Aesthetic Plastic Surgery

, Volume 17, Issue 3, pp 183–192 | Cite as

“No-Touch” submuscular saline breast augmentation technique

  • Richard A. Mladick


This article represents a retrospective view of the author's 17-year experience with 2863 saline implants in 1327 patients and details his “no-touch” technique. The experience included almost an equal number of submammary and subpectoral procedures. The submammary procedures were done early on and were replaced with subpectoral procedures, done exclusively at the present time. There were significantly less complications-capsules, wrinkling (visible folds), and deflations-with the subpectoral procedures. Followup is longer for submammary procedures which could be the reason for the slight difference in number of deflations. Analyzing the results from three different periods, during which the technique changed, the last period in which the no-touch subpectoral technique was used had markedly fewer complications. The no-touch technique, which had been introduced in orthopedic surgery over 50 years ago, was added to the augmentation procedure in an attempt to eliminate any possible contact with skin or breast bacteria. There were no infections in the entire series, and, during the no-touch period, capsules were almost eliminated (0.6%). Saline implants can achieve excellent results when placed subpectorally using the no-touch technique.

Key words

Breast augmentation “No-touch” submuscular technique Subpectoral technique advantages Submammary technique disadvantages 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bern S, Burd A, May JW: The biophysical and histologic properties of capsules formed by smooth and textured silicone implants in the rabbit. Plast Reconstr Surg89:1037–1042, 1992Google Scholar
  2. 2.
    Biggs TM, Yarish RS: Augmentation mammaplasty: retropectoral versus retromammary implantation. Clin Plast Surg15:549–555, 1988Google Scholar
  3. 3.
    Biggs TM, Yarish RS: Augmentation mammaplasty: a comparative analysis. Plast Reconstr Surg85:368–372, 1990Google Scholar
  4. 4.
    Burkhardt, BR: Capsular contracture: hard breasts, soft data. Clin Plast Surg15:521–532, 1988Google Scholar
  5. 5.
    Dershaw DD, Chlaglassian TA: Mammography after prosthesis placement for augmentation or reconstructive mammaplasty. Radiology170:69–74, 1989Google Scholar
  6. 6.
    Dubin D: Presented at Annual Meeting of Am Soc Aesth Plast Surg, Orlando, FL, USA, May 1980Google Scholar
  7. 7.
    Fairbank HAT: The non-touch technique. Br Med J2:238, 1942Google Scholar
  8. 8.
    Flowers R: Capsular contracture: prevention and cure (with attention to steroid related complications). In: Georgiode NG (ed): Aesthetic Breast Surgery. Baltimore: Williams & Wilkins Co., 1983, Vol 9, pp 95–109Google Scholar
  9. 9.
    Handel N, Silverstein MJ, Gamgami P, et al: Effect of augmentation mammaplasty on breast cancer diagnosis and prognosis. Presented at Annual Meeting of Am Soc Plast Reconstr Surg, Atlanta, GA, USA, November 11, 1987Google Scholar
  10. 10.
    Hayes H Jr, Vandergrift J, Dinner WC: Mammography and breast implants. Plast Reconstr Surg82:1–8, 1988Google Scholar
  11. 11.
    Puck CL, Croll GH, Reichel CA, et al: A critical look at capsular contracture in subglandular versus subpectoral mammary augmentation. Aesth Plast Surg11:23, 1987Google Scholar
  12. 12.
    Regnault P: Partially submuscular augmentation. Plast Reconstr Surg59:72, 1977Google Scholar
  13. 13.
    Robles J et al: A larger subpectoral implant for breast implants. Plast Reconstr Surg62:78, 1978Google Scholar
  14. 14.
    Sanger JR, Sheth NK, Franson TR: Adherence of microorganisms to breast prosthesis: an in vitro study. Ann Plast Surg22:337–342, 1989Google Scholar
  15. 15.
    Silverstein MJ, Handel N, Gamgami P, et al: Breast cancer in women after augmentation mammaplasty. Arch Surg123:681, 1988Google Scholar
  16. 16.
    Spear SL, Matsuba H, Romm S, Little JW: Methyl prednisolone in double lumen gel-saline submuscular mammary prosthesis: a double blind prospective controlled clinical trial. Plast Reconstr Surg,87:483–487, 1991Google Scholar
  17. 17.
    Vasquez B, Given KS, Houston GC: Breast augmentation: a review of subglandular and submuscular implantation. Aesth Plast Surg11:101–105, 1987Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1993

Authors and Affiliations

  • Richard A. Mladick
    • 1
  1. 1.Center for Cosmetic Plastic SurgeryVirginia BeachUSA

Personalised recommendations