(A) A practical incision based on that of Stewart is planned by choosing two points, in line with the nipple, to either side of the breast, with the lateral site along the posterior axillary fold under the hairline.
(B) The breast skin is pulled down orthogonal to that imaginary line and a straight line drawn between the points.
(C) The breast is pushed up orthogonal to the imaginary line between the two points and a lower straight line drawn between the points below the nipple.
(D) With the breast relaxed, an ellipse has formed, which will close relatively flat against the chest.
Reproduced with permission from: Shaughnessy EA. Simple mastectomy. In: Master Techniques in General Surgery: Breast Surgery, Bland KI, Klimberg SV (Eds), Lippincott Williams & Wilkins, Philadelphia 2011. Copyright © 2011 Lippincott Williams & Wilkins.
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