With the suture ends grasped between thumb and the ulnar three digits of the left hand for traction, the left index finger is placed over the dome of the lesion. A Senn rake elevates the skin.
The lesion is excised sharply using scissors. Pushing down on the lesion and pushing the tips of the scissors away from the finger tip ensures a nice margin of normal tissue. If a lesion is within dense glandular breast tissue, a heavier scissors (Mayo) is used.
After the lesion is excised and hemostasis is achieved, only the subcutaneous tissue and skin are closed with absorbable suture.
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