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Representative intraoperative reduction mammoplasty photographs. (a) Markings for skin and breast parenchymal resection. (b) Elevation of the superior flap. Note that the area between the surgeon's left hand must be thinned to accommodate the dermal pedicle. (c) Elevation of the pedicle with preservation of chest wall perforators. (d) Placement of shaping sutures from the pedicle to the chest wall to facilitate central projection.
