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Dunking the Dog - The 5 D's to prevent dog-ears in vertical breast reductions and breast lifts: A retrospective clinical review
Swapnil D. Kachare, MD, MBA
Milind D. Kachare, MD
Bradley J. Vivace, BS
Brooke Barrow, MEng
Bradon J. Wilhelmi, MD, FACS
University of Louisville
2022-01-15
Presenter: Candice L Nguyen
Affidavit:
Agree
Director Name: Bradon J. Wilhelmi
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background
Reduction mammoplasty combines both the reconstructive and aesthetic components of breast surgery. Several techniques have been described with the vertical pattern becoming an increasingly popular option. The vertical mammoplasty technique involves less scar but a higher risk for excess skin and dog-ear in the inferior pole. Here in we describe five technical steps to eliminate dog-ear formation in vertical breast reduction and mastopexy and our clinical experience.
Methods
A retrospective chart review was performed on all patients who underwent vertical breast reduction and mastopexy between the years 2008 – 2020 performed by the senior author. The five steps employed in eliminating the dog-ear are delineated and depicted pictorially.
Results
A total of 58 patients were identified and 89 breasts were operated upon. The majority, 66.6% were Caucasian, 33.3% were African American, and 1 patient was of Hispanic descent. The mean age was 53.2 years, (range, 19 - 73 years) and average BMI was 31.5 kg/m2 (range, 21.3 - 42.7 kg/m2). The average resection weights for reduction and mastopexy patients were 479 grams (range, 100 – 1500 grams) and 58.1 grams (range, 18-100 grams), respectively. Mean follow-up was 7.5 months (range, 1 – 21 months) with no occurrences of dog-ear deformity requiring revision.
Conclusion
Utilizing the five technical steps reduces the risk of dog-ear deformity and thereby diminishes the overall need for revisional surgery in patients undergoing short scar vertical mammoplasty.
