title: Chain purse-string suture used to shorten the vertical incision in vertical breast reduction.
abstract: BACKGROUND
  Reduction mammaplasty is one of the most frequently performed operations in plastic surgery. Breast scarring can be troublesome for both the patient and the surgeon. This report offers an easy method for suturing a vertical incision that provides a better shape in final breast appearance.
  
  
  METHODS
  In this study, 10 patients with an average age of 33 years (range, 27-44 years) underwent short-scar medial pedicle breast reduction. For the patients who underwent a medium reduction (401-800 g), after the excision of sufficient glandular and skin tissue, the vertical incision was closed as follows. Loose subcuticular sutures were placed, starting from the top of the incision and proceeding toward its bottom. In the distal corner of the incision, counterpart suturing was performed out through the opposite direction before the wound was approximated. In this way, the suture chain was completed. At the top of the incision, the sutures were pulled tight to gather the skin in a short vertical scar.
  
  
  RESULTS
  The patients were followed up on the average for 12 months after the surgery. The majority of the patients were sufficiently satisfied with the results of the operations, including the scar length and the final appearance. Pseudoptosis did not occur.
  
  
  CONCLUSIONS
  The findings show that the reported technique is an improvement over the existing vertical incision method by allowing for faster and simpler closure and resulting in a better breast shape and scar length. The bidirectional continuous suture is performed as a purse string in the longitudinal incision.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors                      www.springer.com/00266                                        .
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kahramanmaras Necip Fazıl State Hospital, Antep Yolu 14.km. Karacasu Mevkii, 46100, Kahramanmaras, Turkey. selmankaraci@yahoo.com
authors.forename: S
authors.initials: S
authors.lastname: Karacı
authors.forename: R
authors.initials: R
authors.lastname: Kose
authors.forename: H
authors.initials: H
authors.lastname: Baykan
authors.forename: M
authors.initials: M
authors.lastname: Ozkose
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D013536:Suture Techniques