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Figure 5: Modified wise‑pattern for upper quadrant skin resection (skin‑ Figure 6: Scarring is comparable to the skin‑sparing mastectomy type‑IV
sparing mastectomy type‑V) was applied on the affected breast. Standard with an additional equatorial scar located at the superior medial/lateral
wise‑pattern was used to perform mastopexy/reduction on the opposite quadrant, which is less disfiguring when compared to a conventional
side. Deep inferior epigastric perforator flap markings with a round skin mastectomy
paddle and the de‑epithelialized area (pink color) of the flap. The round
skin paddle can replace the nipple areola‑complex (NAC) if intraoperative REFERENCES
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marked and the new nipple position was located at 23 cm breast during postmastectomy breast reconstruction. Clin Plast Surg 1984;11:365‑8.
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while a “standard” WP was used to perform a mastopexy 7. Jahkola T, Asko‑Seliavaara S, von Smitten K. Immediate breast reconstruction.
or breast reduction on the opposite side [Figure 5]. Scand J Surg 2003;92:249‑56.
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While the general surgeon performed the SSM‑V with Surg 2001;108:1163‑71.
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pattern reduction mammaplasty, a new tool for upper quadrantectomies: a
harvested the DIEP flap, tailoring it according to the preliminary report. Ann Surg Oncol 2009;16:1122‑7.
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end‑to‑end anastomoses to the circumflex scapular vessels. 11. Granzow JW, Levine JL, Chiu ES, Allen RJ. Breast reconstruction with the
The NAC was harvested and grafted if intraoperative deep inferior epigastric perforator flap: history and an update on current
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preserving the skin envelope and infra‑mammary fold on
the affected side using a SSM‑V, the WP can be applied How to cite this article: Longo B, Laporta R, Pagnoni M,
to perform a simultaneous contralateral symmetrization, di Pompeo FS. A novel approach to achieve breast symmetry in a
allowing both NACs to be placed at the same position. single-stage procedure. Plast Aesthet Res 2015;2:76-8.
Furthermore, by preserving the skin envelope on the affected Source of Support: Nil, Conflict of Interest: I myself Fabio Santanelli
side a natural‑appearing breast is achieved especially after di Pompeo have submitted for publication on Plastic and Aesthetic
autologous tissue reconstruction. Scarring is comparable to Research a manuscript entitled: “A novel approach to achieve breast
symmetry in a single-stage procedure”. I, hereby certify, that to the best of
the SSM‑IV with an additional equatorial scar located at the our knowledge no financial support or benefits have been received by me
superior medial/lateral quadrant, which is less disfiguring or any co-author, by any member of my (our) immediate family or any
when compared with a conventional mastectomy. Despite individual or entity with whom or with which I (we) have a significant
its surgical complexity, immediate DIEP flap reconstruction is relationship from any commercial source which is related directly or
the best chance for obtaining long‑term symmetry because indirectly to the scientific work which is reported on in the article.
both breasts maintain natural ptosis and softness. [11,12] Received: 12-10-2014; Accepted: 03-11-2014

78 Plast Aesthet Res || Vol 2 || Issue 2 || Mar 13, 2015