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Indian Journal of Plastic Surgery, Vol. 36, No. 2, Dec, 2003, pp. 138-139 Letter To Editor An effective method of retaining preoperative markings for reduction mammoplasty during surgical procedure Bhattacharya V, Watts RK Department of Plastic Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005 Code Number: pl03031 Sir, Appropriate results in aesthetic surgery are attained only when they are convincing and satisfying to both the patient as well as the surgeon, especially in mirror image organs like the breasts where symmetry is essential. For this a few things are essential; foreseeing the result, proper selection of technique, preoperative planning with marking and skillful execution. There are two types of situations in aesthetic surgery according to the organ or region. Group A- there is no change in shape when the patient is made supine on the operation table e.g. in rhinoplatsy, genioplasty, corrective otoplasty etc. Group B- where the organ or the region changes its shape and configuration e.g. in mammoplasty, abdominoplasty etc. That is why in Group B preoperative markings are made in standing position. In mammoplasty adequate counseling with the patient regarding the future position and configuration of the breast is discussed in detail. Substantial time and knowledge is utilized in preoperative markings of a reduction mammoplasty with specific measurements from bony landmarks to calculate the amount of breast tissue to be reduced, to find out the position of the nipple areola complex, placement of the final suture line and to make the breasts appealing and symmetrical. Different types of inks or dyes or markers are described in literature. The breasts will become flatter and displaced as soon as the patient lies supine. The markings get faded or splashed by the peroperative preparations with antiseptics. Remaining marks disappear by mopping during surgery. Thus the surgeon faces difficulty and is likely to be inaccurate in achieving symmetry. The assistant distorting the organ while holding it, which can repeatedly change the shape, adds to this. We are using a method, which is easy and the preoperative markings remain distinct throughout the procedure. The surgeon feels confident. It does not get affected by any maneuvering and the surgeon performs the procedure smoothly. The detailed markings are made one day prior to the surgery [Figure - 1]. After the patient is anesthetized, the back of a no.15 scalpel blade is used to make adequate scratch impression on the skin bilaterally over the previous markings. Then thorough preparation of the area is done with antiseptic lotions without any fear of washing away the marks. In fact most of the ink marks are removed during this process and only [Figure:2a] & [Figure:2b]. The whole surgical procedure is performed easily. The procedure is completed bilaterally with symmetrical result [Figure - 3]. This is a simple and effective procedure. It avoids the possibility of permanent skin marking/ tattooing, which can occur sometimes. Copyright 2003 - Indian Journal of Plastic Surgery The following images related to this document are available:Photo images[pl03031f3.jpg] [pl03031f2a.jpg] [pl03031f2b.jpg] [pl03031f1.jpg] |
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