Breast Reduction Surgery: Horizontal Scar Technique

Horizontal scar technique is one type of breast reduction (reduction mammoplasty) surgery that is currently available. It is the oldest, continuously performed breast reduction procedure. The anchor incision pattern, T-incision and Wise technique are also terms used to describe the horizontal scar technique, which was developed by Dr. Robert Wise in 1956.ᅠ

The Procedure

The procedure is the most invasive breast reduction technique and it is performed under general anesthesia. Horizontal scar technique refers to the incision made under the breast; however, the procedure consists of 3 distinct incisions. In most cases, it is necessary to reposition the nipple and areola after the excess breast tissue has been removed. In order to do this, the surgeon will make the first incision around the circumference of the areola.ᅠ

The second incision is made vertically. It begins just below the areola and extends downward toward the lower portion of the breast. It will connect with the horizontal incision made under the breast. The horizontal incision is made on a slight upward curve. The connection between the vertical and horizontal incisions looks like the shape of an anchor. This is why it is referred to as the anchor incision pattern.ᅠ

Glandular tissue, fat and excess skin are removed from the periareolar pedicle. This is the region adjacent to the areola. Additional tissue, fat and skin may be removed through the vertical and horizontal incisions. The nipple and areola are repositioned a little higher on the breast. This gives the breasts a more natural appearance. The horizontal incision allows for greater excess skin removal and the result is smoother looking breasts.ᅠ

Candidates for Horizontal Scar Procedure

Horizontal scar technique is usually performed on women suffering from macromastia. Macromastia is the term used to describe the development of overly large breasts. The procedure is performed to relieve the physical and psychological discomforts that are associated with the weight and size of larger breasts. It is also used to treat the rare cases of gigantomastia, a condition that results in the development of enormous breasts.ᅠ

Advantages of the Horizontal Scar Technique

Horizontal scar technique is considered the best reduction option for women with overly large breasts. It is superior to other methods, because the surgeon is able to remove more excess skin without causing the puckering and wrinkling that occurs with other procedures. The ability to smooth the skin makes the breasts appear more natural.

Disadvantages of the Horizontal Scar Technique

The separation and repositioning of the areola and nipple may reduce a woman's future ability to breastfeed. This is caused by the separation of blood vessels and milk ducts during the surgery. This may also cause a loss or reduction in nipple sensation.

Horizontal scar technique results in more visible scarring than other procedures. These scars are rarely visible, because they are covered by clothing. Clothing with low necklines will not reveal the scars, because they are positioned on the lower portion of the breast.

Post Operative Stage

After surgery, there may be some swelling and tenderness, which may be exacerbated with the first menstrual cycle following the procedure. In most cases, women will notice a remarkable difference within one month, but the ultimate results may not be visible for at least six months.

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