Yazan Masannat, Consultant Oncoplastic Breast Surgeon, Aberdeen Royal Infirmary

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In many ladies that had breast cancer surgery there is significant asymmetry that needs correction surgically. These ladies surgery is challenging and many factors will come into consideration when deciding on the type and timing of surgery. This lady had Implant based reconstruction with inferior dermal sling with good results that wanted symmetrization.

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Marking in these cases is more challenging but the previous surgery was through wise pattern incision for her implant based reconstruction. When marking her pre-operatively the breast meridian is marked first on both sides. The infra-mammary fold is marked on both sides and the position of the nipple is marked at the level of the IMF. On marking the vertical and horizontal scar, I have tried to match the length and position of these on the other side to improve symmetry though it is not possible to predict the exact final result. I have used an inferior pedicle wise pattern reduction.

Surgery

The first thing to do is to remark everything on the table, and then measure the length of lateral and medial lines and make sure that they are the same length or longer than the line inferior line in the IMF to decrease tension on the closure. The pedicle is de-epithelialised using curved scissors of a knife and the the resection and reduction is done as shown in the video trying to mirror the resection in both sides to achieve better symmetry.

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