The document discusses the history and techniques of breast incisions for cancer surgery and reconstruction. It outlines how the transverse elliptical incision became standard but often led to unnatural breast shapes. The Wise pattern introduced in 1956 uses skin tailoring within a keyhole pattern to better preserve the breast's natural appearance and shape. Today, multidisciplinary teams plan oncologically justified incisions tailored to each patient's breast within the Wise pattern principles for optimal cosmetic and medical outcomes.
1. BREAST INCISIONS a history, basic science and technique of The New Standard of Care Joel A. Aronowitz, MD Division of Plastic Surgery Cedars Sinai Medical Center Los Angeles, CA Conflict of Interest Disclosure: Nothing to disclose
8. before After bilateral mastectomy TRAM reconstruction Courtesy J. Anderson, COH Nat’l Med.Ctr The New Standard of Care 1. Low threshold use of needle biopsy 2. Incisions planned with 1st principles 3. Skin resection justified oncologically 4. Multidisciplinary approach
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10. LaPlace predicts breast shape Breast diameter is > in lower pole therefore the skin below the nipple is under greater tension and stretches the most. Nipple decent with the breast.
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