Mobilization of the breast off the chest wall can be aided by placing Allis clamps along the superior border of the breast, including the investing "fascia" of the muscle (perimysium). The tissue is pulled up or inferiorly with gentle traction. The dissection is performed utilizing electrocautery or sharp dissection, traveling in parallel to the chest wall muscle fibers. Since the pectoralis major muscle fibers splay, the angle of dissection shifts as one progresses within the dissection.
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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