The Reverse Dual Plane: A Novel Technique for Endoscopic Transaxillary Breast Augmentation

Abstract

Background Quite a few Asian patients prefer axillary incision for breast augmentation. However, this surgery needs to improve. Objective To introduce a reverse dual-plane technique through a transaxillary approach and compare it to a transaxillary dual-plane approach. Methods Eighty-two patients were divided into group A (n = 40) and group B (n = 42). Axillary incision and endoscope were utilized in the two groups. Tebbetts’ dual-plane was performed in group A. Patients in group B underwent our reverse dual-plane technique, in which the upper 70% was subfascial and the lower 30% was subpectoral, with the fascia of the external oblique and anterior serratus being elevated together with the pectoral muscle. The Numeric Pain Rating Scale (NPRS) scores were recorded daily for 7 days. Breast shape and softness, in both sitting and supine positions, were assessed by the patients, and complications were compared. Results The NPRS scores of group B were significantly lower than group A (P < .01). The satisfaction rate of shape and softness in the seated position was not significantly different (P > .05). However, in the supine position, only 20 patients (50.0%) in group A and 32 patients (76.2%) in group B were satisfied with their breast softness (P < .01), the others breasts became stiffer. Breast animation deformity (BAD) occurred in 2 cases in group A and none in group B (P < .01). Other complications were not significantly different. Conclusions Compared to Tebbetts’ dual-plane, this procedure significantly reduced pain, improved breast softness, and eliminated BAD, without increasing complications.