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J Cosmet Med 2018; 2(2): 100-105

Published online December 31, 2018

https://doi.org/10.25056/JCM.2018.2.2.100

Subfascial endoscopic transaxillary breast augmentation: long-term evaluation of 3,004 patients over a 10-year period

Surin Plasen , MD, PhD

Praram 3 Cosmetic Surgery Clinic, and Thai Association and Academy of Cosmetic Surgery and Medicine, Bangkok, Thailand

Correspondence to :
Surin Plasen, E-mail: surinmd9812@gmail.com, ORCID: https://orcid.org/0000-0002-4923-5543

Received: October 11, 2018; Revised: December 6, 2018; Accepted: December 7, 2018

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Subfascial endoscopic transaxillary breast augmentation were reported the benefits over the submuscular implant since 2000. Long term outcome was not reported in any large number of cases.
Objective: To evaluate the long-term outcome in 3,004 cases over 10-year period.
Methods: From 2007 to 2018, 3,004 cases were operated in our center. 2,949 cases undergo subfascial endoscopic transaxillary breast augmentation with textured round implant, 35 cases with smooth round gel, and 20 cases with textured anatomical implants. Inclusion criteria for patient selection is the pinch test in all patient group and this value is more than 1.5 inch. Post-operative follows up time from 2007 to 2018 with yearly visit with postoperative photograph. Postoperative complications were evaluated by the capsular contracture, abnormal chest muscle movement, rippling, infection, seroma, bottom out, hematoma, implant rotation and implant border palpation.
Results: Early postoperative hematoma was found in 0.16% in textured round implant and was not found in smooth gel and anatomical textured implant. The rate of capsular contractor was 0.16% in textured round implant, 20.0% in smooth gel and 10.0% in anatomical textured implant. The rate of infection and seroma formation occurs 0.2% in textured round implant. The rate of rippling is 0.33% in textured round implant, 10.0% in anatomical textured implant and no rippling in smooth gel implant.
Conclusion: Subfascial endoscopic transaxillary breast augmentation can be used in patients with thick breast tissues. Rippling and implant border palpation occurs frequently in textured round implant and textured anatomical implant. Capsular contracture is noticeably high in textured anatomical and smooth round implant. Careful selection of the patients is the key to success in this type of breast augmentation.

Keywords: breast augmentation, endoscopic, late complication, rippling, sub fascial, textured round implant

  1. Benito-Ruiz J. Nipple shields in transaxillary breast augmentation. Ann Plast Surg 2017;78:397-402.
    Pubmed CrossRef
  2. Handel N. Transumbilical breast augmentation. Clin Plast Surg 2009;36:63-74, vi.
    Pubmed CrossRef
  3. Tebbetts JB. Incision approaches. In: Tebbetts JB, editor. Augmentation mammaplasty. Edinburgh: Mosby, Elsevier; 2010. p. 219-30.
    CrossRef
  4. Graf RM, Bernardes A, Auersvald A, Damasio RC. Subfascial endoscopic transaxillary augmentation mammaplasty. Aesthetic Plast Surg 2000;24:216-20.
    Pubmed CrossRef
  5. Stoff-Khalili MA, Scholze R, Morgan WR, Metcalf JD. Subfascial periareolar augmentation mammaplasty. Plast Reconstr Surg 2004;114:1280-8; discussion 1289-91.
    Pubmed CrossRef
  6. Aygit AC, Basaran K, Mercan ES. Transaxillary totally subfascial breast augmentation with anatomical breast implants:review of 27 cases. Plast Reconstr Surg 2013;131:1149-56.
    Pubmed CrossRef
  7. Salgarello M, Visconti G, Barone-Adesi L. Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements. Plast Reconstr Surg 2010;126:1460-71.
    Pubmed CrossRef
  8. Tebbetts JB. Implant pocket locations. In: Tebbetts JB, editor. Augmentation mammaplasty. Edinburgh: Mosby, Elsevier;2010. p. 181-217.
    CrossRef
  9. Jinde L, Xiaoping C, Wanquan Z, Xia G, Ligang X. Can the pectoral fascia integrity be preserved during subfascial breast augmentation through the axillary approach? Aesthetic Plast Surg 2010;34:29-32.
    Pubmed CrossRef

Article

Original Article

J Cosmet Med 2018; 2(2): 100-105

Published online December 31, 2018 https://doi.org/10.25056/JCM.2018.2.2.100

Copyright © Korean Society of Korean Cosmetic Surgery.

Subfascial endoscopic transaxillary breast augmentation: long-term evaluation of 3,004 patients over a 10-year period

Surin Plasen , MD, PhD

Praram 3 Cosmetic Surgery Clinic, and Thai Association and Academy of Cosmetic Surgery and Medicine, Bangkok, Thailand

Correspondence to:Surin Plasen, E-mail: surinmd9812@gmail.com, ORCID: https://orcid.org/0000-0002-4923-5543

Received: October 11, 2018; Revised: December 6, 2018; Accepted: December 7, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Subfascial endoscopic transaxillary breast augmentation were reported the benefits over the submuscular implant since 2000. Long term outcome was not reported in any large number of cases.
Objective: To evaluate the long-term outcome in 3,004 cases over 10-year period.
Methods: From 2007 to 2018, 3,004 cases were operated in our center. 2,949 cases undergo subfascial endoscopic transaxillary breast augmentation with textured round implant, 35 cases with smooth round gel, and 20 cases with textured anatomical implants. Inclusion criteria for patient selection is the pinch test in all patient group and this value is more than 1.5 inch. Post-operative follows up time from 2007 to 2018 with yearly visit with postoperative photograph. Postoperative complications were evaluated by the capsular contracture, abnormal chest muscle movement, rippling, infection, seroma, bottom out, hematoma, implant rotation and implant border palpation.
Results: Early postoperative hematoma was found in 0.16% in textured round implant and was not found in smooth gel and anatomical textured implant. The rate of capsular contractor was 0.16% in textured round implant, 20.0% in smooth gel and 10.0% in anatomical textured implant. The rate of infection and seroma formation occurs 0.2% in textured round implant. The rate of rippling is 0.33% in textured round implant, 10.0% in anatomical textured implant and no rippling in smooth gel implant.
Conclusion: Subfascial endoscopic transaxillary breast augmentation can be used in patients with thick breast tissues. Rippling and implant border palpation occurs frequently in textured round implant and textured anatomical implant. Capsular contracture is noticeably high in textured anatomical and smooth round implant. Careful selection of the patients is the key to success in this type of breast augmentation.

Keywords: breast augmentation, endoscopic, late complication, rippling, sub fascial, textured round implant

References

  1. Benito-Ruiz J. Nipple shields in transaxillary breast augmentation. Ann Plast Surg 2017;78:397-402.
    Pubmed CrossRef
  2. Handel N. Transumbilical breast augmentation. Clin Plast Surg 2009;36:63-74, vi.
    Pubmed CrossRef
  3. Tebbetts JB. Incision approaches. In: Tebbetts JB, editor. Augmentation mammaplasty. Edinburgh: Mosby, Elsevier; 2010. p. 219-30.
    CrossRef
  4. Graf RM, Bernardes A, Auersvald A, Damasio RC. Subfascial endoscopic transaxillary augmentation mammaplasty. Aesthetic Plast Surg 2000;24:216-20.
    Pubmed CrossRef
  5. Stoff-Khalili MA, Scholze R, Morgan WR, Metcalf JD. Subfascial periareolar augmentation mammaplasty. Plast Reconstr Surg 2004;114:1280-8; discussion 1289-91.
    Pubmed CrossRef
  6. Aygit AC, Basaran K, Mercan ES. Transaxillary totally subfascial breast augmentation with anatomical breast implants:review of 27 cases. Plast Reconstr Surg 2013;131:1149-56.
    Pubmed CrossRef
  7. Salgarello M, Visconti G, Barone-Adesi L. Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements. Plast Reconstr Surg 2010;126:1460-71.
    Pubmed CrossRef
  8. Tebbetts JB. Implant pocket locations. In: Tebbetts JB, editor. Augmentation mammaplasty. Edinburgh: Mosby, Elsevier;2010. p. 181-217.
    CrossRef
  9. Jinde L, Xiaoping C, Wanquan Z, Xia G, Ligang X. Can the pectoral fascia integrity be preserved during subfascial breast augmentation through the axillary approach? Aesthetic Plast Surg 2010;34:29-32.
    Pubmed CrossRef

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