Why do you mark the patient standing up prior to Breast Reduction Surgery?

Why do you mark the patient standing up instead of laying down, prior to Inferior Pedicle Wise Pattern Breast Reduction Mammoplasty? Does it matter whether your laying on your back or are in a standing position when your being marked pre surgery? Or is it not that big of a deal, cause if your Surgeon's Board Certified, he is so skilled he can mark you in any position.

Doctor Answers 6

Why Plastic Surgeons Mark Their Patients in the Standing Position Prior to Surgery.

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I have performed approximately 2,000 breast reduction surgeries and I prefer to mark the patient in the standing position for the following reasons.
1. If marked in the supine position the breast fall to the side and this will give a distorted final determination of the new position of the nipple. 
2. I prefer standing as opposed to sitting because I prefer the abdominal tissues (which are forced upward during sitting)  to not effect the markings. 

Eau Claire Plastic Surgeon
4.7 out of 5 stars 22 reviews


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Marking is a personal thing. I prefer to mark the patient in the standing position because it takes gravity into account and allows me an opportunity to account for that as I try and provide the best symmetry.  I have seen very skilled plastic surgeons who do not mark at all and get excellent results.  I think whatever the surgeon you chose does routinely to get good results is important.

All the best,

Arun Rao Plastic Surgeon Tucson, Arizona

Arun Rao, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast Marking

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I guess ever since the pyramids were built,  breasts have been marked in the upright position.  So part of the answer is that that is the way we always do it.   But the other side of the answer is that when the patient is lying down we also assess and adjust the markings a bit.   Breast reduction marking is very important.   Another twist on this is that in the upright position the breasts are stationery and comparable to each other.  The surgeon can clearly measure from the sternal notch, and the 6 th rib, and the ziphoid angle and the middle of the arm.  All this becomes vague and hard to compare when reclined.   Then again another answer is that for all the above reasons, marking in the upright position is just better.   I usually have the patient sit upright and not stand.  I have seen surgeons take over an hour to mark breasts.  This is fine.  Most of us take 10 to 15 minutes at most.  My best,  Dr C

Marking breasts before breast reduction surgery

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Great question!

Although, all pre surgical markings are important, I also take into consideration what effects gravity has on the part in question when you are lying on the table. As you know, breasts tend to fall on the sides of the chest when lying on your back. I have made certain that with the Ultimate Breast Reduction technique, breasts are not subject to the forces of gravity.

Plastic surgeons need to look at all aspects of esthetic improvement. This not only requires having an esthetic eye, but technical ability and know-how.

Hope this helps.
Kind regards,
Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Marking for Breast Reduction

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I prefer to mark the patient sitting. This allows me to factor in the effects of gravity on the breasts. 

Dr. ES

I mark patients while sitting...

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Hi HappilyMarried33.  There are many ways to mark patients, and none of them are right or wrong.  I was trained to mark patients while they are sitting.  This has worked well for me over the last 700 or so cases.  Other surgeons probably have equally good results marking patients in other positions. 

Lewis Ladocsi, MD, FACS
Richmond Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.