ONCOPLASTIC SURGERY TECHNIQUES - WISE (INVERTED T) PATTERN

The Wise pattern technique is a widely used oncoplastic surgical method for cases requiring the remov-al of large breast tissue. This technique reshapes the remaining breast tissue, minimizing postoperative deformities and preserving aesthetic symmetry. It is particularly preferred in patients with large breasts and is primarily based on volume displacement. The Wise pattern utilizes pedicle-based approaches for the nipple-areola complex (NAC). Pedicles are tissue flaps containing blood vessels that supply the NAC. Depending on the tumor’s location, different pedicle designs such as inferior, superior, supero-medial, or bipedicled approaches may be chosen. This ensures NAC viability and reduces the risk of complications after surgery. The surgical steps include preoperative skin markings, de-epithelializa-tion, elevation of the selected pedicle, tumor excision, placement of key sutures, and final reshaping of the breast. Throughout these steps, proper NAC positioning and vascular preservation are crucial. The advantages of this technique include allowing wide tumor excision, maintaining breast contour, and improving symmetry. However, potential complications such as NAC necrosis, wound healing issues, and breast asymmetry may occur. Therefore, proper patient selection, thorough preoperative planning, and meticulous surgical execution are essential. The Wise pattern remains a widely used approach that optimizes both oncologic safety and aesthetic outcomes.