This article represents a retrospective view of the author's 17-year experience with 2863 saline implants in 1327 patients and details his "no-touch" technique. The experience included almost an equal number of submammary and subpectoral procedures. The submammary procedures were done early on and were replaced with subpectoral procedures, done exclusively at the present time. There were significantly less complications--capsules, wrinkling (visible folds), and deflations--with the subpectoral procedures. Followup is longer for submammary procedures which could be the reason for the slight difference in number of deflations. Analyzing the results from three different periods, during which the technique changed, the last period in which the no-touch subpectoral technique was used had markedly fewer complications. The no-touch technique, which had been introduced in orthopedic surgery over 50 years ago, was added to the augmentation procedure in an attempt to eliminate any possible contact with skin or breast bacteria. There were no infections in the entire series, and, during the no-touch period, capsules were almost eliminated (0.6%). Saline implants can achieve excellent results when placed subpectorally using the no-touch technique.

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Over a 12-month period, 40 patients were treated for various facial defects using a new, injectable microimplant material--Bioplastique. Areas treated included cheeks, chins, lips, nasolabial lines, nasoglabellar lines, infraoral lines, noses, and miscellaneous depressions. Patients were observed for overcorrection, inflammation, morbidity, allergic reaction, or other complications. Both patient and physician satisfaction were recorded. Use of Bioplastique was found to offer permanent results by means of a quick, simple procedure administered under local anesthesia without scarring. With proper training and a good "eye," subtle corrections are possible. The author anticipates wide application of Bioplastique for the treatment of numerous soft tissue deficiencies.

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