Figure 8.

This drawing shows the outline of the parenchymal resection. Very little tissue is removed superiorly unless the patient has significant upper pole fullness preoperatively. The tissue resection follows a Wise pattern. It is beveled out laterally and medially but undermined inferiorly. Because the inframammary fold rises with this technique, care must be taken to remove excess subcutaneous tissue in the region between the old and the new inframammary folds, especially just lateral to the breast meridian. Postoperative puckers are less a problem of skin excess than a problem of subcutaneous tissue excess. About a centimeter of fat must be left attached to the dermis to prevent scar contracture.