By Professor Ivo Pitanguy M.D., F.B.C.S., F.A.C.S., F.I.C.S. (auth.)
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E) The thoracic contours and the relationship between the rib cage and the thickness of its subcutaneous covenng. f) Presence or absence of the superior pole of the breast. The hypomastia can then be graded according to the classification of Thoreck, Marino and Uriburu (see Sect. 1). Mammography is indicated in patients over the age of 35 and if the findings are equivocal, bilateral biopsy can be carried out. In patients with extensive fibrocystic disease, the author prefers subcutaneous mastectomy followed by implantation of a prosthesis.
Noel A (1928) Asthetische Chirurgie der weiblichen Brust. Ein neues Verfahren zur Korrektur der Hangebrust. Med Welt 2: 51 22. Penn J (1954) Breast reduction. Br J Plast Surg 7: 357 23. Penn J (1959) Breast reduction. In: Transactions of the International Society of Plastic Surgeons, 2nd congress. London. Livingstone, Edinburgh 24. Pitanguy I (1960) Breast hypertrophy. In: Transactions of the International Society of Plastic Surgeons, 2nd congress, London. Livingstone, Edinburgh 25. Pitanguy I (1961) Aproxima<;ao ecletica ao problema das mamaplastias.
The line of the incision, which passes horizontally along the equator of the areola and nipple, is drawn (Fig. 44). The nipple is held with hooks and, using a No. 11 scalpel blade, the nipple and areola are incised so as to obtain access to the Augmentation Mammoplasty - Surgical Technique 39 gland (Fig. 46). The dissection is continued with scissors down to the pectoral fascia, separating the glandular tissue into two equal segments (Fig. 47). The area previously outlined is undermined along the fascial plane by blunt dissection with the finger.