The double S technique to achieve aesthetic flat closure after conventional mastectomy

Abstract

Background Lateral excess tissue after mastectomy is a frequent problem, which should be included into preoperative planning. Women with lateral tissue abundance are frequently impaired cosmetically and functionally. We suggest a novel oncoplastic mastectomy technique to eliminate the above mentioned. Methods Surgical technique Two small horizontal lines are drawn, one line above and one line below the Nipple Areola Complex. These lines should represent the possible skin excision and allow tight skin closure. Consecutively, two ending points of the incision are planned, one close to the xyphoid area and the other one in the anterior axillary line. These points are then interconnected in an s-shaped manner to form a double s-shaped skin excision. Results The double S-shaped technique is an easy reproducible technique which not only allows good access to the lateral side of the mastectomy, but also and mainly the reduction of lateral fat and skin. Conclusion The double S mastectomy allows for simultaneous removal of access in the axillary region, eliminating skin, and fat as needed and preventing the lateral dog ear

Flat Aesthetic Mastectomy Closure with the Angel Wing Technique to Address Lateral Adiposity: Technique and Outcome Analysis

“…Several techniques to address lateral adiposity have been described. Tese techniques include the Y-shaped incision by Szynglarewicz et al [2], the modifed V-Y advancement technique by Gibbs et al [3], the Fish-tail plasty by Hussien et al [4], the modifed M-plasty by Meybodi et al [5], the double S technique by Stefens et al [6], the tear-drop incision by Mirza et al [7], and the L incision and lipoaspiration by El Hajj et al [8]. Te angel wing (AW) technique was frst described by Hill and Henry-Tillman et al in 2018 [9].…”

“…Tis occurs in 1.7-3.6% of patients, and they additionally exhibit an increased risk of dehiscence [2][3][4][5]. Other techniques avoid this Y junction, such as the double S technique [6], the tear-drop incision [7], and the L incision and lipoaspiration [8]. Tese all have their advantages and drawbacks.…”

“…Te double S technique employs two S-shaped incisions, superior and inferior to the nipple areolar complex. Tis enables the surgeon to shift the incision medially or laterally depending on the tumor location and the amount of lateral adiposity [6]. Te tear-drop incision results in a broader incision laterally, including a segment of the axillary fat pad [7].…”