Transaxillary Subfascial Augmentation Mammaplasty with Anatomic Form-Stable Silicone Implants

Munhoz, Alexandre Mendonça; Gemperli, Rolf; Góes, João Carlos Sampaio

doi:10.1016/j.cps.2015.06.016

Cited by 25 publications

(20 citation statements)

References 59 publications

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“…When the base diameter of the implant was wider than the span of the pectoralis major fascia, the deeper fascial layer was utilized to add thickness to the implant envelope, especially in the inferior and lateral regions. Previous studies have documented that the total subfascial technique could reduce the risk of capsular contracture [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

Park

Sim

2018

Arch Plast Surg

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BackgroundDuring breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange.MethodsThis study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20–38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization.ResultsThe mean follow-up period was 14 months (range, 6–24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160–300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery.ConclusionsEndoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.

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Section: Discussionmentioning

confidence: 99%

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

Park

Sim

2018

Arch Plast Surg

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“…Hematomas and seromas were drained with success in a single outpatient treatment (Figures 6-8). In our study, we inserted the implants in the SF plane because of its well-known satisfactory outcomes (6-20) and advantages which include lower morbidity and the capability to give more soft tissue coverage of the prosthetic materials than the SG plane (7,8,(12)(13)(14)20).…”

Section: Outcomes/complicationsmentioning

confidence: 99%

“…Each one of these techniques has advantages, disadvantages and specific indications. The SF plane technique was introduced in the 1990s (6,7), as an alternative to the SG plane technique, offering an additional coverage for the implants (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). This technique provides a shorter recovery time than the SM plane (6)(7)(8)(9)(12)(13)(14)16,17,19,20).…”

Section: Introductionmentioning

confidence: 99%

Hybrid breast augmentation: our surgical approach and formula for preoperative assessment of fat graft volume

et al. 2022

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Background: Autogenous fat grafting (AFG) is a well-known procedure utilized in addition to breast augmentation (BA) to improve breast appearance. Plastic surgeons usually estimate the ideal AFG volume relying on their personal experience based on similar previous cases: inaccurate predictions could result in incorrect evaluation of donor sites and even needless fat transfer. The purpose of this paper is to describe and prove the validity of our surgical technique and provide a simple and easy-to-use mathematical formula to assess the adequate proportion, between the volume of the implants and of the AFG, in order to obtain a natural shape and a proper volume in BA.Methods: One hundred and twenty-two patients (244 breasts) were subjected to primary/secondary hybrid BA (HBA). A formula was utilized to assess the volume of fat graft. Data about their age, body mass index (BMI), incision and implants were collected. Follow-up for analysis was fixed at less than 15 days, 1, 3, 6 and 12 months for analysis. Preoperative photographs were compared with postoperative at 12 months. Pre and postoperative Breast-Q © were administered to every patient. A statistical analysis was performed comparing Breast-Q © preoperative means with postoperative ones through t-student test. We globally defined the patients as follows: "very dissatisfied" if total score 0-25; "somewhat dissatisfied", score 26-50; "somewhat satisfied", score 51-75; "very satisfied", score 76-100.Results: All patients received Ergonomix-style Motiva Smooth/SilkSurface with low/high projection (range, 120-225 mL, mean 170 mL) and an average AFG volume of 600 mL (range, 480-720 mL). Breast-Q © analysis showed a statistically significant difference between preoperative and postoperative modules. 122 (100%) patients were "very satisfied". Thirteen cases of complications presented in 12 patients (10.65%): 5 hypertrophic scarring (4.09%), 3 wound dehiscence (2.46%), 3 hematomas (2.46%), 1 seroma (0.82%), 1 fat necrosis (0.82%).Conclusions: Our surgical technique proves low complication rate and short recovery times. Our mathematical formula to calculate the AFG seems to be both predictive and a precise guide for surgical decision-making in planning the treatment of patients candidated for HBA. In fact, the analysis of Breast-Q © questionnaires shows a high grade of satisfaction among patients. Further investigations should be performed in order to study a wider population and different type of implants.

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“…The transaxillary approach used for augmentation (TBA) is a well-known technique, with its main benefits related to the absence of incisions on the breast [2], [3], [4], [5].…”

Section: Introductionmentioning

confidence: 99%

Chest wall reconstruction following axillary breast augmentation and desmoid tumor resection using capsular flaps and a form-stable silicone implant: A case report, diagnosis and surgical technique

Munhoz

Marques

Milanez

et al. 2017

International Journal of Surgery Case Reports

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HighlightsDesmoid tumors (DT) are a rare benign lesion, and chest desmoid tumors are much less frequent. A rare case of chest DT is presented and discussed.Chest DT following breast augmentation is very rare and few cases have been described; all have been related to the inframammary approach and located in the implant capsule. The authors describe a chest DT following subfascial axillary breast augmentation and subsequent surgical management and chest wall reconstruction.The case illustrates some aspects that may be useful for thoracic and plastic surgeons and may be used as guidance for surgical management.

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Transaxillary Subfascial Augmentation Mammaplasty with Anatomic Form-Stable Silicone Implants

Cited by 25 publications

References 59 publications

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

Endoscopic transaxillary prepectoral conversion for submuscular breast implants

Hybrid breast augmentation: our surgical approach and formula for preoperative assessment of fat graft volume

Chest wall reconstruction following axillary breast augmentation and desmoid tumor resection using capsular flaps and a form-stable silicone implant: A case report, diagnosis and surgical technique

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