Complete submuscular breast augmentation: 650 cases managed using an alternative surgical technique.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Aesthetic Surgery

Background:

• A novel complete submuscular surgical technique for primary breast augmentation is detailed.
• The procedure involves total submuscular placement of textured silicone gel implants, refined since 1998.
• Over 650 patients have undergone this procedure with positive outcomes.

Purpose of the Study:

• To present an alternative surgical method for primary breast augmentation.
• To describe the technique for complete submuscular implant placement.
• To evaluate the outcomes and patient satisfaction with this technique.

Main Methods:

• A semicircular periareolar incision is used to access the submuscular plane.
• Implants are positioned beneath the pectoralis major, external oblique muscles, rectus sheath, and serratus anterior fascia.
• This creates a complete separation of the implant from breast tissue.

Main Results:

• Early cases experienced high-riding implants due to inadequate pocket size.
• A low incidence of Baker II capsular fibrosis was noted; no Baker III or IV contractures occurred.
• No infections or "bottoming out" were reported, with minimal scarring, rippling, or implant visibility.

Conclusions:

• The technique offers advantages, especially for lean patients, as an alternative to subglandular/partial submuscular placement.
• It effectively addresses tuberous and ptotic breasts, with or without mastopexy.
• Successful correctional surgery outcomes were achieved for prior complications like capsular contracture and bottoming out.