Overcoming Dogear of Lateral End of Mastectomy Wound By Y-Closure Technique: Our Experience

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Introduction: The improvement in the treatment of breast cancer is due to early diagnosis, better understanding of the natural history of this disease and therapeutic improvements over the years. There is a gradual shift away from radical surgery to the breast conservative surgery during the last few decades all over the world. Till now, modified radical mastectomy is the most common surgery performed by surgeons for carcinoma breast. Objective: This study aims to evaluate a technique of mastectomy wound closure designed to maximize cosmesis at the lateral end.Methods: As a surgical technique, patients were evaluated according to NCCN guidelines, and all underwent modified radical mastectomy using a transverse Stewart incision. After achieving hemostasis, closure was planned. At the lateral end, equal markings were made on the superior and inferior flaps based on redundant skin over the latissimus dorsi. A triangular flap was advanced medially, three points sutured, residual dog ears excised, producing a Y-shaped closure. This procedure was performed in 31 cases between January 2024 to June 2025 those were undergone modified radical mastectomy by Stewart incision.Result: The patient’s mean age was 46 years (range 28-62 years). The mean weight of the excised breast tissue was 1015 g (range 356–2003). The mean lengths of the two limbs of the Y-plasty were 5.3 cm (range 3–10). The mean length of the base of the flap was 7.6 cm (range 4–14). 9 patients developed a small area of skin necrosis at the apex of the Y-plasty. 8 further patients developed superficial wound infections following marginal flap necrosis, and 3 patients developed wound hematoma. Conclusion: The Y-shaped closure approach (y-closure) for modified radical mastectomy is a simple and safe technique. It improves cosmesis and prevents discomfort in obese women by eliminating lateral dog ear deformity. The Journal of Ad-din Women's Medical College; Vol. 14(1), Jan 2026; p 34-40

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