Introduction: The most common complication of a Wise pattern breast reduction is dehiscence of the wound at the inverted T junction. The inverted T-Junction, where the vertical and horizontal suture lines meet, has the greatest tension when compared to other aspects of the wound and is therefore prone to complication. A triangular dermal flap (TDF) can decrease tension over the inverted T-junction and thus potentially decrease dehiscence rates in patients.

Methods: A retrospective chart review was performed to identify adults (≥18 years) undergoing Wise pattern breast reductions between 2017 and 2020 by two surgeons with varying techniques of closure (with and without TDF). Patient demographics, etiology, closure with TDF, risk factors and complications were all analyzed.

Results: A total of 75 patients with an average age of 49 underwent Wise pattern breast reduction. Of these 47patients had closure with a TDF. When compared with a traditional closure, patients with a TDF were less likely to have a T-Junction dehiscence (n=6 vs n =11, P=0.02, OR = 0.271 CI95% 0.073 – 0.76). Median follow up was 130 days (Range 8 – 679 days).

Conclusion:  Wound dehiscence in breast reduction is a common problem. A simple triangular dermal flap may hold the key to reducing T-junction dehiscence in this patient population.