Use of Mobile Application as an Auxiliary Tool in the Preoperative Marking of Nipple-areola Complex Positioning in Mammoplasty

Background:

Smartphones have the ability to benefit plastic surgeons in many ways. The aim of the study is to demonstrate that the use of a mobile application is a useful auxiliary tool for checking and eventual correction/adjustment of preoperative markings by plastic surgeons in mammoplasty.

Methods:

The retrospective study was performed in a consecutive series of cases from July 2016 to October 2019. After preoperative marking, photographs were taken using the laser-level application (inclinometer, a leveling instrument), produced by Examobile, with an objective of verifying alignment deviations in preoperative marking. Some marking asymmetry related to the vertical height of the areolas was immediately corrected and a new photograph using the application was made for alignment checking.

Results:

Ninety-three patients were included in the study. Comparatively, there was an increase in symmetry index around 28.6% of patients. The application of the Fisher and Chi-square tests evidenced statistical significance between the groups demonstrating the application as an auxiliary preoperative marking tool in relation to the symmetrical vertical positioning of the areolas.

Conclusions:

The use of technology has become an important component of the way plastic surgeons train and practice. Today, there is a big gap between the desire for digital resources and awareness of the resources that are already available. By aggregating and evaluating current mobile applications available, surgeons, residents, and medical students will have more efficient ways to connect to the information that drives education and tactical surgery development.

The "Shirt Pocket" Technique-An Alternative for Augmentation-Mastopexy

Augmentation-mastopexy is a frequent procedure with high rates of early recurrence of breast ptosis, mainly after subglandular approach. The dual-plane techniques, based on the cranial dissection of the pectoralis, is the most used, but this plane does not cover the inferior pole of the breast. Then, the possibility of a downward dissection of the muscle seems to be more reasonable to retain the implant and improve postoperative results. This study aimed to review the anatomy of the pectoralis in cadavers and the use of its downward dissection to create a pocket for breast implant as a "shirt pocket." This maneuver was associated with a superior-based dermoglandular flap to overprotect the inferior pole. No complications were related in the postoperative period. The anatomic review showed that the "shirt pocket" is a safe option if done carefully. The technique demonstrated to be feasible and seemed to be effective, being another alternative to prevent early recurrence of breast ptosis in these procedures.