Aesthetic Flat Closure
A series of figures illustrating the individual features contributing to the "ideal" aesthetic outcome following flat closure. Created for Dr. Kenneth Fan, Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital. Distributed for validation using MTurk.
Aesthetic Inframammary fold (IMF) removal Ideal Outcome: 1. The IMF is the crease located at the bottom portion of the chest where the breast normally sits; the ideal outcome is for this crease to be completely removed.
Aesthetic Feature: Side (lateral) chest wall contour. Ideal Outcome: 2. Each outer side of the chest wall should be smooth without extra skin, folds, wrinkles or bumps.
Aesthetic Feature: Midline (medial) chest wall contour Ideal Outcome: 3. The midline (medial) portion of the chest wall should be smooth without extra skin, folds, wrinkles or bumps.
Aesthetic Feature: Concavity Ideal Outcome: 4. The chest wall should be flat or mildly curve outward (convex). The chest wall should not curve inward (no concavity).
Aesthetic Feature: Quality of incision closure. Ideal Outcome: 5. The incision should be as flat and smooth as possible with no bumps, rippling, or skin folds visible to the naked eye. Aesthetic Feature: Incision symmetry Ideal Outcome: 6. There should be minimal differences in incision size and shape without extra tissue on each side.
Aesthetic Feature: Contour symmetry. Ideal Outcome: 7. There should be an equal distribution of overall skin thickness without puckering, rippling, bumps, or areas of extra tissue.
Aesthetic Feature: Armpit & collarbone aesthetics. Ideal Outcome: 8. The armpit (axillary) and collarbone (clavicular) areas should be continuously smooth (tapered) from the chest, without divots or skin folds.
Aesthetic Feature: Nipples: symmetry* Ideal Outcome: 11. Some patients want to keep their nipples. If retained, nipples should be as equal in size as possible and positioned along the same vertical and horizontal planes on each side. Aesthetic Feature: Nipples: position* Ideal Outcome:12. If retained, nipples should be positioned as close to the ideal position (shown here) as possible.