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Breast Augmentation with Inferior Muscular Support: The Indication, Technique Evolution, and Outcomes.

Jiangmiao Xie1, Runqing Su2, Qiuyun Liu1

  • 1Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongcheng District, Beijing, 100730, P.R. China.

Aesthetic Plastic Surgery
|November 21, 2025
PubMed
Summary
This summary is machine-generated.

Smooth breast implants offer lower risks but face stability issues. New surgical techniques, categorized as mono-muscular flap and bi-muscular flap, enhance lower-pole support to improve implant stability and coverage.

Keywords:
Breast augmentationBreast augmentation mastopexyBreast implant supportComplications of breast implantationImplant malpositionTechnique evolution

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Area of Science:

  • Plastic Surgery
  • Breast Augmentation Techniques

Background:

  • Smooth breast implants have reduced risks of rupture and Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
  • However, smooth implants present challenges in preventing displacement and bottoming out, necessitating improved lower-pole support for stability.

Purpose of the Study:

  • To redefine and categorize surgical techniques that enhance lower-pole support for smooth breast implants.
  • To review advancements in breast augmentation focusing on implant coverage and stability.

Main Methods:

  • Review of surgical techniques involving manipulation of the pectoralis major (PM), serratus anterior (SAM), and external abdominal oblique muscles (EOAM) and their fascia.
  • Categorization of these techniques into mono-muscular flap (MMF) and bi-muscular flap (BMF) approaches.

Main Results:

  • Surgical techniques creating muscle-fascia pockets improve implant coverage and stability.
  • These approaches, particularly those with lower-pole support, are beneficial for patients at high risk of displacement or ptosis, and for revision surgeries.

Conclusions:

  • Advancements in breast augmentation emphasize both implant coverage and stability.
  • Further refinement of techniques balancing muscle support and release is crucial for optimizing outcomes in smooth breast implant surgery.