Subfascial Endoscopic Transaxillary Augmentation Mammaplasty

Abstract

Video endoscopy for breast hypoplasia and glabellar frown lines has been used since 1996 at our private clinic. Breast augmentation with an S-shape incision for transaxillary access is utilized to introduce the implant, in a submuscular or subglandular and, recently (since October 1998), in a subfascial location. From August 1998 through January 1999, 62 patients underwent endoscopic surgeries; 49 were submuscular, 5 subglandular, and 8 subfascial. McGhan 410, anatomical biodimensional implants 155 to 235 g, were used. We observed three cases of complications, two of them malpositioning (rotation), needing reoperation, and one hematoma, treated with drainage. Patient satisfaction was high, especially regarding the axillary incision. There have been no capsular contractions to date.

Transaxillary Subfascial Augmentation Mammaplasty with Anatomic Form-Stable Silicone Implants

“…[2][3][4] The transaxillary approach for breast augmentation (TBA) is a well-known procedure, and its main benefits are related to the absence of incisions on the breast and the ability to place the implant within the submuscular and subglandular plane (Solz H, personal communication, 2005). [5][6][7][8][9][10][11][12][13][14][15][16] Described initially for a submuscular pocket with blunt dissection, 5 the procedure is not without drawbacks, including implant displacement, muscular distortion, and postoperative pain. [17][18][19][20][21] Although TBA has been available for many years, critics have emphasized its limits in attaining precise positioning of the anatomic implant in the lower pole of the breast.…”

“…In addition, endoscopic assistance has enhanced TBA by allowing better placement of the silicone implant inferiorly and improved management of the inframammary crease. 9,11,12,14 An alternative implant pocket is gaining popularity because of the better postoperative recovery it provides compared with submuscular approaches and because it avoids distortion when the pectoral muscle is contracted. 10,[22][23][24][25][26][27][28][29] Introduced in the 1990s, the subfascial technique is helpful for creating a support structure for the upper pole of the implant, which avoids inferior displacement and palpation of the implant edges.…”

“…10,[22][23][24][25][26][27][28][29] Introduced in the 1990s, the subfascial technique is helpful for creating a support structure for the upper pole of the implant, which avoids inferior displacement and palpation of the implant edges. 12,22,23 In addition, with the advent of the subfascial technique, the potential benefits of TBA to patients, such as axillary incision and shorter recovery time, have become clearer. Consequently, because of the association of both procedures, subfascial TBA seems to have gained new popularity.…”

“…Consequently, because of the association of both procedures, subfascial TBA seems to have gained new popularity. 12 Silicone breast implants have advanced in recent decades with the introduction of new textures and anatomically shaped implants. [30][31][32][33][34][35][36][37][38] With advances in implant technology involving different types of textures and gel cohesion, more satisfactory outcomes with lower complication rates can be achieved.…”

Mastopexia com inclusão de implantes mamários após tratamento cirúrgico da obesidade mórbida: avaliação da satisfação das pacientes e resultados cirúrgicos

“…Os implantes podem ser localizados atrás do tecido glandularretroglandular 52,57 , posteriormente à fáscia dos músculos peitoraisretrofascial 58 , ou atrás dos músculos peitorais -retromuscular. 59,60 Gonzales-Ullôa Nas pacientes que apresentaram grande perda ponderal, observa-se ptose mamária acentuada grau III associada a excesso cutâneo e pequena quantidade de tecido parenquimatoso, relativamente.…”