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Plastic and Reconstructive Surgery
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VOLUME 108 • NUMBER 6 • NOVEMBER 2001

Q - AMERICAN SOCIETY OF PLASTIC SURGEONS

Plastic and Reconstructive Surgery

Journal of the American Society of Plastic Surgeons
Official Organ of the American Association of Plastic Surgeons
Official Organ of the American Society for Aesthetic Plastic Surgery, Inc.
Official Organ of the American Society of Maxillofacial Surgeons

http://www.plasreconsurg.org/

Vol. 108, No. 6 / CORRESPONDENCE

REFERENCES

  1. Medical Devices Agency, 1999.
  2. Davies, D. M., and Kirkpatrick, W. N. A. Lipid emulsification after implant rupture. Br.J. Plast. Surg. 52: 238, 1999.
  3. Cole, R. P., and Morris, A. D. P. MR] scan diagnosis of Trilucent breast implant rupture. Br.J. Plast. Surg. 53: 251, 1999.
  4. Monstrey, S., Delanghe, J., Christophe, A., et al. Biocompatibility and oxidative stability of radiolucent breast implants. Plast. Reconstr. Surg. 105: 1429, 2000.
  5. Young, V. L., Lund, H., Ueda, K., Pidgeon, L., Watson Schorr, M., and Kreeger, J. Bleed of and biologic response to triglyceride filler used in radiolucent breast implants. Plast. Reconstr. Surg. 97: 1179, 1996.
  6. Choudhary, S., Cadier, M. A. M., and Cottrell, B. J. Local tissue reactions to oil-based breast implant bleed. Br.J. Plast. Surg. 53: 317, 2000.
  7. Papanastasiou, S., Odili, J., Newman, P., and Evans, J. Are triglyceride breast implants really biocompatible? Ann. Plast. Surg. 45: 172, 2000.
  8. Adams, W. P., Jr., Robinson, J. B.,Jr., and Rohrich, R. J. Lipid infiltration as a possible biologic cause of silicone gel breast implant aging. Plast. Reconstr. Surg. 101: 64, 1998.
  9. Varga, J., Schumacher, H. R., and Jimenez, S. A. Systemic sclerosis after augmentation mammoplasty with silicone implants. Ann. Intern. Med. 1ll: 377, 1989.
  10. Giltman.L. I. Asteroid bodies in fibrocystic mastopathy. Hum. Pathol. 13: 767, 1982.

FIG. 1. The areola marker, manufactured by Padgett Instruments, Inc.

FIG. 2. The original prototype, created by the author, being used on a patient.

AREOLA MARKER FOR VERTICAL
MAMMAPLASTY

Sir:

Limited-scar breast reduction, also known as vertical breast reduction, is rapidly gaining popularity and acceptance in the United States. One of the most difficult aspects of this type of procedure is correct pattern marking, usually done freehand by the surgeon. The superior portion of the markings, the so-called mosque pattern, seems to be the most challenging. I have designed a pattern for an areola marker that makes this process significantly easier and predictable (Figs. 1 and 2). In the last few years I have experimented with various types of patterns including ones using x-ray paper, silicone sheeting, and even large gauge wire. I have found that the wire pattern was easiest to use and quite versatile for a wide range of breast shapes and sizes.

The technique is rather simple: first, the two vertical markings are placed on the breast, using the surgeon's preferred method. Next, the superior aspect of the new areola position is marked, usually in reference to the inframammary fold. At this time, the areola marker pattern is used, either 16-cm circumference or 14-cm circumference for breast lift and smaller reductions. The limbs of the marker are adjusted to meet the vertical markings appropriately. This method obviates the typical freehand method for marking the most difficult part. This pattern is manufactured by Padgett Instruments, Inc., Kansas City, Mo.

Disclaimer: The author is receiving royalties from Padgett Instruments, Inc.

Boris M. Ackerman, M.D. 360 San Miguel Drive, Suite 607 Newport Beach, Calif., 92660
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