Attachment distribution of pectoral muscle origins identified in dual-plane breast implant insertion

Abstract

Background Implant-based dual-plane augmentation mammoplasty requires accurate separation of the pectoralis major muscle (PMM) at its origins. The authors identified the PMM origins during breast reconstruction surgery with the goal of providing additional information on subpectoral implant insertion for reconstructive or aesthetic purposes.Methods This study was conducted on 67 patients who underwent breast reconstruction surgery at the breast center of our hospital between November 2016 and June 2018. In total, 34 left and 39 right hemithoraces were examined. The left and right hemithoraces were each divided into 15 zones to determine the percentage of PMM attachments in each zone. The distribution of PMM origins in each zone was examined to identify any statistically significant differences.Results There were no statistically significant differences in the origins of the PMM between the right and left hemithoraces. The percentage of attachments increased moving from the fourth to the sixth rib and from the lateral to the medial aspect.Conclusions The anatomical findings of this study could be used as a reference for accurate dissection of the origins of the PMM for the preparation of the subpectoral pocket for subpectoral implant placement.

Composite Sling: A Strategy for Enhancing Inferolateral Support in Mastopexy with Implant

“…Additionally, the maintenance of the double sling prevents muscle retraction and rising, which could result in implant support loss, a challenging complication to treat. 8 Upon completion of pocket dissection, we proceed with the composite sling through a vertical incision of the aponeurosis of the external oblique muscle at the midclavicular line near the sixth rib, followed by lateral dissection involving the relevant muscle and aponeurotic structures. This maneuver allows for precise and customized adjustment of Takeaways Question: In dual plane implant mastopexies, inadequate inferolateral support occurs with unfavorable pectoralis major (PM) muscle or chest anatomy.…”