Muscle-Splitting, Subglandular, and Partial Submuscular Augmentation Mammoplasties: A 12-year Retrospective Analysis of 2026 Primary Cases
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Augmentation mammoplasty is a commonly performed procedure with a very high satisfaction rate. Various techniques have been described since the report of the first augmentation mammoplasty in 1963. Muscle-splitting augmentation mammoplasty, a technique first published in 2007, has been used by the author for primary and secondary augmentation mammoplasties and for mastopexy with augmentation.
A retrospective analysis of data prospectively collected using the Excel spreadsheet was performed. The patients were divided into three groups. The mammoplasty for group A used the subglandular pocket. In group B, the partial submuscular pocket was used for mammoplasties. Both of these groups had their mammoplasties performed between 1999 and 2005. Group C, the third group, included patients who had muscle-splitting mammoplasties between 2005 and 2011.
Group A involved 793 patients who had their augmentation mammoplasties in the subglandular pocket. Of these 793 patients, 751 had the same size implants and were included in the analysis. The mean age of the patients in group A was 30.9 ± 7.98 years (range 18–59 years), and their mean implant size was 317.5 cc ± 2.05 (range 200–555). In group A, 45.1 % (n = 339) of the patients were smokers, and 62.2 % (n = 467) had drains. The majority of the patients (78 %) had an overnight stay in the clinic. Hematoma was seen in 2.7 % (n = 20) of the group A patients. Revision was performed for 6 % (n = 45). Periprosthetic infection was seen in 0.4 % (n = 3) and minor wound healing problems in 1.3 % (n = 10). Group B comprised 110 patients who had mammoplasties performed in partial submuscular pockets. All the patients had the same size implants. The mean age of the group B patients was 33 ± 8.26 years (range 20–58 years), and their mean implant size was 300.6 cc ± 35.92 (range 205–395). Of these 110 patients, 51.8 % (n = 57) were smokers, and 94.5 % (n = 104) had drains. Hematoma was seen in 1.8 % (n = 2), and revision was performed for 7.3 % (n = 8) in the submuscular subgroup. Infection was seen in 3.6 % (n = 4) and minor wound healing problems in 4.5 % (n = 5). Group C consisted of 1,123 patients who had breast augmentation in the muscle-splitting biplane. Of these 1,123 patients, 914 had the same size implants. The mean age of the patients was 30.0 ± 8.78 years (range 18–67 years), and their mean implant size was 338.2 cc ± 58.01 (range 170–655). In group C, 33.6 % of the patients were smokers, and 8 % had drains. The majority of the patients (93.4 %) were treated as day cases. Hematoma was seen in 0.7 %, and 1.2 % of the patients had revision surgery. Infection was seen in 1.6 % (n = 15) and minor wound healing in 4 % (n = 45).
Muscle-splitting mammoplasty is a technique that can be performed as a day case without drains. The overall complications in the group were significantly lower than with the other two techniques performed by the author.
Level of Evidence IV
This journal requires that authors assign a 41 level of evidence to each article. For a full description of 42 these Evidence-Based Medicine ratings, please refer to the 43 Table of Contents or the online Instructions to Authors 44 http://www.springer.com/00266.
KeywordsDual-plane mammoplasty Muscle-splitting biplane mammoplasty Partial submuscular mammoplasty Subglandular mammoplasty
The author thanks Mr. E. A. Syed, MSc (Stats) of Pakistan Medical Research Council for help with the statistical analysis.
- 1.Cronin TD, Gerow RM (1964) Augmentation mammoplasty: new “natural feel” prosthesis. In: Translation of the third international congress of the plastic surgery, pp. 41–49. Excerpta medica international congress series, no. 66. Excerpta Medica, AmsterdamGoogle Scholar
- 8.Khan UD (2007) Muscle-splitting biplane breast augmentation. Aesthet Plast Surg 31:353–358Google Scholar
- 18.Khan UD (2012) High transverse capsuloplasty for the correction of malpositioned implants following augmentation mammoplasty in partial submuscular plane. Aesthet Plast Surg 36:590–599Google Scholar
- 19.Khan UD (2012) Secondary augmentation mammoplasties and periprosthetic infection. A three-year retrospective review of 92 secondary mammoplasties performed by a single surgeon. Aesthet Surg J 32:465–733Google Scholar
- 22.Berlanda M (2010) Muscle-splitting augmentation: personal experience with the new technique. In: Umar DK (ed) X Miedzynoraodowy Kongres Medycyny Estetycznej i Anti-Aging, 24–26 September 2010, WarsawGoogle Scholar
- 23.Berlanda M (2009) Mastoplastica additiva “Per separazione intramuscolare”: Esperienza personale con la nuova tecnica descritta da Umar Khan. Presented at the 11th international congress of aesthetic medicine society, 15–17 October 2009, MilanGoogle Scholar
- 24.Stodell M, McArthur G, James M (2010) Biplaner breast augmentation: a case series supporting its use and benefits. Presented at the annual meeting of the British association of aesthetic plastic surgeons (BAAPS), 22–24 September 2010, LondonGoogle Scholar
- 25.Aštrauskas T, Vikšraitis S, Maslauskas K, Kaikaris V (2009) Comparison of two methods of breast augmentation: muscle-splitting versus traditional subpectoral method. Presented at the 11th congress of ESPRAS, 26–27 September 2009, RhodesGoogle Scholar
- 30.Nahi et al (2011) A 15-year experience with primary breast augmentation. Plast Reconstr Surg 127:1301–1313Google Scholar
- 31.Handel N, Cordray T, Gutierrez J, Jensen JA (2006) A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg 117:757–767Google Scholar