Subfascial versus Subglandular Breast Augmentation: A Randomized Prospective Evaluation Considering a 5-Year Follow-Up

Abstract

Breast augmentation is one of the most popular cosmetic surgical procedures worldwide, and many methods have been developed to reach the best result. In this context, the selection of the pocket plane is one of the most critical factors in the dynamics established between the implants and soft tissues after surgery. 1 Cronin and Gerow first introduced subglandular silicone implants in 1962. 2 Subglandular placement has the advantage of more uncomplicated dissection. 3 However, this plane can result in the visibility of the edge and palpability of the implant, particularly in thin patients. 4,5

Multiplanar (4-Dimension) Breast Augmentation—A Personal Surgical Concept for Dynamic Implant-Tissue Interaction Providing Sustainable Shape Stability

“…Fewer patient complaints were seen while morbidity was found to be similar to other techniques 16. In a prospective randomized intraindividual comparison statistical differences between methods were found regarding breast shape and contour, capsular contracture, implant base, and the number of folds showing that subfascial breast augmentation was superior to subglandular breast augmentation 17…”

“…16 In a prospective randomized intraindividual comparison statistical differences between methods were found regarding breast shape and contour, capsular contracture, implant base, and the number of folds showing that subfascial breast augmentation was superior to subglandular breast augmentation. 17 Thus, capsular contracture can be managed by submuscular implantation and insufficient breast shape and volume and animation can be effectively approached through retroglandular or subfascial placement in most cases. 18 Karabeg and colleagues have described a technique of generating a fasciocutaneous lower pole flap in the dual-plane technique instead of just using skin for closure, which is a further development of the previous techniques.…”

The analgesic efficacy of pectoral nerve block for breast augmentation: a meta-analysis of randomized controlled studies

“…Breast augmentation has become one common operation in plastic surgery for cosmetic factor [1][2][3][4][5]. However, many patients suffer from moderate-to-severe pain after the surgery due to the insertion of subpectoral prostheses into the breast tissue and surgical dissection of the tissues [6][7][8].…”

Discussion: Subfascial versus Subglandular Breast Augmentation: A Randomized Prospective Evaluation Considering a 5-Year Follow-Up

“…In this article, the authors report the findings for a prospective, randomized, controlled, double-blind clinical trial carried out in Curitiba, Brazil, spanning a 5-year period. 1 Twenty female patients undergoing breast augmentation were randomly sorted to receive a subglandular or subfascial implant on each breast and then followed over 5 years with five guest surgeons and magnetic resonance imaging evaluation. The most significant finding from guest surgeon evaluation is that although the subglandular and subfascial implants were very similar 1 year after the breast augmentation, the assessment at 5 years postoperatively revealed improved outcomes for the subfascial compared to the subglandular implants in breast consistency, breast contour, and breast shape.…”