issoonline.com/content/4/1/29 © 2007 Devalia et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Lateral skin folds or 'dog-ears' are frequent following mastectomy, particularly in patients with large body habitus. Methods: We describe a method of modifying the mastectomy incision and suturing to eliminate these lateral 'dog-ears'. Conclusion: This surgical technique, as compared to others described in the literature, is simple, does not require additional incisions and is cosmetically acceptable to the patient.
Background Cosmetically sub-optimal lateral skin-folds or 'dog-ears' are frequent following mastectomy. Skin closure can be particularly challenging in patients with large body habitus. The resultant lateral 'dog-ears' tend to hang over the top of the brassiere which can be a nuisance. We illustrate an oncoplastic technique used to eliminate lateral 'dogears'.
Methods The pre-operative marking of the mastectomy incision normally involves drawing an ellipse of varying dimensions depending on the size of the breast. Our technique includes extending this ellipse laterally and upwards towards the axilla (Fig 1). This has the added advantage of flattening the lateral bulge that obese patients tend to develop. Following the mastectomy, a point (point x, Fig 1) approximately one third of the way from the lateral apex along the inferior aspect of the incision is sutured to
a point more medially on the superior flap (point y, Fig 1). The lateral part of the incision can then be secured using dermal sutures, eliminating the 'dog-ear' and drawing the scar up into the axilla.
Discussion Various surgical techniques e.g., fish-shaped incision, tear-drop incision have been described to eliminate 'dogear' deformity after mastectomy [1-3]. Our technique is simple and it does not involve additional incisions. The cosmetic outcome is more acceptable to patients, both aesthetically and for bra/prosthesis fitting. The clinical photographs (Fig
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