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SMS—Split Muscle Support: A Reproducible Approach for Breast Implant Stabilization

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

Abstract

Background

Recent concerns regarding the association between macrotextured breast implants and anaplastic large cell lymphoma (ALCL) have led to renewed interest in the use of devices with less texturing. Smooth implants appear to have a decreased risk of ALCL; however, low implant adherence has led to questions about implant stabilization and bottoming-out. The senior author has used a split muscle support (SMS) technique to help support the implant infero-laterally in over 380 breast augmentations and augmentation–mastopexy using smooth implants, with a low complication and reoperation rate.

Methods

A retrospective chart review of 387 consecutive breast augmentation and augmentation–mastopexy patients operated on by the senior author over 24 months was performed. The SMS technique was classified in three grades according to amount of implant support by the pectoralis major muscle.

Results

Patients were followed for an average of 13 months. Major complications occurred in seven (1.9%) patients, of which five (1.4%) were considered implant-related. There were one case of implant rotation and three cases of malposition during the transition from microtexture to nanotexture implants and one case of capsular contracture in a previously irradiated breast. Three post-massive weight loss patients required reoperation for further skin adjustment, and one patient requested upsizing of her implants at 3 months.

Conclusions

The SMS technique is easily reproducible, adjustable intraoperatively according to patient characteristics, and helps stabilize breast implants. With increasing patient awareness regarding ALCL, the association of smooth implants along with the varying degrees of implant support afforded by SMS can help achieve a low complication and reoperation rate.

Level of Evidence IV

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.

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Funding

No funding from public, private or nonprofit organizations was received.

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Authors and Affiliations

  1. Plastic Surgery Division, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil

    Carlos Oscar Uebel

  2. Porto Alegre, RS, Brazil

    Márcio Hoffmann Rigo, Pedro Salomão Piccinini, Lucas Dal Pozzo Sartori & Carlos Oscar Uebel

  3. Santa Rosa, RS, Brazil

    Luís Antônio Rigo de Carvalho

  4. Hospital Mãe de Deus Center, Av. Soledade, 569 – Três Figueiras, Porto Alegre, RS, Brazil

    Márcio Hoffmann Rigo, Pedro Salomão Piccinini, Lucas Dal Pozzo Sartori, Luís Antônio Rigo de Carvalho & Carlos Oscar Uebel

Authors
  1. Márcio Hoffmann Rigo
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  2. Pedro Salomão Piccinini
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  3. Lucas Dal Pozzo Sartori
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  4. Luís Antônio Rigo de Carvalho
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  5. Carlos Oscar Uebel
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Corresponding author

Correspondence to Márcio Hoffmann Rigo.

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Conflict of interest

The senior author is a clinical instructor for Motiva Experts. The remaining authors declare no conflicts of interest in relation to the content of this manuscript.

Ethical Approval

The study was performed according to the Declaration of Helsinki for Research in Human Subjects and our institutional ethics standards.

Informed Consents

All patients signed informed consent for surgery, use of photographs and data for publication.

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Rigo, M.H., Piccinini, P.S., Sartori, L.D.P. et al. SMS—Split Muscle Support: A Reproducible Approach for Breast Implant Stabilization. Aesth Plast Surg 44, 698–705 (2020). https://doi.org/10.1007/s00266-019-01565-5

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  • DOI: https://doi.org/10.1007/s00266-019-01565-5

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