Abstract
Background
Breast augmentation usually is performed in subglandular, subfascial, or partial submuscular pockets, including the dual plane. A new pocket has been described and used by the author. The initial pocket was made in the subglandular plane up to the lower level of the nipple–areolar complex, and the submuscular plane was reached by splitting the pectoralis major muscle without its release from the costal margin. The implant lies in this plane simultaneously behind and in front of the pectoralis.
Methods
From October 2005 to November 2006, 125 patients underwent bilateral breast augmentation using the new technique. Soft cohesive gel microtextured round implants ranging in size from 230 to 440 ml were used.
Results
All the patients experienced a quick recovery with three-dimensional enhancement and having the benefits of both subglandular and submuscular planes. No rippling, lateral displacement, double-bubble deformity, or muscle contraction–associated deformities were seen. All the patients had aesthetically natural cleavage, with the nipple at the most projected part of the breast. Postoperative analgesia requirements were reduced because of dissection in natural planes.
Conclusion
For adequate cover of the prosthesis, only the upper part of the pectoralis major muscle is required. This can be achieved by using the pectoralis muscle-splitting technique. The pectoralis major was split in the direction of its fibers, avoiding extensive muscle release. Surgical morbidity was reduced, resulting in a quick postoperative recovery and a more natural three-dimensional appearance of the breast.
Similar content being viewed by others
References
Biggs TM, Cukier JM, Worthing LF: Augmentation mammoplasty: A review of 18 years. Plast Reconstr Surg 69:445, 1982
Biggs TM, Yarish RS: Augmentation mammoplasty: A comparative analysis. Plast Reconstr Surg 85:368, 1990
Cronin TD, Gerow RM: Augmentation mammoplasty: New “natural feel” prosthesis. In the translation of the Third International Congress of the Plastic Surgery. Excerpta Medica International Congress Series, no. 66. Excerpta Medica, Amsterdam, pp. 41–49 1964
Dempsey WC, Latham WD: Subpectoral implants in augmentation mammoplasty: A preliminary report. Plast Reconstr Surg 42:515, 1968
Ganong WF: Review of medical physiology. 13th ed. Appleton & Lange, San Mateo, California, 1987
Graf RM, Bernardes A, Rippel R, Araujo LRR, Damasio RCC, Auersvald A: Subfascial breast implant: A new procedure. Plast Reconstr Surg 111:904, 2003
Keramidas E, Rodopoulou S, Khan UD: The ballooning manoeuvre in breast augmentation. Plast Reconstr Surg 115:1795, 2005
Khan UD: Lower pole enhancement in breast augmentation. 6th Croatian Congress of Plastic, Reconstructive, and Aesthetic Surgery, Optija–Rijeka, Croatia, 6–11 October, 2006
Mathes SJ, Nahai F: Classification of the vascular anatomy of muscles: Experimental and clinical correlation. Plast Reconstr Surg 67:177, 1981
Regnault P: Partially submuscular breast augmentation. Plast Reconstr Surg 59:72, 1977
Strasser EJ: Results of subglandular versus subpectoral augmentation over time: One surgeon’s observations. Aesth Surg J 26:45–50, 2006
Tebbetts JB: Dual-plane breast augmentation: Optimizing implant–soft tissue relationship in a wide range of breast types. Plast Reconstr Surg 107:1255, 2001
Acknowledgment
The author extends a big word of thanks to Thomas M. Biggs for his encouragement in the compilation of this article.
Author information
Authors and Affiliations
Corresponding author
Additional information
Oral presentation at the 6th Croatian Congress of Plastic, Reconstructive, and Aesthetic Surgery, Optija–Rijeka, Croatia, 6–11 October 2006
Rights and permissions
About this article
Cite this article
Khan, U.D. Muscle-Splitting Breast Augmentation: A New Pocket in a Different Plane. Aesth Plast Surg 31, 553–558 (2007). https://doi.org/10.1007/s00266-006-0242-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-006-0242-1