Significant reduction of hypertrophic scarring by lateral vertical incision in skin-sparing and nipple-sparing mastectomy.

BACKGROUND: Some kinds of incisions have been reported in skin- or nipple-sparing mastectomy, but few reports have described the advantages and disadvantages of each incision. This study was conducted to compare the lateral horizontal incision with the lateral vertical incision in both mastectomies, in terms of hypertrophic scarring, breast envelope necrosis, nipple-areola necrosis.

MATERIAL AND METHODS: We performed a retrospective analysis of patients who underwent skin- or nipple-sparing mastectomy using lateral horizontal or lateral vertical incisions with immediate breast reconstruction. All data were obtained retrospectively from databases, operation records and postoperative pictures. We compared the frequency of hypertrophic scarring and breast envelope necrosis between lateral horizontal and lateral vertical incision groups by using Pearson's chi-square test. For nipple-sparing mastectomy, we also investigated nipple-areola necrosis.

RESULTS AND CONCLUSIONS: One hundred fifty cases were analyzed and identified as 89 lateral horizontal incision cases and 61 lateral vertical incision cases. Mastectomy comprised SSM in 49 cases and NSM in 101 cases. Hypertrophic scarring was significantly less frequent with lateral vertical incisions (1.6%) than with lateral horizontal incisions (14.6%) (P =0.007). No significant differences were seen in terms of breast envelope necrosis, nipple-areolar necrosis.