"Batwing" mastopexy can be considered for cancers located centrally and above the NAC, but not directly infiltrating the major ducts. Two similar half-circle incisions are made with angled wings to each side of the areola. Tumor should be excised with safety margin and the fibroglandular tissue incontinuity with areola-nipple complex is advanced to close the subsequent defect. Adequate removal of skin overlying the lesion could improve local control of cancers located superficially. Nipple necrosis may take place if dissection extends directly behind the nipple. Patients with pendulous breasts are particularly eligible for this procedure, which can also be applied to the contra lateral breast to achieve symmetry.
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