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Annals of Plastic Surgery Mar 2021The rates of aesthetic breast augmentation have risen substantially in Asia. Outcomes of various breast augmentation approaches in Asia have not been comprehensively... (Review)
Review
BACKGROUND
The rates of aesthetic breast augmentation have risen substantially in Asia. Outcomes of various breast augmentation approaches in Asia have not been comprehensively studied. In the past, the inframammary approach to breast augmentation was not popular because of conspicuous scarring. In this article, the authors review academic articles related to the use of an inframammary incision for breast augmentation in Asian women and present our recommendations for the available techniques.
METHODS
A literature search was performed for articles published after 2015 on Asian women with augmentation mammoplasty describing techniques, incision sites, outcomes, and complications. The search was performed using the MEDLINE, Embase, and Cochrane databases. We also included our own technique to demonstrate the outcome of augmentation mammoplasty through inframammary incision.
RESULTS
Eight articles satisfied our inclusion criteria. Evidence indicates that with proper preoperative design and surgical techniques, scarring resulting from the inframammary approach is not inferior to that resulting from the transaxillary approach in Asian patients. Long-term satisfaction with the inframammary approach to breast augmentation is high in Asian patients.Eight articles reported the outcomes of 1168 women receiving breast augmentation. Inframammary incisions were used in 45.29% of patients (529 patients). After the 2015 publication of Zelken's review paper on Asian breast augmentation, the rate of inframammary incisions increased from 3.1% to 45.29%.
CONCLUSIONS
With precise design of the new inframammary fold, accurate wound suture fixation, and postoperative scar care, the inframammary approach to breast augmentation offers optimal operative visualization, reduced pain, fewer complications, and desirable esthetic outcomes even in Asian patients. This study demonstrates that the percentage of inframammary fold approach of Asian esthetic mammoplasty grows rapidly after 2015.
Topics: Asia; Breast Implantation; Cicatrix; Esthetics; Female; Humans; Mammaplasty
PubMed: 33346556
DOI: 10.1097/SAP.0000000000002616 -
Journal of Plastic, Reconstructive &... May 2021Breast prostheses could be associated with complications, despite many studies on surgical materials and techniques. The role of surgical drainage in preventing... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Breast prostheses could be associated with complications, despite many studies on surgical materials and techniques. The role of surgical drainage in preventing complications on breast prostheses surgery is controversial.
OBJECTIVES
This study aimed to evaluate the role and effectiveness of vacuum drainage in the augmentation mammoplasty.
METHODS
A prospective multicentric randomized comparative clinical trial was conducted with 150 patients, who were the candidates for breast augmentation. The candidates were split into two groups to analyze the breast drain role. Group1: closed-suction drainage; measurements were taken every 24 h for 48 h. Group2: control (no drainage); all the patients were submitted to a clinical and postoperative ultrasonography evaluation (7th day and 3rd month). The late consultations (1st-, 2nd-, and 3rd-year postoperative time) were carried out to identify any complication, such as infection, seroma, hematoma, asymmetry, hypertrophic scarring, rippling, implant position, visible edges, and sensibility alteration.
RESULTS
A total of 150 female patients were operated with 300 breast implants placed into subglandular pocket. In the first 24 h postoperative (D1), the drainage volume ranged from 12 ml to 210 ml (mean= 74.90 ml; SD= 43.29 ml). After 24 h, on the second day (D2), the collected volume ranged from 10 ml to 120 ml (mean= 44.76 ml; SD= 24.80 ml). The total drainage volume in the 48 h ranged from 22 ml to 320 ml (mean= 119.7 ml; SD= 62.20 ml). The breast ultrasonography series (BUSGS) analysis was done on the 7th day and 3rd month in both groups. There was no significant difference between G1 and G2 groups (p = 0.05 and 0.25, respectively). In the follow-up, some patients (33-44%) declared sensitivity disturbing on the nipple-areola complex (NAC) and lower breast segment.
CONCLUSIONS
The closed-suction breast drainage in breast augmentation was associated with high cost and time-consuming and not demonstrated any benefit in a recent postoperative time.
Topics: Adolescent; Adult; Brazil; Breast Implants; Drainage; Female; Humans; Mammaplasty; Middle Aged; Postoperative Complications; Prospective Studies; Ultrasonography, Mammary; Vacuum
PubMed: 33250388
DOI: 10.1016/j.bjps.2020.10.059 -
Aesthetic Surgery Journal May 2022External volume expander (EVE)-assisted autologous fat grafting is suitable for breast augmentation, but no large sample study in Asia has confirmed this method.
BACKGROUND
External volume expander (EVE)-assisted autologous fat grafting is suitable for breast augmentation, but no large sample study in Asia has confirmed this method.
OBJECTIVES
The authors reported their experience and outcomes in augmentation mammoplasty with EVE-assisted autologous fat grafting.
METHODS
A retrospective study was conducted in 305 female patients who underwent augmentation mammoplasty with EVE-assisted fat grafting between September 2012 and December 2020. Doctors utilized Crisalix (Crisalix S.A., Lausanne, Switzerland) for 3-dimensional (3D) imaging acquisition to measure the increase in breast volume to evaluate doctor satisfaction. The Preoperative Satisfaction with Breast and BREAST-Q questionnaires were employed to assess patients' preoperative and postoperative satisfaction, respectively.
RESULTS
The 305 female patients were aged 18 to 50 years (mean, 35.9 years). Among them, 68.52% were "very satisfied," 18.69% were "somewhat satisfied," 11.15% were "somewhat dissatisfied," and 1.64% were "very dissatisfied" based on BREAST-Q analysis, whereas 100% were dissatisfied according to the Preoperative Satisfaction with Breast questionnaire. Doctors employed Crisalix to measure the increase in breast volume to evaluate doctor satisfaction. The results showed 76.01% had an increase in breast volume of 150 to 250 mL or >250 mL and were "satisfied" and "very satisfied," respectively, 21.64% had an increase of 50 to 149 mL and were "somewhat satisfied," and 2.30% had an increase <50 mL and were "dissatisfied." There were no complications, such as obvious fat liquefaction, infection, or fat embolism.
CONCLUSIONS
Augmentation mammoplasty with EVE-assisted fat grafting is effective and satisfying in China. Crisalix for 3D imaging acquisition is convenient and effective in measuring breast volume.
Topics: Adipose Tissue; Breast; Female; Humans; Mammaplasty; Retrospective Studies; Transplantation, Autologous; Treatment Outcome
PubMed: 35182422
DOI: 10.1093/asj/sjac038 -
Health Care For Women International 1996Augmentation mammoplasty is a surgical procedure with known risks and complications. Despite this, millions of women have opted to undergo the procedure. With the recent... (Review)
Review
Augmentation mammoplasty is a surgical procedure with known risks and complications. Despite this, millions of women have opted to undergo the procedure. With the recent publicity surrounding this procedure, and the current concern about long-term side effects, the rationale behind women's choice has been questioned. Often, health care professionals are less than empathetic when a women complains about experiencing complications. This attitude seems to "blame the victim." We examine the complex psychological and sociological factors behind a woman's decision to have her breasts enlarged artificially. It is our hope that the information presented herein will contribute to a better understanding and more compassionate care of women who have breast augmentation surgery.
Topics: Attitude of Health Personnel; Beauty; Breast Implants; Choice Behavior; Cultural Characteristics; Empathy; Female; Humans; Mammaplasty; Self Concept; Women
PubMed: 8707700
DOI: 10.1080/07399339609516222 -
Aesthetic Plastic Surgery Dec 2020In this era of expanding life expectancy and popularity of aesthetic breast surgeries, more women are likely to live more years with their augmented breasts. Thus,...
BACKGROUND
In this era of expanding life expectancy and popularity of aesthetic breast surgeries, more women are likely to live more years with their augmented breasts. Thus, consistent attention to general breast health is crucial, and preoperative ultrasound is helpful to locate suspicious lesions. In this study, we present a combinative procedure of augmentation mammoplasty and vacuum-assisted breast biopsy (VABB).
METHODS
From January of 2018 to December of 2019, a total of 102 patients received simultaneous augmentation mammoplasty and VABB in our institute. Only patients of primary augmentation mammoplasty who received VABB on unilateral breasts were included. We sought to investigate the results of each breast and safety of adding VABB before performing augmentation within the same incision.
RESULTS
Among 204 breasts and implants, 28.43% were done via endoscopic transaxillary approach and 71.57% via inframammary approach. The mean implant volume was 329.34 ± 44.79 ml, and the mean follow-up period was 14.23 ± 4.64 months. All of the complication rates exhibited no statistically significant differences between the two groups.
CONCLUSION
Simultaneous augmentation mammoplasty and VABB prevented unnecessary scars and pain, and the complication rates did not statistically differ from those of augmentation only group. This co-operation is a safe and simple method potentially beneficial to many women interested in breast surgery.
LEVEL OF EVIDENCE III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Breast Implantation; Breast Implants; Breast Neoplasms; Esthetics; Female; Humans; Mammaplasty; Treatment Outcome
PubMed: 32671448
DOI: 10.1007/s00266-020-01858-0 -
Plastic and Reconstructive Surgery Jul 2016After studying this article, the participant should be able to: 1. Assess common clinical problems in the secondary breast augmentation patient. 2. Describe a treatment... (Review)
Review
LEARNING OBJECTIVES
After studying this article, the participant should be able to: 1. Assess common clinical problems in the secondary breast augmentation patient. 2. Describe a treatment plan to correct the most common complications of breast augmentation. 3. Provide surgical and nonsurgical options for managing complications of breast augmentation. 4. Decrease the incidence of future complications through accurate assessment, preoperative planning, and precise surgical technique.
SUMMARY
Breast augmentation has been increasing steadily in popularity over the past three decades. Many of these patients present with secondary problems or complications following their primary breast augmentation. Two of the most common complications are capsular contracture and implant malposition. Familiarity and comfort with the assessment and management of these complications is necessary for all plastic surgeons. An up-to-date understanding of current devices and techniques may decrease the need to manage future complications from the current cohort of breast augmentation patients.
Topics: Breast Implantation; Breast Neoplasms; Female; Humans; Implant Capsular Contracture; Mammaplasty; Reoperation
PubMed: 27348674
DOI: 10.1097/PRS.0000000000002280 -
Obstetrics and Gynecology Clinics of... Sep 1994Women seek reduction mammoplasty for alleviation of their symptoms of mammary hypertrophy, which may include upper back and neck pain, strain, or muscle spasm. Many of... (Review)
Review
Women seek reduction mammoplasty for alleviation of their symptoms of mammary hypertrophy, which may include upper back and neck pain, strain, or muscle spasm. Many of these women also desire an improvement in their appearance. Augmentation mammoplasty is sought by women for enlargement of the breasts and to attain a well-proportioned figure. Women who have experienced postpartum involution of the breasts request augmentation mammoplasty to regain the size and shape of their breasts prior to pregnancy. The historical background of these procedures, preoperative evaluation, and technical considerations are presented.
Topics: Adult; Aftercare; Breast; Breast Implants; Congenital Abnormalities; Female; Humans; Mammaplasty; Preoperative Care; Severity of Illness Index
PubMed: 7816412
DOI: No ID Found -
Aesthetic Surgery Journal Mar 2018The female breast loses superior fullness and becomes more ptotic over time. Women often present to their plastic surgeon requesting reversal of this evolution. While... (Comparative Study)
Comparative Study
BACKGROUND
The female breast loses superior fullness and becomes more ptotic over time. Women often present to their plastic surgeon requesting reversal of this evolution. While liposuction alone has been proven to lift the breast, no solution combining augmentation and liposuction has been reported.
OBJECTIVES
Herein, we introduce a technique called liposuction-augmentation mammaplasty (LAM) that can achieve "scarless" lifting or simply volume equalization prior to inserting same-sized implants. We then compare its safety and efficacy to two gold-standard techniques with similar aims, mastopexy-augmentation mammaplasty (MAM) and reduction-augmentation mammaplasty (RAM).
METHODS
A retrospective 3-year chart review was conducted on 359 patients (652 breasts) undergoing LAM (n = 125), MAM (n = 188), and RAM (n = 46). Patient demographics, operative details, and revisions were documented. Degree of lift was measured on pre- and postoperative photographs using sternal notch-to-nipple distances (SN-N). Statistical differences were assessed between the groups.
RESULTS
The LAM group's mean age and OR time (37 years, 46 minutes) were significantly lower than those of MAM (43 years, 90 minutes) and RAM (42 years, 106 minutes). Mean BMIs and revision rates were uniform between the LAM and MAM groups (24, 2.5%), but significantly higher for RAM (28, 4.6%). Aspirate volumes and resection weights averaged 151 cc and 307 g (left breast) and 173 cc and 298 g (right breast). Minimum follow up was 12 months. The LAM group's mean SN-N reduction (~6%) was statistically significant, albeit much lower than MAM (~16%) and RAM (~22%).
CONCLUSIONS
LAM is a safe, facile, reliable solution for the ptotic, fatty breast. Patients can direct their volumetric outcome and enjoy lower costs and shorter downtime.
Topics: Adult; Aged; Breast Implants; Female; Follow-Up Studies; Humans; Lipectomy; Mammaplasty; Middle Aged; Operative Time; Patient Satisfaction; Patient Selection; Postoperative Complications; Reproducibility of Results; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 29045533
DOI: 10.1093/asj/sjx174 -
Journal of the American Academy of... Jul 2001To inform primary care nurse practitioners (NPs) of the risks and possible complications of augmentation mammoplasty and suggest guidelines for counseling and monitoring... (Review)
Review
PURPOSE
To inform primary care nurse practitioners (NPs) of the risks and possible complications of augmentation mammoplasty and suggest guidelines for counseling and monitoring women who have undergone this procedure.
DATA SOURCES
Selected research and clinical articles, government documents, and the author's experience.
CONCLUSIONS
Because so many women have had breast augmentation mammoplasty, it is inevitable that NPs will see patients in the primary care settings who have complications related to the procedure or the type of implant. The most common complications include (a) changes in breast sensation, (b) capsular contracture, (c) calcifications, (d) mammography distortion or inaccuracies, (e) gel-bleed, (f) implant rupture or leakage, and (g) possible systemic reactions involving the immune system.
IMPLICATIONS FOR PRACTICE
In addition to providing support and high quality preventive care, NPs may need to take on the task of coordinating other specialities and services when treating complications or when screening for breast cancer or implant rupture.
Topics: Breast Implants; Female; Humans; Mammaplasty; Nurse Practitioners; Postoperative Complications; Primary Health Care; Prosthesis Failure
PubMed: 11930603
DOI: 10.1111/j.1745-7599.2001.tb00040.x -
Plastic and Reconstructive Surgery Oct 2012After reading this article, the participant should be able to: 1. Cite the key concepts in the process of breast augmentation that optimize outcomes; 2. Cite key... (Review)
Review
LEARNING OBJECTIVES
After reading this article, the participant should be able to: 1. Cite the key concepts in the process of breast augmentation that optimize outcomes; 2. Cite key components of tissue-based planning for implant selection; 3. Discuss complications and risks of breast augmentation.
SUMMARY
Breast augmentation remains one of the top surgical procedures performed by plastic surgeons. Current literature supports the concept that breast augmentation outcomes are optimized using a concept of "the process of breast augmentation." Breast augmentation is often thought of as a surgical procedure; however, the nonsurgical aspects of the procedure are more important for optimizing outcomes and minimizing reoperation and complications. The process of breast augmentation includes patient education, tissue-based preoperative planning, refined surgical technique, and defined postoperative management. This CME article reviews and discusses the current relevant topics and issues surrounding breast implants. There are also supporting videos to enhance the reader's experience. CME questions are present at the end for a self-assessment.
Topics: Adult; Body Image; Breast Implantation; Breast Implants; Esthetics; Female; Follow-Up Studies; Humans; Mammaplasty; Middle Aged; Patient Education as Topic; Postoperative Complications; Reoperation; Risk Assessment; Treatment Outcome; Wound Healing; Young Adult
PubMed: 23018721
DOI: 10.1097/PRS.0b013e318262f607