Skip to main content

Advertisement

Log in

Scar Assessment After Breast Augmentation Surgery with Axillary Incision versus Inframammary Fold Incision: Long-Term Follow-Up in Chinese Patients

  • Original Article
  • Breast
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

The inframammary fold (IMF) incision is widely used in Western countries for breast augmentation surgery, whereas the axillary incision is the dominant approach used in China, because many Chinese surgeons believe that the Asian population has a higher risk of developing hypertrophic scars. However, comparative data of scar assessment through different incisions in Chinese patients are scarce. The aims of the study were as follows: (1) to evaluate the outcomes of scar assessment using the Vancouver scar scale (VSS), combined with patient satisfaction scoring, in the scar assessment after breast augmentation surgery; (2) to compare the long-term cosmetic effects of surgical scars between axillary and IMF incisions.

Methods

Consecutive patients coming to our department for follow-up care at least 1 year after primary breast augmentation surgeries with axillary and IMF incisions between January 1, 2014 and December 31, 2014 were included in the research. Internal consistency, inter-rater reliability, and convergent validity were examined for the VSS and patient satisfaction scoring. The baseline characteristics and scar scores were tested using the Mann–Whitney U-test and Student’s t test between the two groups.

Results

Sixty-one patients underwent implantation surgeries through the axillary incisions, and 17 patients through the IMF incisions. There were no significant differences in age, follow-up time, body mass index, implant volume, or implant projection between groups. Reliability and validity of the VSS and patient satisfaction scoring were satisfactory. The scores of pigmentation were higher in the IMF group than those in the axilla group with statistical significance (P < 0.05). The scores of other subscales, overall VSS scores, and patient satisfaction were not statistically significant. The scars were significantly longer in the axilla group compared with the IMF group (P < 0.05).

Conclusions

The VSS combined with patient satisfaction scoring constitutes an effective tool to evaluate incision scars after augmentation mammaplasty. Scars in the axilla and IMF can achieve comparable cosmetic effects and patient satisfaction in Chinese women. Chinese patients with proper indications can receive breast augmentation surgery through the IMF incision, with fewer risks and less trauma, and get satisfactory scar appearance as through the axillary incision.

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Tebbetts JB (2010) Augmentation mammaplasty: redefining the patient and surgeon experience. MOSBY ELSEVIER, Amsterdam

    Google Scholar 

  2. Spear SL, Bulan EJ, Venturi ML (2006) Breast augmentation. Plas Reconstr Surg. 118:188S–196S

    Article  CAS  Google Scholar 

  3. Hidalgo DA (2000) Breast augmentation: choosing the optimal incision, implant, and pocket plane. Plast Reconstr Surg. 105:2202–2216 (discussion 2217–2208)

    Article  CAS  PubMed  Google Scholar 

  4. Reece EM, Ghavami A, Hoxworth RE, Alvarez SA, Hatef DA, Brown S, Rohrich RJ (2009) Primary breast augmentation today: a survey of current breast augmentation practice patterns. Aesthet Surg J 29:116–121

    Article  PubMed  Google Scholar 

  5. Sevin A, Sevin K, Senen D, Deren O, Adanali G, Erdogan B (2006) Augmentation mammaplasty: retrospective analysis of 210 cases. Aesthet Plast Surg 30:651–654

    Article  Google Scholar 

  6. Chinese Society of Plastic Surgery (2013) Guidelines for breast augmentation with silicone implants. Zhonghua Zheng Xing Wai Ke Za Zhi 29:1–4

    Google Scholar 

  7. Cheng MH, Huang JJ (2009) Augmentation mammaplasty in asian women. Semin Plast Surg. 23:48–54

    Article  PubMed  PubMed Central  Google Scholar 

  8. Visscher MO, Bailey JK, Hom DB (2014) Scar treatment variations by skin type. Facial Plas Surg Clin N Am. 22:453–462

    Article  Google Scholar 

  9. Atiyeh BS (2007) Nonsurgical management of hypertrophic scars: evidence-based therapies, standard practices, and emerging methods. Aesthet Plast Surg. 31:468–492 (discussion 493–464)

    Article  Google Scholar 

  10. Truong PT, Abnousi F, Yong CM, Hayashi A, Runkel JA, Phillips T, Olivotto IA (2005) Standardized assessment of breast cancer surgical scars integrating the vancouver scar scale, short-form mcgill pain questionnaire, and patients’ perspectives. Plast Reconstr Surg 116:1291–1299

    Article  CAS  PubMed  Google Scholar 

  11. Vercelli S, Ferriero G, Sartorio F, Stissi V, Franchignoni F (2009) How to assess postsurgical scars: a review of outcome measures. Disabil Rehabil 31:2055–2063

    Article  PubMed  Google Scholar 

  12. Sullivan T, Smith J, Kermode J, McIver E, Courtemanche DJ (1990) Rating the burn scar. J Burn Care Rehabil 11:256–260

    Article  CAS  PubMed  Google Scholar 

  13. Sun J, Liu C, Mu D, Wang K, Zhu S, He Y, Luan J (2015) Chinese women’s preferences and concerns regarding incision location for breast augmentation surgery: a survey of 216 patients. Aesthet Plast Surg 39:214–226

    Article  Google Scholar 

  14. Luan J, Mu D, Mu L (2009) Transaxillary dual-plane augmentation mammaplasty: experience with 98 breasts. J Plast Reconstr Aesthet Surg 62:1459–1463

    Article  PubMed  Google Scholar 

  15. van de Kar AL, Corion LUM, Smeulders MJC, Draaijers LJ, van der Horst CMAM, van Zuijlen PPM (2005) Reliable and feasible evaluation of linear scars by the patient and observer scar assessment scale. Plast Reconstr Surg 116:514–522

    Article  PubMed  Google Scholar 

  16. Carmines EG, Zeller RA (1994) Reliability and validity assessment. Sage Publications, Newbury Park, pp 20–27

    Google Scholar 

  17. Bland JM, Altman DG (1997) Statistics notes: cronbach’s alpha. BMJ 314:572

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  19. Alpert BS, Lalonde DH (2008) MOC-PS(SM) CME article: breast augmentation. Plast Reconstr Surg 121:1–7

    Article  PubMed  Google Scholar 

  20. Haibing Liu, Dan Tang, Haiyan Cao et al (2006) Reliability of Vancouver scar scale. Chin J Rehabil Med 21(3):240–242

    Google Scholar 

  21. Celik M, Tuncer S, Eryilmaz E (2003) Running W incision in open rhinoplasty: better scar quality. Aesthet Plast Surg 27:388–389

    Article  Google Scholar 

  22. Blount AL, Martin MD, Lineberry KD, Kettaneh N, Alfonso DR (2013) Capsular contracture rate in a low-risk population after primary augmentation mammaplasty. Aesthet Surg J. 33:516–521

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jie Luan.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sun, J., Mu, D., Liu, C. et al. Scar Assessment After Breast Augmentation Surgery with Axillary Incision versus Inframammary Fold Incision: Long-Term Follow-Up in Chinese Patients. Aesth Plast Surg 40, 699–706 (2016). https://doi.org/10.1007/s00266-016-0671-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-016-0671-4

Keywords

Navigation