Toronto — Mammoplasty involving vertical scar reduction leaves about a third of the scar than typically occurs with the more common forms of the procedure, and allows for faster healing, according to a surgeon here.
Speaking at the annual meeting of the Canadian Society for Aesthetic (Cosmetic) Plastic Surgery here, Frank Lista, M.D., described the less invasive technique which requires a shorter recovery period than the more common inverted T-scar reduction Mammoplasty.
"The operation that leaves a horizontal scar in the bra crease has been the gold standard for many years," Dr. Lista tells Cosmetic Surgery Times, "but it leaves huge scars that go around the nipple. Patients then find the end result disappointing."With this operation, the breast is not as wide and flat. The breast has more projection, is more conical in shape and appears more natural. "
Less table time
In addition to the patient advantages, the procedure is also less demanding for the clinician.
It can be performed in less than an hour as less sewing is involved. By contrast, the standard procedure takes between two to three hours, according to Dr. Lista.
"It's easier to perform, requires less anesthesia and less cutting," Dr. Lista says. "Most patients are back to work in two weeks. With the more common procedure, the patients can be off for three to six weeks."
Caveats for success
Keys to making the vertical scar reduction a success include using a mosque dome skin marking pattern and closing the wound in two planes, with gathering of the skin of the vertical wound, Dr. Lista explains.
Another critical aspect is proper positioning of the nipple. It should be on a superior or medial dermoglandular pedicle, depending on the position of the nipple-areola complex with respect to the skin markings.
"The position of the nipple has to be set lower than in the older operation," Dr. Lista says. "It cannot be placed too high. In addition, the vertical incision should end above the inframammary crease, so that it does not fall below the crease."
Also key to success is the use of tumescence on the breast as is done with a liposuction procedure. Tumescence use minimizes the chance of nipple necrosis, he explains. Use of boxing sutures is also recommended to contribute to a better appearance of the breast following the procedure, Dr. Lista notes.