title: Vertical Mastectomy Incision in Implant Breast Reconstruction After Skin Sparing Mastectomy: Advantages and Outcomes.
abstract: BACKGROUND
  The type of since skin-sparing mastectomy (SSM) incision directly impacts the final aesthetic and functional results of reconstruction. Different incisions are used for SSM depending on tumor location, previous biopsy scars, breast weight, and ptosis degree. A vertical scar is less visible to the patient, reminiscent of a mastopexy, and patients may not have the stigma of mastectomy.
  
  
  OBJECTIVE
  This study investigates complication rates, patient demographics, patient reported outcomes, and plastic surgeon evaluations to compare vertical incision mastectomy to other incisions.
  
  
  METHODS
  After institutional review board approval, a retrospective chart review was performed. A total population of 167 patients that underwent mastectomy with tissue expander reconstruction was separated into vertical incision and nonvertical incision mastectomy groups consisting of 38 and 129 patients, respectively. Patient demographics, complications, tumor margins, staging, breast weight, and breast implant volume were compared. BREASTQ Survey analysis was conducted using patient reported outcomes from the patient's perspective. Aesthetic evaluations of postoperative photos were systematically scored by plastic surgeons to obtain data from the plastic surgeon's perspective.
  
  
  RESULTS
  Vertical incision orientation did not increase surgical complication rates or mastectomy skin necrosis (P = 0.142). Vertical incisions did not interfere with obtaining adequate tumor margins (P = 0.907). Vertical incisions did not have a significantly different breast weight or implant volume. There was no statistical difference for patient satisfaction or plastic surgeon aesthetic evaluation.
  
  
  CONCLUSIONS
  The use of vertical incision does not increase complication rates; does not interfere with tumor margins; and can be applied to all age, BMI, breast weight, and breast implant volume groups.
authors.affiliation: From the *Department of Surgery, Division of Plastic Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL; †University of South Florida, Morsani College of Medicine, Tampa, FL; and ‡Moffitt Cancer Center, Center for Women's Oncology, Tampa, FL.
authors.forename: Deniz
authors.initials: D
authors.lastname: Dayicioglu
authors.forename: Bugra
authors.initials: B
authors.lastname: Tugertimur
authors.forename: Kristen
authors.initials: K
authors.lastname: Zemina
authors.forename: Johnathan
authors.initials: J
authors.lastname: Dallarosa
authors.forename: Sequoya
authors.initials: S
authors.lastname: Killebrew
authors.forename: Augustine
authors.initials: A
authors.lastname: Wilson
authors.forename: Dunya
authors.initials: D
authors.lastname: Atisha
authors.forename: Nazanin
authors.initials: N
authors.lastname: Khakpour
mesh_terms: D000328:Adult; D000368:Aged; D019928:Breast Implantation; D005260:Female; D006801:Humans; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies