Breast Contouring Using Short Scar Techniques

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Breast Contouring Using Short Scar Techniques
James C. Grotting M.D.

The vertical
reduction mammoplasty is part of a growing trend to use
shorter incisions in surgical techniques that to reduce,
lift, or to correct asymmetry in the breasts.

inverted T has been the standard procedure for the last
40 years. This procedure produces a periareolar scar with
a vertical and a horizontal component, with the horizontal
scar being primarily in the inframammary fold. The horizontal
scar can extend quite far laterally and can even meet the
opposite side in the midline.

of this procedure include its relative safety to the nipple
and other breast tissue. The procedure can be performed
with few complications, and is fairly easy to learn. The
disadvantages primarily have been with regard to a long,
sometimes quite visible scar. The scar has a tendency to
be become either hypertrophic or keloid and has been a major
source of patient dissatisfaction with the inverted T procedure.

Reduction Mammoplasty

most widely used new technique for breast reduction called
vertical reduction mammoplasty, which leaves a ‘lollipop’
shaped incision. The incision is made around the areola
and includes a vertical incision that extends to the inframammary
fold. Skin is removed around the areola and in the vertical
segment, but there is no horizontal scar in the fold. The
vertical reduction mammoplasty technique relies on the inherent
ability of the skin to shrink down and reshape itself after
the glands have been reduced or lifted.

ideal candidates for the vertical technique are those without
striae and with firm glandular tissue as opposed to fat.
The patients need to be advised that it takes a little longer
for the final breast shape to evolve and occasional revisions
are necessary if there’s excess skin at the bottom of the
vertical lift, but these are oftentimes able to be done
in the office under local anesthesia. The revision rate
should be less than ten percent.

patients who do not have a considerable number of striae
of the skin can still be treated with the vertical technique.
As surgeons have gained more experience with the vertical