division of plastic surgery federal university of são paulo – epm. são paulo - brazil unifesp...
TRANSCRIPT
Division of Plastic SurgeryFederal University of São Paulo – EPM.
São Paulo - Brazil
UNIFESP
Breast Augmentation with Transaxillary Approach: The Advantages of a Z Incision. A 344 Case Experience
Authors:
Élvio Bueno Garcia, MD, PhD*
Antonio C. Graziozi, MD, PhD*
Marcel V. A. de Menezes, MD
Natasha Sallum, MD
Lydia M. Ferreira, MD, PhD*
Breast Augmentation with Transaxillary Approach: The Advantages of a Z Incision. A 344 Case Experience
Authors:
Élvio Bueno Garcia, MD, PhD*
Antonio C. Graziozi, MD, PhD*
Marcel V. A. de Menezes, MD
Natasha Sallum, MD
Lydia M. Ferreira, MD, PhD*
This study describes the axillary incision in a Z form in order to facilitate its approach with a
direct access to the pectoralis muscle margin and better aesthetic results in a scar with tension line
breaking.
OBJECTIVE
Nothing to disclose
344 patients were operated aging from 18 to 50 years old between 2004 and 2009.
Inclusion critteria: patients desiring breast augmentation and breasts free of scars. Exclusion critteria: previous breast surgery, ptosis, asymmetry, tubular breast.
MATERIAL AND METHODSMATERIAL AND METHODS
Non endoscopic axillary approach Submuscular plane
Textured silicone gel implants ranging from 175 cc and 350 cc
MATERIAL AND METHODSMATERIAL AND METHODS
The Z incision: located inside the axilla’s hair 2cm each leg of the Z
Skin is moved by traction superiorly towards the pectoralis muscle margin.
MATERIAL AND METHODSMATERIAL AND METHODS
Dissection:made with a rhombus dissectorfrom the upper pole until 2 cm under the inframammary crease
Implant placed through the axillaClosure leaving suction drains
MATERIAL AND METHODSMATERIAL AND METHODS
The Z scar permitted a wide access which facilitated the pectoralis muscle approach. It also abbreviated surgical time since no
subcutaneous tunnel is needed. The scar's aesthetic result was well disguised.
Follow up: 1 to 6 years
RESULTSRESULTS
RESULTSRESULTS
Complication rate:
Seroma …………………………………..….6,17%Unfavorable aesthetic result ………………5,2%
Inframammary fold asymmetry …..……1,7%Implant lateralization ………………..….0,85%Double inframammary crease ……..….0,58%Implant cranially malpositioned ……….1,7%
The Z scar hasn't been prolonged beyond the limits planned.
It could possibly happen with a linear or curved incision when moved laterally by tracion.
DISCUSSIONDISCUSSION
Provides the same result on the breastSmaller and broken lined scarLess noticeable scar
Comparative studies about aesthetic results between different types of scars could be published.
DISCUSSIONDISCUSSION