Mastectomy
Simple Mastectomy A 20-in. blade is used to make an elliptical skin incision that includes the nipple-areola complex (see the image below). The skin ellipse should be tailored so as to ensure the following: The resulting defect can be closed without tension Any old biopsy sites or surgical scars are included in the ellipse if possible The lateral end of the ellipse is medial to the midaxillary line The incision is then deepened by means of a coagulation diathermy device. Subdermal veins will be encountered that must be coagulated. Littlewoods or skin hooks are applied to the superior flap, and the assistant lifts the superior flap (see the image below). Flaps should always be lifted straight up, perpendicular to the chest wall. Sufficient tension should be maintained during lifting to ensure that the flap is the same thickness throughout and to prevent buttonholing.
