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

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.