Suprapubic Breast Augmentation (SUBA): A Cadaveric Study For a New Anatomic Approach

Area of Science:

• Plastic Surgery
• Minimally Invasive Surgery
• Surgical Anatomy

Background:

• Breast augmentation is frequently combined with abdominal wall repairs.
• Traditional breast augmentation incisions have limitations.
• A suprapubic approach, inspired by laparoscopy, offers a novel alternative for reduced scarring and combined procedures.

Purpose of the Study:

• To evaluate the anatomical feasibility of a suprapubic approach for breast augmentation.
• To assess the potential for concurrent abdominal procedures via a single suprapubic incision.
• To determine operative times and technical challenges associated with this novel technique.

Main Methods:

• A cadaveric feasibility study was performed on two embalmed female specimens.
• A 3 cm suprapubic incision was utilized, with subcutaneous tunneling to access retroglandular and retromuscular spaces.
• Laparoscopic guidance was employed for dissection and implant placement, with evaluation of feasibility, techniques, and operative times.

Main Results:

• The suprapubic breast augmentation was successfully completed in both cadavers without major complications.
• Mean operative times for different dissection phases ranged from 15 to 36 minutes.
• Retromuscular dissection presented challenges but did not significantly increase operative time; implant stability was satisfactory.

Conclusions:

• The suprapubic approach is anatomically feasible for breast augmentation, offering potential aesthetic and reconstructive benefits.
• This technique allows simultaneous abdominal repairs (e.g., rectus diastasis) and breast augmentation through a single incision, minimizing scarring.
• Further refinement and studies on long-term outcomes are necessary before widespread clinical adoption, as advanced laparoscopic skills are required.