Skip to main content
Top
Published in: Aesthetic Plastic Surgery 1/2016

01-02-2016 | Original Article

New Design for Axillary Dual-Plane Endoscopic Breast Augmentation for Asians: the Feasibility of Two Types of Dual-Plane Implant Pockets in 70 Patients as Measured by the BREAST-Q

Authors: Haiqian Xu, Wenjie Li, Yida Chen, Yangdong Zhu, Lijun Hao

Published in: Aesthetic Plastic Surgery | Issue 1/2016

Login to get access

Abstract

Background

The design methods for dual-plane implant pockets for axillary endoscopic breast augmentation vary among different countries. We applied a modified approach for an Asian population.

Methods

Seventy patients with micromastia underwent our modified approach between 2011 and 2014. Breasts were divided into two types according to the soft-tissue pinch thickness of the lower pole: type I (thickness >2 cm; Group I) and type II (thickness ≤2 cm; Group II). The levels at which the pectoralis major (PM) was severed were 6–6.5 cm and 3–4 cm below the nipple for type I and II pockets, respectively. Then, dissection of the retromammary space was continued from the severance level downward to the new inframammary fold for type I pockets, whereas no dissection was made for type II pockets. All patients completed the pre- and post-operative BREAST-Q augmentation modules.

Results

During a mean follow-up of 10 months (range, 6–12 months), patients reported higher satisfaction with breasts after surgery than before surgery (satisfaction scores of 64.9 ± 5.6 vs. 14.7 ± 11.0). The mean satisfaction score for the overall outcome was 91.3 ± 17.3. However, there was no significant difference in physical well-being (87.1 ± 10.4 vs. 85.2 ± 11.7). No complications such as severe capsular contracture or displacement occurred.

Conclusion

Distinguishing the need for a type I or II dual-plane pocket can lead to good outcomes and optimal soft-tissue coverage. The higher satisfaction and quality of life reported by our patients indicate that our new design is feasible and safe for most Asians with a medium build.

Level of Evidence II

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.
Literature
1.
go back to reference Eaves FF 3rd, Bostwick J 3rd, Nahai F et al (1995) Endoscopic techniques in aesthetic breast surgery. Augmentation, mastectomy, biopsy, capsulotomy, capsulorrhaphy, reduction, mastopexy, and reconstructive techniques. Clin Plast Surg 22:683–695PubMed Eaves FF 3rd, Bostwick J 3rd, Nahai F et al (1995) Endoscopic techniques in aesthetic breast surgery. Augmentation, mastectomy, biopsy, capsulotomy, capsulorrhaphy, reduction, mastopexy, and reconstructive techniques. Clin Plast Surg 22:683–695PubMed
2.
go back to reference Avrahami R, Nudelman I, Watenberg S et al (1998) Minimally invasive surgery for axillary dissection. Cadaveric feasibility study. Surg Endosc 12:466–468CrossRefPubMed Avrahami R, Nudelman I, Watenberg S et al (1998) Minimally invasive surgery for axillary dissection. Cadaveric feasibility study. Surg Endosc 12:466–468CrossRefPubMed
3.
go back to reference Ho WS, Ying SY, Chan AC (2002) Endoscopic-assisted subcutaneous mastectomy and axillary dissection with immediate mammary prosthesis reconstruction for early breast cancer. Surg Endosc 16:302–306CrossRefPubMed Ho WS, Ying SY, Chan AC (2002) Endoscopic-assisted subcutaneous mastectomy and axillary dissection with immediate mammary prosthesis reconstruction for early breast cancer. Surg Endosc 16:302–306CrossRefPubMed
4.
go back to reference Tebbetts JB (2001) Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 107:1255–1272CrossRefPubMed Tebbetts JB (2001) Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 107:1255–1272CrossRefPubMed
5.
go back to reference Luan J, Mu D, Mu L (2009) Transaxillary dual-plane augmentation mammaplasty: experience with 98 breasts. J Plast Reconstr Aesthet Surg 62:1459–1463CrossRefPubMed Luan J, Mu D, Mu L (2009) Transaxillary dual-plane augmentation mammaplasty: experience with 98 breasts. J Plast Reconstr Aesthet Surg 62:1459–1463CrossRefPubMed
6.
go back to reference Lee SH, Yoon WJ (2014) Axillary endoscopic subglandular tunneling approach for types 2 and 3 dual-plane breast augmentation. Aesthet Plast Surg 38:521–527CrossRef Lee SH, Yoon WJ (2014) Axillary endoscopic subglandular tunneling approach for types 2 and 3 dual-plane breast augmentation. Aesthet Plast Surg 38:521–527CrossRef
7.
go back to reference Tebbetts JB (2006) Axillary endoscopic breast augmentation: processes derived from a 28-year experience to optimize outcomes. Plast Reconstr Surg 118:53s–80sCrossRefPubMed Tebbetts JB (2006) Axillary endoscopic breast augmentation: processes derived from a 28-year experience to optimize outcomes. Plast Reconstr Surg 118:53s–80sCrossRefPubMed
9.
go back to reference Xu HQ, Yu DM, Luo S (2014) Applied anatomic study of transaxillary dual-plane breast augmentation under endoscope. Chin J Aesthet Plast Surg 25:72–75 Xu HQ, Yu DM, Luo S (2014) Applied anatomic study of transaxillary dual-plane breast augmentation under endoscope. Chin J Aesthet Plast Surg 25:72–75
10.
go back to reference Hao LJ, Xu HQ, Zhu Y (2014) Analysis of transaxillary dual-plane augmentation under endoscope on 128 cases: how to get the doctorpatient satisfaction with clinical effectiveness. Chin J Aesthet Plast Surg 25:708–711 Hao LJ, Xu HQ, Zhu Y (2014) Analysis of transaxillary dual-plane augmentation under endoscope on 128 cases: how to get the doctorpatient satisfaction with clinical effectiveness. Chin J Aesthet Plast Surg 25:708–711
11.
go back to reference Hao LJ, Xu HQ (2012) Endoscopic transaxillary dual-plane breast augmentation using silicone gel implants: 58 cases report. Chin J Aesthet Plast Surg 23:712–715 Hao LJ, Xu HQ (2012) Endoscopic transaxillary dual-plane breast augmentation using silicone gel implants: 58 cases report. Chin J Aesthet Plast Surg 23:712–715
12.
go back to reference Tebbetts JB, Adams WP (2006) Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. Plast Reconstr Surg 118:35s–45sCrossRefPubMed Tebbetts JB, Adams WP (2006) Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. Plast Reconstr Surg 118:35s–45sCrossRefPubMed
13.
go back to reference Tebbetts JB, Adams WP (2005) Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. Plast Reconstr Surg 116:2005–2016PubMed Tebbetts JB, Adams WP (2005) Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. Plast Reconstr Surg 116:2005–2016PubMed
14.
go back to reference Tebbetts JB (2002) A system for breast implant selection based on patient tissue characteristics and implant-soft tissue dynamics. Plast Reconstr Surg 109:1396–1409 discussion 1410-1395 CrossRefPubMed Tebbetts JB (2002) A system for breast implant selection based on patient tissue characteristics and implant-soft tissue dynamics. Plast Reconstr Surg 109:1396–1409 discussion 1410-1395 CrossRefPubMed
15.
go back to reference Adams WP, Bengston BP, Glicksman CA et al (2004) Decision and management algorithms to address patient and food and drug administration concerns regarding breast augmentation and implants. Plast Reconstr Surg 114:1252–1257CrossRefPubMed Adams WP, Bengston BP, Glicksman CA et al (2004) Decision and management algorithms to address patient and food and drug administration concerns regarding breast augmentation and implants. Plast Reconstr Surg 114:1252–1257CrossRefPubMed
16.
go back to reference Largent JA, Reisman NR, Kaplan HM et al (2013) Clinical trial outcomes of high- and extra high-profile breast implants. Aesthet Surg J 33:529–539CrossRefPubMed Largent JA, Reisman NR, Kaplan HM et al (2013) Clinical trial outcomes of high- and extra high-profile breast implants. Aesthet Surg J 33:529–539CrossRefPubMed
17.
go back to reference Li J, Li Q, Gao Y et al (2014) Quailty of Iife questionnaire for women with breast surgery:evaluation of the Chinese version of BREAST-Q augmentation module. Chin J Medical Aesthet Cosmetic 20:413–415 Li J, Li Q, Gao Y et al (2014) Quailty of Iife questionnaire for women with breast surgery:evaluation of the Chinese version of BREAST-Q augmentation module. Chin J Medical Aesthet Cosmetic 20:413–415
18.
go back to reference Coriddi M, Angelos T, Nadeau M et al (2013) Analysis of satisfaction and well-being in the short follow-up from breast augmentation using the BREAST-Q, a validated survey instrument. Aesthet Surg J 33:245–251CrossRefPubMed Coriddi M, Angelos T, Nadeau M et al (2013) Analysis of satisfaction and well-being in the short follow-up from breast augmentation using the BREAST-Q, a validated survey instrument. Aesthet Surg J 33:245–251CrossRefPubMed
19.
go back to reference Alderman AK, Bauer J, Fardo D et al (2014) Understanding the effect of breast augmentation on quality of life: prospective analysis using the BREAST-Q. Plast Reconstr Surg 133:787–795PubMed Alderman AK, Bauer J, Fardo D et al (2014) Understanding the effect of breast augmentation on quality of life: prospective analysis using the BREAST-Q. Plast Reconstr Surg 133:787–795PubMed
22.
go back to reference Lang Stumpfle R, Figueras Pereira-Lima L, Alves Valiati A et al (2012) Transaxillary muscle-splitting breast augmentation: experience with 160 cases. Aesthet Plast Surg 36:343–348CrossRef Lang Stumpfle R, Figueras Pereira-Lima L, Alves Valiati A et al (2012) Transaxillary muscle-splitting breast augmentation: experience with 160 cases. Aesthet Plast Surg 36:343–348CrossRef
23.
go back to reference Spear SL, Carter ME, Ganz JC (2003) The correction of capsular contracture by conversion to “dual-plane” positioning: technique and outcomes. Plast Reconstr Surg 112:456–466CrossRefPubMed Spear SL, Carter ME, Ganz JC (2003) The correction of capsular contracture by conversion to “dual-plane” positioning: technique and outcomes. Plast Reconstr Surg 112:456–466CrossRefPubMed
24.
go back to reference Yu L, Wang J, Zhang B et al (2008) Endoscopic transaxillary capsular contracture treatment. Aesthet Plast Surg 32:329–332CrossRef Yu L, Wang J, Zhang B et al (2008) Endoscopic transaxillary capsular contracture treatment. Aesthet Plast Surg 32:329–332CrossRef
Metadata
Title
New Design for Axillary Dual-Plane Endoscopic Breast Augmentation for Asians: the Feasibility of Two Types of Dual-Plane Implant Pockets in 70 Patients as Measured by the BREAST-Q
Authors
Haiqian Xu
Wenjie Li
Yida Chen
Yangdong Zhu
Lijun Hao
Publication date
01-02-2016
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 1/2016
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-015-0591-8

Other articles of this Issue 1/2016

Aesthetic Plastic Surgery 1/2016 Go to the issue