내시경을 이용한 겨드랑절개 이중평면 유방확대술

Endoscopic Transaxillary Dual Plane Breast Augmentation

  • 투고 : 2008.04.27
  • 심사 : 2008.05.30
  • 발행 : 2008.10.15

초록

Purpose: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. Methods: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350 cc. Through a 4 cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. Results: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. Conclusion: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.

키워드

참고문헌

  1. Tebbetts JB: Transaxillary subpectoral augmentation mammaplasty: long-term follow-up and refinements. Plast Reconstr Surg 74: 636, 1984 https://doi.org/10.1097/00006534-198411000-00008
  2. Ho LC: Endoscopic assisted transaxillary augmentation mammaplasty. Br J Plast Surg 46: 332, 1993 https://doi.org/10.1016/0007-1226(93)90015-4
  3. Price CI, Eaves FF 3rd, Nahai F, Jones G, Bostwick J 3rd: Endoscopic transaxillary subpectoral breast augmentation. Plast Reconstr Surg 94: 612, 1994 https://doi.org/10.1097/00006534-199410000-00007
  4. Tebbetts JB: Dual plane breast augmentation optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 107: 1255, 2001 https://doi.org/10.1097/00006534-200104150-00027
  5. Troilius C: Total muscle coverage of a breast implant is possible through the transaxillary approach. Plast Reconstr Surg 95: 509, 1995
  6. Howard PS: The role of endoscopy and implant texture in transaxillary submuscular breast augmentation. Ann Plast Surg 42: 245, 1999 https://doi.org/10.1097/00000637-199903000-00003
  7. Fryzek JP, Signorello LB, Hakelius L, Lipworth L, McLaughlin JK, Bolt WJ, Nyren O: Local complications and subsequent symptom reporting among women with cosmetic breast implants. Plast Reconstr Surg 107: 214, 2001 https://doi.org/10.1097/00006534-200101000-00035
  8. Handel N, Cordray T, Gutierrez J, Jensen JA: A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg 117: 757, 2006 https://doi.org/10.1097/01.prs.0000201457.00772.1d
  9. Tebbetts JB: Axillary endoscopic breast augmentation processes derived from a 28-year experience to optimize outcomes. Plast Reconstr Surg 118: 53S, 2006 https://doi.org/10.1097/00006534-200609151-00064
  10. Momeni A, Padron NT, Bannasch H, Borges J, Björn Stark G: Endoscopic transaxillary subpectoral augmentation mammaplasty: a safe and predictable procedure. J Plast Reconstr Aesthet Surg 59: 1076, 2006 https://doi.org/10.1016/j.bjps.2006.01.031
  11. Burden WR, Kelly PM: Endoscopic breast subpectoral augmentation for second-degree breast ptosis. Ann Plast Surg 46: 238, 2001 https://doi.org/10.1097/00000637-200103000-00006
  12. Tebbetts JB: Achieving a predictable 24-hour return to normal activities after breast augmentation: part II. patient preparation, refined surgical techniques, and instrumentation. Plast Reconstr Surg 109: 293, 2002 https://doi.org/10.1097/00006534-200201000-00046
  13. Lindsey JT: The case against medial pectoral releases: a retrospective review of 315 primary breast augmentation patients. Ann Plast Surg 52: 253, 2004 https://doi.org/10.1097/01.sap.0000110480.86712.db
  14. Munhoz AM, Aldrighi C, Buschpiegel C, Ono C, Montag E, Fells K, Arruda E, Sturtz G, Kovac P, Filassi JR, Gemperli R, Ferreira MC: The feasibility of sentinel lymph node detection in patients with previous transaxillary implant breast augmentation: preliminary results. Aesthetic Plast Surg 29: 163, 2005 https://doi.org/10.1007/s00266-004-0103-8
  15. Park WJ: Endoscopic assisted transaxillary subpectoral augmentation mammaplasty. J Korean Soc Plast Reconstr Surg 24: 133, 1997