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Plast Reconstr Surg 2022 Feb;149(2):209e-215e

From private practice.

Background: Because of the multiplying number of patients undergoing breast augmentation, nonprimary augmentation mastopexy will be increasingly requested in the future; this operation represents an even more significant challenge than primary augmentation mastopexy. The authors describe a standardized approach for subglandular-to-subpectoral implant pocket conversion in mastopexy that provides a tight neopocket with inferolateral muscular support, which minimizes implant displacement complications and allows operative strategies to reduce the risk of bacterial load on implants.

Methods: The authors' technique proposes the following: (1) modified subpectoral pocket, with muscular inferolateral support for the implant; (2) independent approaches to the submuscular pocket and subglandular (preexisting) pocket; and (3) preestablished four-step surgical sequence. Read More

Aesthetic Plast Surg 2022 Jan 24. Epub 2022 Jan 24.

Anaesthetic and Pain Medicine Department, Royal Perth Hospital, Perth, Australia.

Background: Breast augmentation is the most common cosmetic, surgical procedure (1). Implant insertion planes include subglandular or submuscular. Submuscular augmentation is often preferred in women with less soft tissue coverage; requiring pectoralis major dissection (2). Read More

JPRAS Open 2021 Dec 5;30:146-152. Epub 2021 Sep 5.

Canniesburn Plastic Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK, G4 0SF.

Background: Abdominoplasty and breast augmentation are two of the most commonly performed aesthetic procedures in the UK. When performed as a combined procedure, separate inframammary and abdominoplasty incisions are most frequently used. Transabdominoplasty breast augmentation, performed via a single abdominoplasty incision is also described. Read More

Aesthetic Plast Surg 2022 Apr 22;46(2):686-693. Epub 2021 Oct 22.

Plastic and Reconstructive Surgery Department, Ahmed Maher Teaching Hospitals, Cairo, Egypt.

Background: Revision augmentation-mastopexy is a complex procedure that aims to correct the complications of a previous surgery. The purpose of this study was to evaluate the reliability of the inferior-based dermoglandular flap with partial subpectoral implant coverage to correct implant- and tissue-related complications associated with primary subglandular breast augmentation and its influence on improving outcomes.

Methods: This was a retrospective study in which a total of 53 patients (106 breasts) underwent revision augmentation-mastopexy using the double coverage technique for an implant with an inferior-based dermoglandular flap and superior-based pectoralis major muscle (biplane) as the first layer and a nipple-areolar flap with breast pillars as the second layer. Read More

Aesthet Surg J 2022 04;42(5):NP282-NP292

University of Groningen and University Medical Centre Groningen (UMCG), Groningen, the Netherlands.

Background: Breast augmentation is one of the most commonly performed aesthetic plastic surgical procedures, with over 250,000 procedures in the United States in 2020 alone. However, the safety of breast implants should be closely researched and monitored, especially in the long term.

Objectives: This study was undertaken to evaluate the long-term results of round micro-textured Eurosilicone (Eurosilicone S. Read More

Aesthetic Plast Surg 2022 Apr 19;46(2):694-696. Epub 2021 Oct 19.

, 1021 Park Avenue, New York, NY, 10028, USA.

Indian J Plast Surg 2021 Sep 17;54(3):362-366. Epub 2021 Sep 17.

Division of Plastic Surgery of the Federal University of São Paulo, São Paulo, Brazil.

Augmentation-mastopexy is a frequent procedure with high rates of early recurrence of breast ptosis, mainly after subglandular approach. The dual-plane techniques, based on the cranial dissection of the pectoralis, is the most used, but this plane does not cover the inferior pole of the breast. Then, the possibility of a downward dissection of the muscle seems to be more reasonable to retain the implant and improve postoperative results. Read More

Plast Reconstr Surg 2021 10;148(4):771-773

From the Division of Plastic Surgery, University of Louisville; and the Division of Plastic Surgery, University of Kentucky.

Plast Reconstr Surg 2021 Oct;148(4):760-770

From the Plastic Surgery Service, Hospital de Clínicas, Federal University of Paraná; private practice; Hospital Erasto Gaertner; and Diagnóstico Avançado por Imagem (Advanced Diagnostic Imaging Center).

Background: Subfascial breast augmentation is becoming popular because of a better understanding of breast anatomy. However, because the subglandular approach is also another popular method, it is critical to assess the influence of the superficial fascia of the pectoralis major muscle on the subfascial and subglandular pockets to determine if one method is superior to another. This study investigated whether there are clinical/radiological differences between subfascial and subglandular pockets following primary breast augmentation. Read More

Aesthet Surg J Open Forum 2021 Sep 26;3(3):ojab014. Epub 2021 Apr 26.

Department of Plastic Surgery, University of Texas Southwestern Medical School, Dallas, TX, USA.

Aesthet Surg J Open Forum 2021 Jun 2;3(2):ojab009. Epub 2021 Mar 2.

Division of Plastic and Reconstructive Surgery, Louisiana State University, New Orleans, LA, USA.

Background: Patients with long-term complications associated with subglandular breast augmentation are being seen in increasing numbers in the Southern California community. Late deformities include a characteristic "slide-down" deformity as well as capsular contracture, implant wrinkling, and nipple-areola complex enlargement. Repositioning the implant to a subpectoral pocket is a recognized revisionary technique to treat this problem; however, technical details of how this is accomplished are lacking in the literature. Read More

Aesthet Surg J 2021 10;41(11):NP1486-NP1495

Division of Mechanical Engineering PUC RIO, Rio de Janeiro, Brazil.

Background: Breast parenchyma interacts dynamically with an inserted implant, which may lead to local atrophy and sensory involvement, changes in vascular tissue and lactation, and volume reduction over time. The inversely proportional relationship between pressure and volume cannot be stated with certainty; that is, the larger implants having more local pressure would lead to compression, thus leading to atrophy of parenchyma more intensely compared with smaller implants. The objective of this study was to assess and list breast parenchyma volume changes with different pressure levels due to silicone implants of several sizes. Read More

Breast J 2021 04 12;27(4):352-358. Epub 2021 Feb 12.

Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.

Transfeminine patients facing barriers to gender confirming surgery sometimes pursue illicit feminization procedures such as "street" hormones and silicone injections. These procedures often yield complications and disfigurement, making surgeons and insurance companies wary of secondary breast reconstruction. This clinical series assesses illicit treatment among our transfeminine breast surgery patients and describes the presentation, surgical approaches, and outcomes of each patient. Read More

Plast Reconstr Surg Glob Open 2021 Jan 21;9(1):e3362. Epub 2021 Jan 21.

Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass.

Transgender women seeking gender-affirming breast augmentation often present with differences in preoperative chest measurements and contours in comparison with cisgender women. These include a more robust pectoralis muscle and limited glandular tissue, raising important considerations in determining the optimal anatomical plane for implantation. Abundant literature has described advantages and drawbacks of the available planes for breast augmentation in cisgender women. Read More

J Plast Reconstr Aesthet Surg 2021 05 7;74(5):1093-1100. Epub 2020 Nov 7.

Department of Plastic, Reconstructive and Aesthetic Surgery, Training and Research State University Hospital of Rio de Janeiro - UERJ-RJ, av. Mal.Rondon, 381.São francisco Xavier. Rio de Janeiro. CEP: 20950-003, Brazil. Electronic address:

Background: Breast prostheses could be associated with complications, despite many studies on surgical materials and techniques. The role of surgical drainage in preventing complications on breast prostheses surgery is controversial.

Objectives: This study aimed to evaluate the role and effectiveness of vacuum drainage in the augmentation mammoplasty. Read More

Plast Reconstr Surg 2020 12;146(6):1249-1257

From private practice.

Background: Subfascial placement of breast implants has the advantages of subglandular and submuscular placement without the adverse outcomes. There are few large series with longitudinal follow-up and outcome measures.

Methods: Seven hundred eighty-three patients underwent subfascial breast augmentation and were followed up for 10 years. Read More

Aesthetic Plast Surg 2021 06 19;45(3):845-850. Epub 2020 Oct 19.

, 2/40 Clyde Road, Berwick, VIC, 3806, Australia.

Background: The management of capsular contraction following breast augmentation has numerous, often conflicting potential treatment protocols, each designed to reduce the incidence of further recurrence. The use of the subfascial plane has not been investigated as an alternative to other treatment options.

Objectives: To examine the outcomes from patients presenting with recurrent capsular contraction after being treated for the first capsule by placement of an implant into the subfascial (SF) plane. Read More

J Plast Reconstr Aesthet Surg 2020 Dec 26;73(12):2225-2231. Epub 2020 May 26.

Chimay Plastic Surgery Clinic, 2F, No. 50, Section 4, Ren'ai Road, Da'an District, Taipei 106, Taiwan; School of Health Care Administration, Taipei Medical University, Taiwan. Electronic address:

Capsulectomy is a standard treatment for capsular contracture after breast augmentation. Incision via the endoscopic transaxillary approach is generally preferred by Asian women, but relevant literature addressing endoscopic transaxillary capsulectomy is limited. This study described the techniques of endoscopic transaxillary capsulectomy with reimplantation performed as a single-operator outpatient procedure. Read More

Aesthet Surg J 2020 08;40(9):981-986

Department of Plastic and Reconstructive Surgery, Brest University Hospital, Brest Cedex, France.

Background: Secondary procedures following breast augmentation are often more difficult than primary cases because the soft-tissue envelope changes over time.

Objectives: This study was conducted to confirm the utility of a composite technique in breast revisional surgery.

Methods: This was a 9-year retrospective chart and photographic data study of one surgeon's experience with the combined use of fat and implants in revisional cases. Read More

Ann Plast Surg 2021 01;86(1):115-120

Department of Breast Surgery, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

Aims: To review cases of galactorrhea and galactocele postbreast augmentation, determine possible risk factors and consider management strategies of this rare complication.

Methods: A systematic literature review was conducted in July 2019 searching Pubmed, Embase, and Google Scholar.

Results: The searches revealed 19 articles (17 case reports/series and 2 retrospective chart reviews) collectively comprising 38 women. Read More

Aesthetic Plast Surg 2021 02 14;45(1):127-134. Epub 2020 Feb 14.

Department of Plastic Surgery, Odense University Hospital and OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, J. B. Winsløws Vej 4, 5000, Odense, Denmark.

Background: Breast reshaping or mastopexy following massive weight loss can be challenging. The LOPOSAM (lower pole subglandular advancement mastoplasty) technique has shown promising results for correction of ptotic, wide, lateralized and deflated breasts following massive weight loss.

Materials And Methods: We compared the LOPOSAM technique to the mastopexy technique after massive weight loss described by Rubin JP, in a randomized trial. Read More

Plast Reconstr Surg 2020 Feb;145(2):330-332

From the Department of Plastic Surgery, Kaplan Medical Center.

Dual-plane breast augmentation offers the advantages of a subpectoral implant location with the ability to expand its use to glandular ptotic and constricted lower pole breasts. Alas, high implant position or very loose breast tissue can lead to a notorious breast shape known as the "waterfall deformity." To prevent many of these undesired deformities, the authors introduce a novel pectoralis major median myotomy they call the "median cut. Read More

J Med Radiat Sci 2020 Jun 24;67(2):102-110. Epub 2020 Jan 24.

Faculty of Science, School of Dentistry & Health Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia.

Aim: This study seeks to document the imaging series used in contemporary Australian practice for imaging the augmented breast, with a secondary focus on differences in practice and opinion between BreastScreen Australia and diagnostic imaging services.

Methods: A SurveyMonkey link was distributed through the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) and was assessable during December 2017 and January 2018. The questionnaire investigated: years of experience, facility type and location, image acquisition systems, appointment times, patients imaged per week, technique and imaging series used, use of limited compression views, rationale for variation in imaging series and the use of ultrasound. Read More

Aesthet Surg J 2020 04;40(5):513-515

Clinical Faculty Member, Division of Plastic Surgery, University of Louisville, Louisville, KY.

J Plast Reconstr Aesthet Surg 2019 Dec 24;72(12):1986-1995. Epub 2019 Sep 24.

Department of Plastic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, China. Electronic address:

Background: Techniques based on three planes of implant placement, including the subglandular (SG), subpectoral (SP), and subfascial (SF) planes are used for breast augmentation. The placement that offers the greatest balance of risks and benefits is unclear. This study presents a systematic review with a Bayesian network meta-analysis to compare different implant placement techniques for augmentation mammaplasty. Read More

Plast Reconstr Surg Glob Open 2019 Aug 12;7(8):e2344. Epub 2019 Aug 12.

Plastic & Reconstructive Surgery, Clinical Professor of Surgery, University of California-San Francisco, 2100 Webster St Suite 424, San Francisco, Calif.

Dual-plane augmentation mammaplasty has gained wide popularity in treating breast ptosis. However, in our experience, dual-plane augmentation mastopexy fails to treat severe cases of ptosis (grade 3) and glandular ptosis. Therefore, we conceived a method to manage these cases effectively. Read More

Aesthet Surg J 2020 04;40(5):499-512

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Background: Previous studies have reported decreased rates of capsular contracture associated with the use of textured surface breast implants placed in the subglandular plane during breast augmentation. However, since the publication of these studies, our understanding of the pathophysiology of capsular contracture, as well as the surgical techniques utilized to minimize bacterial contamination of the implant, have advanced considerably.

Objectives: The purpose of this study was to re-evaluate the relation between implant surface texturization and capsular contracture rates for breast implants placed in the subglandular plane during primary breast augmentation. Read More

Aesthet Surg J 2020 04;40(5):NP253-NP262

Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom.

Background: Breast implants may increase breast skin tension and interact with surrounding tissues to alter breast position and motion during dynamic activity. Reducing implant mass and changing implant location (submuscular/subglandular) may also affect breast kinematics and the subsequent loads on breast structures.

Objectives: The aim of this pilot study was to describe the kinematics of breasts augmented with reduced-mass implants during standing, walking, and running, compared with natural breasts, and to provide insight into how implant location (submuscular/subglandular) alters breast kinematics. Read More

Aesthetic Plast Surg 2019 12 6;43(6):1437-1438. Epub 2019 Sep 6.

106-75 Dyrgas Gate, Banff Plastic Surgery, Canmore, AB, T1W 06, Canada.

Med Arch 2019 Jun;73(3):178-182

University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina.

Introduction: Breast augmentation is one of the most frequently performed aesthetic surgical procedures in the world. The most important preoperative decisions which influence the final appearance of the augmented breast are the breast implant pocket choice and selection of the most appropriate implant. Described pocket locations are subglandular, subfascial, partially retropectoral, totally submuscular and dual plane. Read More