Mastectomy skin flap development

Development of the skin flaps proceeds with retraction of the skin at a right angle to the table. With traction on the breast tissue, pressing down or pulling away from the skin flap, the tissue plane is more readily identifiable. The plane between the adipose of the skin and that of the breast is usually found 2 to 4 mm below the dermis. The adipose of the skin is the thinnest near the areola and slowly becomes thicker toward the chest wall. Adair breast tenaculae are depicted here in the retraction, but other methods are utilized as well.