Solving the Dilemma of Congenital and Pathological Breast Asymmetry Using Modified Supine Oblique Sitting Marking Technique

Background: The female breast is one of the most attractiveaesthetic areas in female anatomy. The size, shape, andsymmetry of the breasts can have a dramatic effect on thewomen's well-being, poor self-esteem, altered self-image, andother psychological effects. All surgical techniques was donebased in the presurgical marking. However it is of little valueif symmetry procedure will be done in other breast.Material and Methods: We retrospectively reviewed 41patients admitted to our multi-disciplinary team breast clinicin Ain Shams University Hospital, between July 2015 andSeptember 2019. Patients' age ranged from 14 to 63 years.Congenital and pathological breast asymmetries were includede.g.: Chronic granulomatous mastitis, burns, and tumors ofthe breast (benign and malignant masses). Physiological breastasymmetry were excluded from the study.Patients were operated upon using the modified SOSmarking technique and followed-up for a mean of 13.24months post-operatively (range 3-30 months). All patientswere photographed before and after the surgery. Post-operativephotographs of these patients were examined by five plasticsurgeons (3 men and 2 woman). We compared both breastsusing a 5 point subscale consisting of volume, contour, placementof the breast mound, scar and the inframammary foldand all patients were asked to complete a satisfaction questionnairebased on the Harvard scale.Conclusion: It is a novel marking technique solved thedilemma of changing the pre-operative plane according to theintraoperative judgment and altering the amount of tissue to beexcised or reconstructed in patients suffering from congenitaland pathological breast asymmetry. It is technical easy to learn,reliable with satisfactory aesthetic outcome especial in congenitalasymmetries, with acceptable complication rate.