Background: Although isolated accessory breasts have been reported in many locations on the torso, we noted that lean men presenting for liposuction had mounds of fullness in a curvilinear array (axilla to groin) consistent with the configuration of the embryological mammary ridge. We hypothesized that grid mapping and pinch testing would elucidate the pattern of fullness and its relation to the “milk line.” Methods: Twenty lean participants (10 men, 10 women) each underwent standardized photography and grid mapping of anterior torsos. We then pinch-tested each for subcutaneous fullness in 250 standardized loci. We used plotted pinch values and OLS regression models to determine if focal fullness corresponded to published configurations of the embryologic mammary ridge. Results: We identified a pattern of paired mounds in all participants running bilaterally in curved linear arrays from axillae to groin in the exact form of milk lines. Regression models applied to the male and female pinch data indicated that focal thickness matched mammary ridge configurations in all subjects ( P = 0.023 for men, <0.001 for women). Fatty fullness never appeared elsewhere on the anterior torsos. Conclusions: The linear pattern of paired focal fat mounds present on the anterior torsos is consistent with the paths of embryological mammary ridges, suggesting these focal fat pads are of breast origin. The consistent mounds are distinct from general subcutaneous fullness and therefore represent a new finding of gross human anatomy. We recommend further research to define differential physiology of distinct subpopulations of yellow fat and clinical implications.
Background: Cosmetic outcomes are among patients’ top concerns when discussing treatment options for facial nevi. Benign lesions of the face often enlarge with time, and many patients seek care to minimize the perceived deformity. Complete excision remains the frontline treatment for facial lesions, but a choice must be made between the deformity from the lesion itself and scar deformity incurred from its removal. Traditional elliptical excision results in a linear scar that is often conspicuous, while alternatives to surgical excision seek to minimize scarring but possess their own disadvantages. We report a new application for nevus reduction (subtotal or near-total excision) to diminish deformity from the lesion itself while minimizing scar visibility with a novel “irregularly irregular stellate incision” approach. Methods: Incisions are made in a stellate pattern with irregularly irregular borders circumscribed within the lesion. Therefore, the scar is restricted to the lesion surface, while a reduction in area and projection off the skin surface can be tailored to fit the patient’s wishes for any benign skin feature. Results: This technique has been employed with hundreds of facial lesions, with two representative cases shown. No significant complications have been observed and the method has been used on a wide variety of sizes and types of lesions. Conclusions: The technique presented meets the need for minimal scarring when reducing benign lesions of the face. The method is applicable to a wide range of presentations and can also function as a method to biopsy lesions, should there be concerns about pathology.
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