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Inframammary Approach to Subglandular Breast Augmentation

  • Anthony Erian
  • Amal Dass

Abstract

Breast augmentation via a subglandular approach is, at least in theory, an anatomically correct approach; that is, we seek augmentation of the breasts and not the pectoral muscles. The ideal breast has a teardrop shape, a well-defined inframammary fold, good volume, and adequate projection. With subpectoral augmentation, the breast assumes a hemispherical shape, especially when viewed laterally, due to pectoral muscle cover and compression of the implant by it. This fullness of the superior pole is also contributed to by contraction of the muscle, which has a tendency to push the implant upward. The inframammary approach also gives better control over the inframammary fold, which may need to be lowered with inferior quadrant hypomastia. It also permits complete visualization of the pocket, enabling an easier dissection. The scar can fashioned such that it is hidden by the lower pole of the augmented breast.

Keywords

Breast Augmentation Breast Implant Capsular Contracture Silicone Implant Inframammary Fold 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Society of Plastic Surgeons: 2005 quick facts, cosmetic and plastic surgery trends. American Society of Plastic Surgeons, 2006Google Scholar
  2. British Association of Aesthetic Plastic Surgeons: Over 22,000 surgical procedures in the UK in 2005. British Association of Aesthetic Plastic Surgeons, 2006Google Scholar
  3. Ellenbogen R, Ellenbogen R, Rubin L: Injectable fluid silicone therapy. JAMA 1975;234(3):308–309PubMedCrossRefGoogle Scholar
  4. Gonzales-Ulloa M: Correction of hypotrophy of the breast by means of exogenous material. Plast Reconstr Surg 1965;25:15CrossRefGoogle Scholar
  5. Conway H, Smith J Jr: Breast plastic surgery: reduction mammaplasty, mastopexy, augmentation mammaplasty and mammary construction; analysis of two hundred forty-five cases. Plast Reconstr Surg 1958;21(1):8–19CrossRefGoogle Scholar
  6. Cronin T, Gerow F: Augmentation Mammaplasty; a new natural feel prosthesis. Transactions of the Third International Congress of Plastic Surgery. Amsterdam, Excerpta Medica Foundation 1964, p 41Google Scholar
  7. Beale S, Lisper H, Palm B: A psychological study of patients seeking augmentation mammaplasty. Br J Psych 1980;136:133CrossRefGoogle Scholar
  8. Sarwer DB, LaRossa D, Bartlett SP, Low DW, Bucky LP, Whitaker LA: Body image concerns of breast augmentation patients. Plast Reconstr Surg 2003 Jul;112(1):83–90PubMedCrossRefGoogle Scholar
  9. Park AJ, Chetty U, Watson AC: Patient satisfaction after insertion of silicone breast implants. Br J Plast Surg 1996;49(8):515–518PubMedCrossRefGoogle Scholar
  10. Hudson DA: Submuscle saline breast augmentation: are we making sense in the new millennium? Aesthet Plast Surg 2002;26(4):287–290CrossRefGoogle Scholar
  11. Biggs TM, Yarish RS: Augmentation mammaplasty: retropectoral versus retromammary implantation. Clin Plast Surg 1988;15(4):549–555PubMedGoogle Scholar
  12. Burkhardt BR: Capsular contracture: hard breasts, soft data. Clin Plast Surg 1988;15(4):521–532PubMedGoogle Scholar
  13. Hidalgo DA: Breast augmentation: choosing the optimal incision, implant, and pocket plane. Plast Reconstr Surg 2000;105(6):2202–2216; discussion 2217–2218PubMedCrossRefGoogle Scholar
  14. Feng LJ, Amini SB: Analysis of risk factors associated with rupture of silicone breast implants. Plast Reconstr Surg 1999;104(4):955–963PubMedCrossRefGoogle Scholar
  15. Maxwell PG, Hartley WR: Breast augmentation. In: Mathes SJ (ed). Plastic Surgery, 2nd edn. Philadelphia, Elsevier Saunders 2006, pp 1–33Google Scholar
  16. Spear SL, Elmaraghy M, Hess C: Textured-surface saline-filled silicone breast implants for augmentation mammaplasty. Plast Reconstr Surg. 2000;105(4):1542–1552 discussion 1553–1554PubMedCrossRefGoogle Scholar
  17. Burkhardt BR, Dempsey PD, Schnur PL, Tofield JJ: Capsular contracture: a prospective study of the effect of local antibacterial agents. Plast Reconstr Surg 1986;77(6):919–932PubMedGoogle Scholar
  18. Puckett CL, Croll GH, Reichel CA, Concannon MJ: A critical look at capsule contracture in subglandular versus subpectoral mammary augmentation. Aesthetic Plast Surg 1987;11(1):23–28PubMedCrossRefGoogle Scholar
  19. Gylbert L, Asplund O, Jurell G: Capsular contracture after breast reconstruction with silicone-gel and saline-filled implants: a 6-year follow-up. Plast Reconstr Surg 1990;85(3):373–377PubMedCrossRefGoogle Scholar
  20. Gutowski KA, Mesna GT, Cunningham BL: Saline-filled breast implants: a Plastic Surgery Educational Foundation multicenter outcomes study. Plast Reconstr Surg 1997;100(4):1019–1027PubMedGoogle Scholar
  21. Cederna JP: Valve design as a cause of saline-filled implant deflation. Plast Reconstr Surg 2002;109(6):2166PubMedCrossRefGoogle Scholar
  22. Hester TR Jr, Tebbetts JB, Maxwell GP: The polyurethane-covered mammary prosthesis: facts and fiction (II): a look back and a “peek” ahead. Clin Plast Surg 2001;28(3):579–586PubMedGoogle Scholar
  23. Collis N, Coleman D, Foo IT, Sharpe DT: Ten-year review of a prospective randomized controlled trial of textured versus smooth subglandular silicone gel breast implants. Plast Reconstr Surg 2000;106(4):786–791PubMedCrossRefGoogle Scholar
  24. Muntan CD, Sundine M, Rink RD, Acland RD: Inframammary fold: a histologic reappraisal. Plast Reconstr Surg 2000;105(2):549–556 discussion 557PubMedCrossRefGoogle Scholar
  25. Caffee HH: Textured silicone and capsule contracture. Ann Plast Surg 1990;24(3):197–199PubMedCrossRefGoogle Scholar
  26. Gherardini G, Zaccheddu R, Basoccu G: Trilucent breast implants: voluntary removal following the Medical Device Agency recommendation. Report on 115 consecutive patients. Plast Reconstr Surg 2004;113(3):1024–1027PubMedCrossRefGoogle Scholar
  27. MHRA UK: Medical Device Alert DA 2000(07) Breast Implants—PIP Hydrogel, December 2000Google Scholar
  28. Kessler DA: The basis of the FDA’s decision on breast implants. N Engl J Med 1992;326(25):1713–1715PubMedGoogle Scholar
  29. Tinkler JJB, Campbell HJ, Senior JM, Ludgate SM: Evidence for an association between the implantation of silicones and connective tissue disease. MDD Report MDD/92/42. London, UK Department of Health 1993Google Scholar
  30. Report of the Independent Review Group Silicone Gel Breast Implants, July 1998:25–26Google Scholar
  31. Baker JL: Augmentation mammaplasty: general considerations. In: Spear SL (ed). Breast Principles and Art. Philadelphia, Lippincott Raven 1998Google Scholar
  32. Tebbetts JB: Transaxillary subpectoral augmentation mammaplasty: long-term follow-up and refinements. Plast Reconstr Surg 1984;74(5):636–649PubMedCrossRefGoogle Scholar
  33. Tebbetts JB: A surgical perspective from two decades of breast augmentation: toward state of the art in 2001. Clin Plast Surg. 2001;28(3):425–434PubMedGoogle Scholar
  34. Ahn CY, DeBruhl ND, Gorcyzca DP, Shaw WW, Bassett LW: Comparative silicone breast implant evaluation using mammography, sonography, and magnetic resonance imaging: experience with 59 implants. Plast Reconstr Surg 1994;94(5):620–627PubMedCrossRefGoogle Scholar
  35. Gorney M: Preventing litigation in breast augmentation. Clin Plast Surg 2001;28(3):607–615PubMedGoogle Scholar
  36. Tebbetts JB: Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 2001;107(5):1255–1272PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Anthony Erian
    • 1
  • Amal Dass
    • 2
  1. 1.CambridgeUK
  2. 2.Fellow in Cosmetic SurgerySingaporeSingapore

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