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Erschienen in: Aesthetic Plastic Surgery 2/2021

16.12.2019 | Original Article

Revisionary Surgery Following Primary Augmentation Mammoplasty in Muscle Splitting Biplane Pocket: An Appraisal of 93 Revisionary Surgeries

verfasst von: Umar Daraz Khan

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 2/2021

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Abstract

Background

Muscle splitting augmentation mammoplasty is the creation of a submuscular pocket which is gaining attention and acceptance by plastic surgeons worldwide. First introduced in 2007, muscle splitting augmentation mammoplasty has since been used for primary and secondary augmentation mammoplasty and augmentation mastopexy procedures. A personal experience of revision surgeries following muscle splitting augmentation mammoplasty is presented.

Methods

A retrospective data analysis for revision surgeries, following muscle splitting primary augmentation mammoplasties, performed between October 2005 and October 2018 was carried out.

Results

A total of 1511 primary augmentation mammoplasties were performed. Of these 1511 patients, 93 (6.1%) patients had revisionary or secondary surgery. The mean age of the patients was 33.8 + 9 years (range 20–60). Of the 93 patients, 78 patients had same size implants, mean 337 cc + 53.5 (range 230–495), and 14 had different size implants. Of these 14 patients, mean implant size on right and left was 331 cc + 59.4 (range 225–425) and 351 cc + 61.7 (range 260–450), respectively. Of the recorded texturing in 1495 patients, only 3.1% had smooth implants. Leading causes for revision were implant exchange for various reasons, in 33 (35.4%); 25 (26.8%) wanted larger implants, revisionary surgery for capsular contracture in 18 (19.3%), implant rupture was seen in 9 (9.6%), 4 (4.3%) patients had surgery for recurrent back-to-front flipping, 2 (2.1%) patients wanted a smaller size, 1 (1.07%) patient had fold flaw failure, and in 1 (1.07%) the cause was not recorded. There were no haematoma and breast implant-associated anaplastic large cell lymphoma (BIA ALCL) recorded in the series.

Conclusion

The incidence of revisionary surgery following muscle splitting primary augmentation mammoplasty is acceptable and can be corrected using the described techniques.

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.
Literatur
1.
Zurück zum Zitat Khan UD (2007) Muscle splitting breast augmentation: a new pocket in a different plane. Aesthet Plast Surg 31:553–558CrossRef Khan UD (2007) Muscle splitting breast augmentation: a new pocket in a different plane. Aesthet Plast Surg 31:553–558CrossRef
2.
Zurück zum Zitat Regnault P (1977) Partially submuscular breast augmentation. Plast Reconstr Surg 59:72CrossRef Regnault P (1977) Partially submuscular breast augmentation. Plast Reconstr Surg 59:72CrossRef
3.
Zurück zum Zitat Khan UD (2013) Muscle splitting, subglandular and partial submuscular augmentation mammoplasties: a 12 year retrospective analysis of 2026 primary cases. Aesthet Plast Surg 37(2):290–302CrossRef Khan UD (2013) Muscle splitting, subglandular and partial submuscular augmentation mammoplasties: a 12 year retrospective analysis of 2026 primary cases. Aesthet Plast Surg 37(2):290–302CrossRef
4.
Zurück zum Zitat Khan UD (2010) Augmentation mastopexy in muscle-splitting biplane: an outcome of first 44 consecutive cases of mastopexies in a new pocket. Aesthet Plast Surg 34:313–321CrossRef Khan UD (2010) Augmentation mastopexy in muscle-splitting biplane: an outcome of first 44 consecutive cases of mastopexies in a new pocket. Aesthet Plast Surg 34:313–321CrossRef
5.
Zurück zum Zitat Khan UD (2011) Multiplane technique for simultaneous submuscular breast augmentation and internal glandulopexy using inframammary crease in selected patients with early ptosis. Eur J Plast Surg 34:337–343CrossRef Khan UD (2011) Multiplane technique for simultaneous submuscular breast augmentation and internal glandulopexy using inframammary crease in selected patients with early ptosis. Eur J Plast Surg 34:337–343CrossRef
6.
Zurück zum Zitat Khan UD (2018) One-stage mastopexy and augmentation mammoplasty in layers: outcome analysis of first 50 consecutive cases. Plast Aesthet Res 5:45CrossRef Khan UD (2018) One-stage mastopexy and augmentation mammoplasty in layers: outcome analysis of first 50 consecutive cases. Plast Aesthet Res 5:45CrossRef
7.
Zurück zum Zitat Stodell M, McArthur G, James M (2016) Bi-plane breast augmentation: a case series supporting its use and benefits. Plast Aesthet Res 3:17–20CrossRef Stodell M, McArthur G, James M (2016) Bi-plane breast augmentation: a case series supporting its use and benefits. Plast Aesthet Res 3:17–20CrossRef
8.
Zurück zum Zitat Stumpfle RL, Pereira-Lima LF, Valiati AA, Da Mazzini GS (2012) Transaxillary muscle splitting breast augmentation: experience with 160 cases. Aesthet Plast Surg 36:343–348CrossRef Stumpfle RL, Pereira-Lima LF, Valiati AA, Da Mazzini GS (2012) Transaxillary muscle splitting breast augmentation: experience with 160 cases. Aesthet Plast Surg 36:343–348CrossRef
9.
Zurück zum Zitat Baxter RA (2005) Subfascial breast augmentation: theme and variation. Aesthet Surg J 25:447–453CrossRef Baxter RA (2005) Subfascial breast augmentation: theme and variation. Aesthet Surg J 25:447–453CrossRef
10.
Zurück zum Zitat Khan UD (2009) Acquired synmastia following subglandular mammoplasty and the use of submuscular splitting biplane for its correction. Aesthet Plast Surg 33:605–610CrossRef Khan UD (2009) Acquired synmastia following subglandular mammoplasty and the use of submuscular splitting biplane for its correction. Aesthet Plast Surg 33:605–610CrossRef
11.
Zurück zum Zitat Khan UD (2010) Combining muscle splitting biplane with multilayer capsuloraphy for the correction of bottoming down following subglandular augmentation. Eur J Plast Surg 33:259–269CrossRef Khan UD (2010) Combining muscle splitting biplane with multilayer capsuloraphy for the correction of bottoming down following subglandular augmentation. Eur J Plast Surg 33:259–269CrossRef
12.
Zurück zum Zitat Khan UD (2015) Subglandular to muscle splitting biplane conversion for revision augmentation mammoplasty. In: Mugea TT, Shiffman MA (eds) Aesthetic surgery of breast, 1st edn. Springer, Berlin, pp 535–541CrossRef Khan UD (2015) Subglandular to muscle splitting biplane conversion for revision augmentation mammoplasty. In: Mugea TT, Shiffman MA (eds) Aesthetic surgery of breast, 1st edn. Springer, Berlin, pp 535–541CrossRef
13.
Zurück zum Zitat Baxter RA (2011) Update on the split-muscle technique for breast augmentation: prevention and correction of animation distortion and double bubble deformity. Aesthet Plast Surg 33:353–360 Baxter RA (2011) Update on the split-muscle technique for breast augmentation: prevention and correction of animation distortion and double bubble deformity. Aesthet Plast Surg 33:353–360
14.
Zurück zum Zitat Khan UD (2009) Dynamic breasts: a common complication following partial submuscular augmentation and its correction using muscle splitting biplane technique. Aesthet Plast Surg 33:353–360CrossRef Khan UD (2009) Dynamic breasts: a common complication following partial submuscular augmentation and its correction using muscle splitting biplane technique. Aesthet Plast Surg 33:353–360CrossRef
15.
Zurück zum Zitat Khan UD (2012) High transverse capsuloplasty for the correction of malpositioned implants following augmentation mammoplasty in partial submuscular plane. Aesthet Plast Surg 36:590–599CrossRef Khan UD (2012) High transverse capsuloplasty for the correction of malpositioned implants following augmentation mammoplasty in partial submuscular plane. Aesthet Plast Surg 36:590–599CrossRef
16.
Zurück zum Zitat Tebbet JB (2001) Dual-plane breast augmentation: optimizing implant-soft tissue relationship in a wide range of breast types. Plast Reconstr Surg 107:1255CrossRef Tebbet JB (2001) Dual-plane breast augmentation: optimizing implant-soft tissue relationship in a wide range of breast types. Plast Reconstr Surg 107:1255CrossRef
17.
Zurück zum Zitat Spear SL, Scwartz J, Dayan JH et al (2009) Outcome assessment of breast distortion following submuscular breast augmentation. Aesthet Plast Surg 33:44–48CrossRef Spear SL, Scwartz J, Dayan JH et al (2009) Outcome assessment of breast distortion following submuscular breast augmentation. Aesthet Plast Surg 33:44–48CrossRef
19.
Zurück zum Zitat Khan UD (2016) A long term review of augmentation mastopexy in muscle splitting biplane. Plast Aesthet Res 3:21–25CrossRef Khan UD (2016) A long term review of augmentation mastopexy in muscle splitting biplane. Plast Aesthet Res 3:21–25CrossRef
20.
Zurück zum Zitat Khan UD (2016) Augmentation mastopexy and augmentation mammoplasty: an analysis of 1,406 consecutive cases. Plast Aesthet Res 3:26–30CrossRef Khan UD (2016) Augmentation mastopexy and augmentation mammoplasty: an analysis of 1,406 consecutive cases. Plast Aesthet Res 3:26–30CrossRef
21.
Zurück zum Zitat Saleh DB, Callear J, Riaz M (2016) An anatomic appraisal of biplane muscle-splitting breast augmentation. Aesthet Surg J 36(9):1019–1025CrossRef Saleh DB, Callear J, Riaz M (2016) An anatomic appraisal of biplane muscle-splitting breast augmentation. Aesthet Surg J 36(9):1019–1025CrossRef
22.
Zurück zum Zitat Graf RM, Bernardes A, Rippel R et al (2003) Subfascial breast implant: a new procedure. Plast Reconstr Surg 111:904–908CrossRef Graf RM, Bernardes A, Rippel R et al (2003) Subfascial breast implant: a new procedure. Plast Reconstr Surg 111:904–908CrossRef
23.
Zurück zum Zitat Nigro LC, Blanchet NP (2017) Animation deformity in postmastectomy implant based reconstruction. Plast Reconstr Surg Glob Open 5:e1407CrossRef Nigro LC, Blanchet NP (2017) Animation deformity in postmastectomy implant based reconstruction. Plast Reconstr Surg Glob Open 5:e1407CrossRef
24.
Zurück zum Zitat Dyrberg DL, Camilla B, Gunnarsson GL et al (2019) Breast animation deformity. Arch Plast Surg 46:7–15CrossRef Dyrberg DL, Camilla B, Gunnarsson GL et al (2019) Breast animation deformity. Arch Plast Surg 46:7–15CrossRef
25.
Zurück zum Zitat Alnaif N, Safran T, Alex Viezel-Mathieu, Alhalabi B, Dionisopoulos T (2019) Treatment of breast animation deformity: a systematic review. J Plast Reconstr Aesthet Surg 72:781–788CrossRef Alnaif N, Safran T, Alex Viezel-Mathieu, Alhalabi B, Dionisopoulos T (2019) Treatment of breast animation deformity: a systematic review. J Plast Reconstr Aesthet Surg 72:781–788CrossRef
26.
Zurück zum Zitat Gabriel A, Sigalove S, Sigalove NM et al (2018) Prepectoral revision breast reconstruction for treatment of implant-associated animation deformity: a review of 102 reconstructions. Aesthet Surg J 38(5):519–526CrossRef Gabriel A, Sigalove S, Sigalove NM et al (2018) Prepectoral revision breast reconstruction for treatment of implant-associated animation deformity: a review of 102 reconstructions. Aesthet Surg J 38(5):519–526CrossRef
27.
Zurück zum Zitat Brown T (2012) Subfascial breast augmentation: is there any advantage over the submammary plane? Aesthetic Plast Surg 36(3):566–569CrossRef Brown T (2012) Subfascial breast augmentation: is there any advantage over the submammary plane? Aesthetic Plast Surg 36(3):566–569CrossRef
28.
Zurück zum Zitat Khan UD, Riaz M (2015) Use of multiplane internal mastopexy for ptosis correction revision augmentation mammoplasty. Plast Aesthet Res 2:120–126CrossRef Khan UD, Riaz M (2015) Use of multiplane internal mastopexy for ptosis correction revision augmentation mammoplasty. Plast Aesthet Res 2:120–126CrossRef
29.
Zurück zum Zitat Khan UD (2013) The impact of preoperative breast implant selection on the 3-year reoperation rate. Eur J Plast Surg 36:503–510CrossRef Khan UD (2013) The impact of preoperative breast implant selection on the 3-year reoperation rate. Eur J Plast Surg 36:503–510CrossRef
30.
Zurück zum Zitat Tebbets JB (2006) Achieving a zero percent reoperation rate at 3 years in a 50-consecutive case augmentation mammoplasty premarket study. Plast Reconstr Surg 118:1453–1457CrossRef Tebbets JB (2006) Achieving a zero percent reoperation rate at 3 years in a 50-consecutive case augmentation mammoplasty premarket study. Plast Reconstr Surg 118:1453–1457CrossRef
31.
Zurück zum Zitat Khan UD (2017) Low risk primary augmentation mammoplasty and capsular contracture using textured round cohesive silicone gel implants revisited. A long term follow up in a single surgeon’s practice. Pak J Plast Surg 5:6–19 Khan UD (2017) Low risk primary augmentation mammoplasty and capsular contracture using textured round cohesive silicone gel implants revisited. A long term follow up in a single surgeon’s practice. Pak J Plast Surg 5:6–19
32.
Zurück zum Zitat Khan UD (2011) Back to front flipping of implants following augmentation mammoplasty and the role of physical characteristics in a round cohesive gel silicone breast implant. retrospective analysis of 3458 breast implants by a single surgeon. Aesthet Plast Surg 35:125–128CrossRef Khan UD (2011) Back to front flipping of implants following augmentation mammoplasty and the role of physical characteristics in a round cohesive gel silicone breast implant. retrospective analysis of 3458 breast implants by a single surgeon. Aesthet Plast Surg 35:125–128CrossRef
33.
Zurück zum Zitat Khan UD (2010) Breast augmentation, antibiotic prophylaxis and infection: comparative analysis of 1628 primary augmentation mammoplasties to assess the role and efficacy of length of antibiotic prophylaxis. Aesthet Plast Surg 34:42–47CrossRef Khan UD (2010) Breast augmentation, antibiotic prophylaxis and infection: comparative analysis of 1628 primary augmentation mammoplasties to assess the role and efficacy of length of antibiotic prophylaxis. Aesthet Plast Surg 34:42–47CrossRef
Metadaten
Titel
Revisionary Surgery Following Primary Augmentation Mammoplasty in Muscle Splitting Biplane Pocket: An Appraisal of 93 Revisionary Surgeries
verfasst von
Umar Daraz Khan
Publikationsdatum
16.12.2019
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 2/2021
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-019-01580-6

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