The silk is held under tension in the palm of the surgeon's left hand while the index finger is used to push down on the breast tissue. The scissors is placed above the finger and pushed away from the tissue to be excised before cutting, creating a safe margin of resection.
Anesthesia is infiltrated successively ahead of the dissection so the patient feels no pain during the procedure. Around the center of the lesion, the resection plane is cylindrical and tapers to a point beyond the end of the needle. Before dividing the last attachments, orienting sutures are placed in the specimen (long lateral, short superior, and the double stay indicating superficial).
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