Surgical techniques to avoid lateral dog ear of the mastectomy scar: A systematic review

International Journal of Surgery
Geok Hoon Lim, Hui Fuan Tan

Abstract

Mastectomy is commonly performed for breast cancer. However, a dog ear may arise at the lateral aspect of the mastectomy scar. This dog ear is not only unsightly but can also be a source of discomfort. While various surgical techniques have been reported to tackle this lateral dog ear, there is no standardized technique. We hence conduct the first systematic review of these surgical techniques with the aim of comparing the merits and limitations of each technique. A systematic literature search using the search terms "mastectomy scar", "mastectomy dog ear", "mastectomy lateral fold" and "mastectomy cosmesis" was performed. All relevant articles written in English and involving human subjects were included. There were 2503 potentially relevant articles but only 12 articles met the inclusion criteria. The 'fish-shaped' incision or Y closure and its variations were the most commonly described techniques. Other techniques include the 'tear-drop' incision, 'L' scar technique etc. 'Fish-shaped' incision or Y closure is safe and provides good exposure to the axilla but its limitations are that of an additional scar and risk of skin necrosis at the apex of the Y incision. The other techniques attempt to eliminate the lateral dog ear wh...Continue Reading

References

Nov 1, 1988·American Journal of Surgery·W B Farrar, W J Fanning
Dec 16, 1998·Journal of the American College of Surgeons·E R Gibbs, R B Kent
Mar 22, 2003·Annals of the Royal College of Surgeons of England·M MirzaK Fortes-Mayer
Jun 5, 2004·The Breast : Official Journal of the European Society of Mastology·Maged HussienR M Watkins
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Jan 12, 2013·ANZ Journal of Surgery·Rebecca ThomasBurton King
Nov 20, 2014·JAMA Surgery·Kristy L KummerowMary A Hooks

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Citations

Mar 12, 2020·Annals of the Royal College of Surgeons of England·R SinhaM E Banwell
Oct 31, 2020·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Naomi SakamotoEisuke Fukuma
Jan 5, 2021·Annals of Surgical Oncology·Jennifer L BakerDeanna J Attai

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