B-flap resection. (a) Shows multiple stars with possible tumor locations. (b) Shows location of skin incision, including disk of skin to be preserved. (c) Shows surgical cavity after excision of central lumpectomy with removal of nipple-areolar complex (inset). For illustration purposes, medial profile view of right breast shows multiple “stars” indicating possible tumor locations suitable for this approach. (d) Shows surgical cavity, areas of de-epithelized skin, preserved disk of epithelized skin, and location of incision to be made in the glandular tissue. (e) Shows advancement and clockwise rotation of lower outer quadrant until disk of skin occupies the nipple-areolar complex position. (f) Shows breast following approximation and closure of the skin incisions. De-epithelized skin is buried below the skin of the lower inner quadrant and the disk of skin forms a new areola.
