The vertical scar technique

Authors: Mia Demant, MD, Magnus Balslev Avnstorp, MD and Mia Steffensen, MD

The vertical scar technique typically involves a shorter scar (not involving the IMF) and is restricted to cases of mild mamma hypertrophy, or women of a younger age due to the density of the breast tissue. The excision before closing looks like a snowman figure or keyhole. The scar will be located around the NAC and vertically on the inferior part of the breast down to the IMF. When using a superomedial pedicle the technique may be referred to as the Hall-Findlay technique.

Step-by-step surgery

Step 1: Excision and de-epithelization

Excision and de-epithelization of the marked pedicle is performed.

Step 2: Tissue excision

A suitable amount of breast tissue is excised according to the preoperative markings and pedicle chosen.

Step 3: NAC

The NAC remains on the de-epithelized pedicle to secure the neurovascular supply.

Step 4: Remodeling

The breast is remodeled by re-approximating the lateral and medial pillars with sutures and the NAC is relocated superiorly.

Step 5: Closing

The pedicle is sutured with absorbable multifilament sutures 2-0, the pillars with absorbable multifilament sutures 3-0, and the skin sutured with intradermal continuous monofilament sutures 4-0.

Step 6: Final result

Finally micropore tape is carefully placed and a low compression bra is put on

Acknowledgments

Illustrators: Christian Paaskesen, med.stud.

References

Hall-Findlay EJ. Pedicles in vertical breast reduction and mastopexy. Clin Plast Surg. 2002 Jul;29(3):379–91.