Breast augmentation: Part III--preoperative considerations and planning

Area of Science:

• Plastic Surgery
• Biomaterials Science

Background:

• Silicone mammary prostheses have evolved significantly over 40 years, improving quality and durability.
• Understanding of adverse capsular contracture (ACC) has advanced, highlighting surgical technique's importance.

Purpose of the Study:

• To review key elements for achieving optimal primary breast augmentation (BA) results.
• To provide a rational basis for selecting BA options tailored to patients and tissue characteristics.
• To address pertinent medico-legal issues in BA.

Main Methods:

• Review of advancements in silicone mammary prostheses and ACC prevention.
• Analysis of the paradigm shift in BA approaches from volumetric to tissue-based.
• Consideration of surgical technique as the primary determinant of outcomes.

Main Results:

• Surgical technique is now the most critical factor for immediate and long-term BA outcomes.
• A shift towards a tissue-based approach offers a more tailored strategy.
• High-quality, stable long-term results are now the standard expectation.

Conclusions:

• Optimal primary breast augmentation requires a thorough understanding of available options.
• Patient and tissue characteristics, alongside medico-legal considerations, are vital for treatment selection.
• Evolution in BA philosophies provides surgeons with diverse choices for improved patient outcomes.