Mastectomy closure and drain placement

Closure of the incision, with a Jackson-Pratt drain exiting the skin of the low axilla and secured externally with a nylon suture. With the drain under the lower flap, it catches the fluid dependently.
(A) The incision with a simple closure of the ellipse.
(B) With a Y-plasty modification in the context of those larger individuals who have developed a ridge of tissue extending to the lateral thorax or back secondary to the weight of the breast over time. This closure results in reducing the excess tissue laterally, beyond the breast, which may stick out after closure.
Alternatively, two additional oblique incisions can be added to the traditional transverse elliptical incision at the lateral part of the mastectomy incision site (B, upper panel). The resulting lateral triangular flap is advanced medially during the closure of the wound, and the redundant skin in the superior and inferior areas is excised.