• Top
• Abstract
• Background
• Methods
• Discussion
• Conclusion
• Competing interests
• Authors' contributions
• References

Research

An oncoplastic technique to reduce the formation of lateral 'dog-ears' after mastectomy

Haresh Devalia^{* 1} , Anushka Chaudhry^{* 1} , Richard M Rainsbury^{* 2} , Neda Minakaran^{* 1} and Dibyesh Banerjee¹

¹St George's Hospital, Blackshaw Road, London, UK

²Royal Hampshire County Hospital, Winchester, Hants, UK

author email corresponding author email* Contributed equally

International Seminars in Surgical Oncology 2007, 4:29doi:10.1186/1477-7800-4-29

The electronic version of this article is the complete one and can be found online at: http://www.issoonline.com/content/4/1/29

Received:	7 October 2007
Accepted:	17 December 2007
Published:	17 December 2007

© 2007 Devalia et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Lateral skin folds or 'dog-ears' are frequent following mastectomy, particularly in patients with large body habitus.

Methods

We describe a method of modifying the mastectomy incision and suturing to eliminate these lateral 'dog-ears'.

Conclusion

This surgical technique, as compared to others described in the literature, is simple, does not require additional incisions and is cosmetically acceptable to the patient.

Background

Cosmetically sub-optimal lateral skin-folds or 'dog-ears' are frequent following mastectomy. Skin closure can be particularly challenging in patients with large body habitus. The resultant lateral 'dog-ears' tend to hang over the top of the brassiere which can be a nuisance. We illustrate an oncoplastic technique used to eliminate lateral 'dog-ears'.

Methods

The pre-operative marking of the mastectomy incision normally involves drawing an ellipse of varying dimensions depending on the size of the breast. Our technique includes extending this ellipse laterally and upwards towards the axilla (Fig 1). This has the added advantage of flattening the lateral bulge that obese patients tend to develop. Following the mastectomy, a point (point x, Fig 1) approximately one third of the way from the lateral apex along the inferior aspect of the incision is sutured to a point more medially on the superior flap (point y, Fig 1). The lateral part of the incision can then be secured using dermal sutures, eliminating the 'dog-ear' and drawing the scar up into the axilla.

Discussion

Various surgical techniques e.g., fish-shaped incision, tear-drop incision have been described to eliminate 'dog-ear' deformity after mastectomy [1-3]. Our technique is simple and it does not involve additional incisions. The cosmetic outcome is more acceptable to patients, both aesthetically and for bra/prosthesis fitting. The clinical photographs (Fig 2) and (Fig 3) demonstrate this difference.

Conclusion

The technique described can be used in oncoplastic surgery to improve cosmetic outcome.

Competing interests

The author(s) declare that they have no competing interests.

Authors' contributions

HD: Clinical studies, design, data acquisition, manuscript preparation, literature search.

AC: Data acquisition, manuscript preparation.

RMR: Concept, definition of intellectual content.

NM: Literature search, manuscript preparation.

DB: Clinical studies, manuscript editing, manuscript review.

References

1. Mirza M, Sinha KS, Fortes-Mayer K: Tear-drop incision for mastectomy to avoid dog-ear deformity.

   Ann R Coll Surg Engl 2003, 85:131. PubMed Abstract | Publisher Full Text | PubMed Central Full Text

2. Nowacki MP, Towpik E, Tchorzewska H: Early experience with 'fish-shaped' incision for mastectomy.

   Eur J Surg Oncol 1991, 17:615-7. PubMed Abstract

3. Farrar WB, Fanning WJ: Eliminating the dog-ear in modified radical mastectomy.

   Am J Surg 1988, 156:401-2. PubMed Abstract | Publisher Full Text

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