A specially designed ruler and a triangular suture to simplify reduction mammaplasty

Abstract

Although reduction mammaplasty using a superiorly [1] or inferiorly [2] based dermal pedicle is a well-established technique suitable for many cases, inaccurate pre-operative marking frequently causes visible, displaced scarring, which mars the results. To prevent this common pitfall, we recommend herein a simple method for marking exact resection lines preoperatively by using a specially designed ruler [3]. The ruler is made of transparent plastic and has a triangular shape (Fig. 41.1). Two straight sides have centimeter scales and at a right angle. The ruler has a red midline and also four black lines marking a five-degree distance to the next line. The corner of the scaled borders is the top of the ruler. However, unless the resection lines are marked exactly prior to the en bloc resection of the inferior portion of the breast preoperatively, the results may be flawed by dog-eared scaring outside the original submammary fold. To ensure exact marking, we place a strong temporary suture [4] at three marked points which will later be sutured to form the junction point of the inverted T-line. All the excess tissue volume, which will be resected later, now protrudes medially and laterally as a big dog-ear. Once this dog-ear is submerged, the correct resection lines become visible. © 2009 Springer-Verlag Berlin Heidelberg.