A Step-Up Guide of Oncoplastic Breast-Conserving Surgery Proposed by the JOPBS OPBCS Working Group－Volume displacement：Step 2-②Partial Mastectomy Using Reduction Mammoplasty or Mastopexy-Vertical Scar Mammoplasty

Abstract

Vertical scar mammoplasty is a step 2-② procedure in OPBCS Volume displacement.　Generally, for tumors in the lower pole, a superior-based pedicle is chosen, and breast parenchyma is mainly mobilized by resection from the pectoralis muscle with limited subcutaneous dissection. On the other hand, for the tumors in the upper pole, an inferior pedicle or a central mound pedicle is chosen for the nipple-areolar complex. The breast parenchyma of the lower pole can be mobilized to the upper pole without dissection from the underlying pectoralis muscle because of the thick and loose retro-mammary connective tissue in the ptotic breast. It is mandatory to fully understand the blood supply of the nipple-areola complex and breast parenchyma. Concomitant dual-plane dissection both from the skin and the pectoralis muscle to make extended pedicles should be avoided as much as possible.