Analysis of the vertical mammaplasty design in skin-sparing mastectomy and immediate autologous reconstruction

Autologous Breast Reconstruction Skin Paddle Designs: Classification and Aesthetic Outcomes

“…With regard to these scar patterns, Bourne et al showed no significant difference in shape or overall postoperative appearance in vertical skin resection pattern versus a transverse scar adjacent to the skin paddle. 11 Several subsets of patients were excluded from this classification system. Patients who received regional autologous flaps, such as the pedicled latissimus dorsi myocutaneous flap (LDMC) were not included in this study, as this flap does not frequently have a sufficient skin component to allow near total breast skin replacement.…”

Microsurgical Flaps in Nipple Sparing Mastectomy: Surgical Techniques and Aesthetic Principles

“…Breasts reconstructed with the vertical design have been shown to be aesthetically rated higher than their original appearance, particularly if done bilaterally [25]. One disadvantage to using this incision in a unilateral ptotic breast reconstruction is that the patient must typically also undergo a mastopexy in the unaffected breast for symmetry.…”

“…Although the Wise-Pattern incision results in a high incidence of postoperative complications at the T junction where there are thin, angulated flaps coming together with great tension and inadequate blood flow [25,30], the Modified Wise-Pattern attempts to resolve this problem while allowing for de-epithelialization of large amounts of excess tissue and good control of the resulting shape of the breast [25] (Figure 1C). Because the inferior flap has a stronger blood supply, it should be designed longer in high-risk patients to allow for a shorter superior flap, which is less perfused [30].…”