Vertical Mastopexy
This chapter will list indications, essential operative steps and postoperative care, and potential complications involving vertical mastopexy procedure. Following an outline of detailed intraoperative steps, a sample operative dictation is provided for t
- PDF / 141,237 Bytes
- 3 Pages / 504.567 x 720 pts Page_size
- 61 Downloads / 371 Views
32
Tuan Anh Tran, Klara Sputova, and Wrood Kassira
Indications 1. To elevate the position of the nipple areolar complex on the breast 2. Breast ptosis, grades I and II
Essential Steps Preoperative Markings 1. With the patient standing upright, mark the sternal midline, bilateral breast meridian lines, and inframammary folds. T.A. Tran, M.D., M.B.A. (*) Division of Plastic Surgery, Department of General Surgery, University of Miami/Jackson Memorial Hospital, 1120 NW 14th Street, 4th floor, Miami, FL 33136, USA Division of Hand Surgery, Department of Orthopedic Surgery, University of California at Davis Medical Center, 4860 Y Street, Suite 3800, Sacramento, CA 95817, USA e-mail: [email protected] K. Sputova, B.A. University of Miami Miller School of Medicine, Miami, FL, USA e-mail: [email protected] W. Kassira, M.D. Department of Plastic, Aesthetic, and Reconstructive Surgery, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Clinical Research Building. 4th floor, Miami, FL 33136, USA e-mail: [email protected]
2. Mark ideal position of the nipple areolar complex. 3. Based around the selected nipple position, draw a circumareolar pattern, with the superior aspect 2 cm above the new nipple position. 4. The lateral, medial, and inferior markings should skirt borders of the areola, creating an oval (mosque-dome) shape, which includes the existing areola. 5. Important: The vertical component of the scar should not cross the inframammary fold.
Intraoperative Details 1. General anesthesia. 2. Place patient in supine position. 3. Inject the incision lines prior to initial incision with tumescent solution consisting of 1 % lidocaine with 1:200,000 epinephrine. 4. Incise skin based on preoperative markings. 5. Mobilize a superiorly based parenchymal flap over the pectoralis fascia. 6. Suture the medial and lateral pillars together to narrow the breast and add support. 7. Close surgical incisions in layers.
Postoperative Care 1 . Keep incisions covered and dry × 72 h. 2. Postoperative antibiotics × 2–5 days.
© Springer International Publishing Switzerland 2017 T.A. Tran et al. (eds.), Operative Dictations in Plastic and Reconstructive Surgery, DOI 10.1007/978-3-319-40631-2_32
137
138
3 . Patient can return to desk work in 1 week. 4. Patients should be cautioned against heavy lifting or strenuous physical activity for a minimum of 6 weeks following the procedure. 5. Patient should be counseled that the initial postoperative appearance of the breast will be of an “upside-down” breast with exaggerated upper-pole fullness and that the final breast shape will not be apparent for 3 months.
Possible Complications 1. Delayed healing 2. Fat necrosis 3. Seroma 4. Diminished nipple areolar sensation 5. Complex scar 6. Asymmetry
Operative Dictation Diagnosis: Breast ptosis and/or breast asymmetry Procedure: Vertical mastopexy
Indication This is a ________ with significant breast ptosis/ breast asymmetry, who wants to restore a youthful appearance of her breasts. The risks, benefits, and a
Data Loading...
