Kachare Swapnil D, Kachare Milind D, Vivace Bradley J, Barrow Brooke E, Ablavsky Michael, Abell Sara, Choo Joshua H, Wilhelmi Bradon J
Division of Plastic and Reconstructive Surgery, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY.
Eplasty. 2023 Feb 27;23:e13. eCollection 2023.
In 2020, reduction mammoplasties and mastopexies comprised 34.2% of all breast surgeries performed by plastic surgeons. Various approaches for the skin incision of these procedures have been described. The vertical pattern has become an increasingly popular option due to its lower scar burden. However, it is prone to dog-ear formation along the caudal aspect of the incision. Herein, we describe 5 technical steps to eliminate the dog-ear in patients undergoing vertical mammoplasties.
A retrospective chart review was performed on all patients who underwent vertical breast reduction and mastopexy between the years 2008 and 2020 performed by the senior author. The 5 steps employed in eliminating the dog-ear are delineated and depicted pictorially.
A total of 58 patients and 89 breasts were operated upon. A majority of 66.6% were Caucasian, 33.3% were African American, and 1 patient was of Hispanic descent. The mean age was 53.2 years (19-73 years), and average BMI was 31.5 kg/m (21.3-42.7 kg/m). The average resection weights for reduction and mastopexy patients were 479 grams (100-1500 grams) and 58.1 grams (18-100 grams), respectively. Mean follow-up was 10.5 months (1-35 months). Only one patient developed a dog-ear (1.7%) in bilateral breasts (2.2%); however, the patient did not request a revision. Our revision rate over 13 years remained at 0%.
Utilizing these 5 technical steps reduces the risk of dog-ear deformity and thereby diminishes the overall need for revisional surgery in patients undergoing short scar vertical mammoplasties.
2020年，缩乳术和乳房上提术占整形外科医生进行的所有乳房手术的34.2%。已经描述了这些手术皮肤切口的各种方法。垂直切口模式因其较低的瘢痕负担而越来越受欢迎。然而，它在切口尾端容易形成“狗耳”。在此，我们描述了5个技术步骤来消除接受垂直乳房整形术患者的“狗耳”。
对2008年至2020年间由资深作者进行的所有接受垂直乳房缩小术和乳房上提术的患者进行回顾性图表审查。描绘并图示了消除“狗耳”所采用的5个步骤。
共对58例患者的89个乳房进行了手术。大多数患者（66.6%）为白种人，33.3%为非裔美国人，1例患者为西班牙裔。平均年龄为53.2岁（19 - 73岁），平均体重指数为31.5 kg/m²（21.3 - 42.7 kg/m²）。缩乳术和乳房上提术患者的平均切除重量分别为479克（100 - 1500克）和58.1克（18 - 100克）。平均随访时间为10.5个月（1 - 35个月）。只有1例患者双侧乳房出现“狗耳”（1.7%）（2.2%）；然而，该患者未要求修复。我们13年的修复率保持在0%。
采用这5个技术步骤可降低“狗耳”畸形的风险，从而减少接受短瘢痕垂直乳房整形术患者的整体修复手术需求。
