Breast Augmentation - Principles and Practice

Foreword

Preface

Contents

List of Contributors

Anatomy, Benign Breast Disease, Malignant Breast Disease, Mammograms

Embryology and Anatomy of the Breast

Introduction

Embryogenesis

Congenital Anomalies

Anatomy

Histology

Conclusions

References

Nerves, Ligaments, and Vessels of the Chest and Breast

Introduction

Nerves, Ligaments, Vessels

References

Anthropomorphic Measurement of the Breast

Introduction

Shape

Volume

Position

Pathological Morphology of the Breast

Ptosis and Projection

Protocol History

Breast Envelope Quality

Protocol Method

Definitions

Accuracy

Clinical Application

References

Anatomy and Clinical Significance of the Pectoral Fascia

Introduction

Results

Technique

Discussion

Conclusions

References

The Inframammary Crease

Introduction

Anatomy

Reconstruction of the Inframammary Fold

Discussion

References

Breast Asymmetries: A Working Formulation

Introduction Materials and Methods

Results

Discussion

Conclusions

References

Benign Disorders of the Breast

Introduction

Benign Disorders

History

Physical Examination

Mammography

Discussion

References

Malignant Breast Diseases

Introduction

Breast Augmentation

Cancer

Genetic Testing Chromosome

Breast Cancer Prevention Options

Discussion

Conclusions

Mammograms in Cosmetic Breast Surgery

Introduction

Preoperative Mammograms

Postoperative Mammograms Following Cosmetic

Breast Surgery

Cosmetic Surgeries

Discussion

References

Preoperative Consultation

Initial Consultation

Introduction

Subjective Reasons for Breast Augmentation

Physical Examination

History

Informed Consent Discussion

Implants

Method for Determining Bra Size and Predicting Postaugmentation Breast Size

Introduction Technique

Discussion

Results

Conclusions

References

Breast Assessment and Implant Selection Using the TTM Aesthetic Breast Chart

Introduction

Preoperative Assessment Using the TTM Chart

Implant Selection

Soft Tissue Cover Tension and Capsule Formation

Conclusions

References

The Golden Ratios of the Breast

Introduction Method

Results

Discussion

Choosing the Right Prosthesis

Conclusions

References

Body Image and Other Psychological Issues in Breast Augmentation

Introduction

Preoperative Psychosocial Status of Breast Augmentation Candidates

Changes in Psychosocial Status Following Breast Augmentation

Cosmetic Breast Augmentation and Suicide

Preoperative Psychological Assessment of Breast Augmentation Patients

References

Conclusions

Body Dysmorphic Disorder

Introduction

Definition

Symptoms

Consequences of BDD

Discussion

Associated Disorders

Treatment Conclusions

References

Use of Decision and Management Algorithms in a Breast Augmentation Practice

Introduction Incorporating the Algorithms in Patient Education Use of Decision and Management Algorithms

Practical Clinical Use of Algorithms in the Office

Implant Size Change

Alternatives for Managing Possible Periprosthetic Space Infection

Alternatives for Managing Capsular Contracture Grades 3 and 4

Alternatives for Managing Stretch Deformities and Implant Malposition

Management of Shell Disruption or Leaking Silicone Gel Implant

Alternatives for Managing Undefined Symptom Complexes

Conclusions

References

Implants

Silicone Versus Saline Implants

Introduction

Implant Characteristics

Patient Characteristics

Conclusions

References

Choice of Prosthesis Surface: Myth or Necessity?

Introduction

History

Variety of Available Prostheses

Definitions

Effect of Smooth-Textured Prostheses on Augmentation Mammaplasty Surgery

Effect of Texturization and Smoothness on Augmentation Mammaplasty

Effect of Textured Prostheses on Augmentation Mammaplasty

Adherence of Textured Prostheses (Advantage of Adhesion to Surrounding Tissue)

Effect of Texture on Capsule Formation

Conclusions

References

Enhanced Projection: Adjustable Gel Implants

Introduction

Saline Implants

Silicone Implants

Double-Lumen Adjustable Implants

Enhanced Projection: Adjustable Gel Implant

Betadine and Breast Implants

Introduction Discussion

Study on Betadine

Conclusions

References

Mechanical Analysis of Explanted Silicone Breast Implants

Introduction

Materials and Methods

Results

Discussion

References

Cohesive Gel Silicone Implants

Introduction Contraindications

Anesthesia

Patient Selection

Technique

Preoperative Routine Examination

Postoperative Care

Results

Complications

Conclusions

Surgical Approaches

Principles of Breast Augmentation Surgery

Introduction

Principles

Controversies of Certain Methods

Postoperative Manipulation of the Implants

Conclusions

Intraoperative Assessment of Breast Prosthesis Volume Using a Set of Graduated Expanders

Introduction

Technique

References

Discussion

Conclusions

Breast Augmentation: Intraareolar Approach

Introduction

Technique

Preoperative

Postoperative Care

Discussion

Breast Augmentation Using the Periareolar Approach

Introduction

Technique

Results

Discussion

References

Conclusions

Inframammary Approach to Subglandular Breast Augmentation

Introduction Breast Implants and Subglandular

Breast Augmentation

Patient Evaluation

Patient Examination

Operative Technique

Postoperative Care

References

Complications

Breast Augmentation: Axillary Approach

Introduction

Initial Consultation

Indications for Breast Augmentation

Augmentation, Mastopexy, or Both?

Preoperative Work-Up

Technique

Mastopexy and Augmentation Performed Postoperative Care Simultaneously:

Results

Avoidance of Common Complications

Discussion

Conclusions

References

Hydrodissection Axillary Breast Augmentation

Introduction

Surgical Technique

Preoperative

Postoperative Care

Complications

Conclusions

Nipple or Areolar Reduction with Simultaneous Breast Augmentation

Introduction

Surgical Technique

Results

Complications

Discussion

References

Conclusions

Classification of Breast Ptosis

Introduction

Lalardrie–Jouglard Classification

Regnault Classification of Breast Ptosis

Lewis Classification

Brink Classification

Brink Procedural Specifics for Forms of Breast Ptosis

LaTrenta and Hoffman Classification

Conclusions

De la Torre and Vasconez Classification

References

Breast Augmentation with Mastopexy

Introduction

Definition of Ptosis

Types of Mastopexy

Estimating Volume

Technique

Case Examples

Conclusions

References

Crescent Mastopexy with Augmentation

33.1

Introduction

33.2

Indications

33.3

Technique

33.4

Case Results

33.5

Complications

33.6

Discussion

References

33.7

Conclusions

Breast Augmentation with Periareolar Mastopexy

Introduction

History

Indications

Augmentation Alone

Preoperative Planning

Staging

Operative Technique

Risks and Complications

Conclusions

References

Mastopexy/Reduction and Augmentation Without Vertical Scar

Introduction Consultation

Surgical Procedure

Postoperative Care

Complications

Conclusions

Classification of the Tuberous Breast

Introduction Grolleau Classification

Von Heimburg Classification

Discussion

References

The Incidence of Tuberous Breast Deformity in Asymmetric and Symmetric Mammaplasty Patients

Introduction

Technique

Discussion

Results

References

Conclusions

Aesthetic Reconstruction of the Tuberous Breast Deformity

Introduction

History

Anatomy and Embryology

Techniques

Complications Discussion

References

Periareolar Technique for Correction and Augmentation of the Tuberous Breast

Introduction Anatomy

Surgical Treatment

Results and Complications

Discussion

Conclusions

References

The Effect of Breast Parenchymal Maldistribution on Augmentation Mammoplasty Decisions

References

Management of Anterior Chest Wall Deformity in Breast Augmentation

Introduction

Clinical Evaluation

Types of Deformities

Radiographic Evaluation

Manubriosternal Prominence, Pectus Carinatum, and Prominent Costosternal Junction

Pectus Excavatum

Poland’s Syndrome

Sunken Chest (Anterior Thoracic Hypoplasia)

Scoliosis

Customized Chest Wall Implant: Moulage Preparation

Conclusions

Discussion

References

Poland’s Syndrome

Introduction

Etiology

Clinical Presentations

Treatment

References

Breast Augmentation in the Transsexual

Introduction

Discussion

Technique

Conclusions

Anesthetic Drip System to Reduce Pain in Cosmetic Surgery

Introduction Technique

Discussion

References

Position of Implant

Submammary Versus Subpectoral Implant

Introduction

Submammary Pocket

Markings

Subpectoral Pocket

Discussion

Conclusions

References

Treatment of the Submammary Fold in Breast Implantation

Introduction

Anatomy

Factors Distorting the Inframammary Fold

Surgical Maneuvers Treatment of the Submammary Fold

Nipple–Inframammary Fold Relationships

Implant Size and Submammary Fold Problems

References

Conclusions

Subfascial Prepectoral Implant Using the Inframammary Approach

Introduction

Incision Site

Pocket Dissection

Discussion

References

Subfascial Transaxillary Breast Augmentation

Introduction Technique

Postoperative Care

Results

Discussion

Conclusions

References

Modified Subfascial Breast Augmentation

Introduction

Technique

Results

Complications

Discussion

Conclusions

References

Submuscular Fascial Dual-Plane Breast Augmentation

Introduction

Retromuscular Glandular Dual-Plane

Breast Augmentation

Retromuscular Fascial Dual-Plane

Breast Augmentation

Technique

Clinical Cases

Conclusions

References

“Reverse” Dual-Plane Mammaplasty

Introduction

Technique

Postoperative Care

Discussion

Results

Conclusions

References

Breast Augmentation with Autologous Tissue

History of Breast Augmentation with Autologous Fat

Introduction Recent History with Liposuctioned Fat

Historical Contributions

Discussion

References

Breast Augmentation with Autologous Fat

Introduction

Case Reports

Technique

References

Discussion

Fat Transfer with Platelet-Rich Plasma for Breast Augmentation

Introduction

General Biology of Wound and Graft Healing with PRP

Autologous Fat Graft Healing Model

Technique

Results and Complications

Discussion

Conclusions

References

Fat Transfer and Implant Breast Augmentation

Introduction

Clinical Case

Technique

Discussion

References

Breast Augmentation with the Brava® External Tissue Expander

Introduction

History

Discussion

Conclusions

References

Autogenous Augmentation Mammaplasty with Microsurgical Tissue Transfer

Introduction History

Technique

Results and Complications

Discussion

Conclusions

References

Complications

Complications of Breast Augmentation

Introduction

Capsular Contracture

Implant Displacement

Implant Rotation

Implant Deflation or Rupture

Implant Rippling

Seroma

Hematoma

Infection

Hypertrophic Scarring

Sensory Changes to Nipple–Areolar Complex

References

Mondor’s Disease

Steroids and Other Complications

Pneumothorax

Less Common Complications of Breast Augmentation

Introduction Areolar Retraction

Axillary Banding

Autoinflation, Spontaneous

Capsule Contracture

Double Bubble

Calcifications

Chronic Pain

Elevated Platinum Levels

Fibrotic Retraction

Galactorrhea

Idiosyncratic Allergic Reaction

Improper Implant Placement

Late Bleeding After Breast Augmentation

Malposition of the Inframammary Scar

Lactation Problems

Methicillin-Resistant

Infection

Community-Acquired Methicillin-Resistant (CA-MRSA)

Migration of Implant

Myospasm of Pectoralis Major Muscle

Neurologic Injury

Necrosis

Pneumothorax

Periareolar Scar Indentation

Synmastia

Rippling

Serous Fluid Drainage

Thromboembolism

Synmastia (Symmastia)

Toxic Shock Syndrome

Capsular Contracture Following Augmentation Mammaplasty: Etiology and Pathogenesis

Introduction

Histological Characteristics of Capsules Surrounding Mammary Prostheses

The Enigma of Myofibroblasts

Etiology of Capsular Contracture

Miscellaneous Factors

References

Management of Established Capsular Contracture

Complications Related to the Implant

Introduction

History

Techniques

Rupture

Radiolucency

Saline Implants

Silicone

Polyurethane-Coated Implants

Titanium-Coated Implants

Soybean Implants (Triglyceride-Filled) Conclusions

PVP Implants

References

Surrounding Mammary Prostheses Within the Breast

Introduction

Mammographic Imaging

Ultrasound

Magnetic Resonance Imaging

Expected Outcomes of Imaging Implants

Conclusions

References

Treatment of Capsule Contracture with Endoscopic CO Laser

Introduction

Technique

Discussion

Results

Conclusions

References

Hammock Capsulorrhaphy

Introduction

Physiopathology

Etiology

Anatomic Features

Technique

Results

Conclusions

Breast Implant Malposition: Prevention and Correction

Introduction

Preoperative Analysis

Operative Technique

Postoperative Management

Correction of Implant Malposition

Conclusions

References

Aesthetic Outcome of Breast Implant Removal

Introduction Reasons for Implant Removal

Implant Removal and Timing of Any Reconstructive Options

Technique and Results

Conclusions

References

Inframammary Fold Elevation and External Synmastia Repair: Morgan–Metcalf Method

Introduction

Technique

Synmastia

References

Intracapsular Allogenic Dermal Grafts for Periprosthetic Breast Implant Problems

Introduction

Technique

Complications

Results

Discussion

Conclusions

References

Submammary Flap for Correction of Severe Sequelae from Augmentation Mammaplasty

Introduction

Historical Background

Timing of the Operation

Anatomic Considerations

Step-by-Step Surgical Technique

Other Surgical Options

Conclusions

References

Idiosyncratic Allergic Reaction: A Rare Complication of Augmentation Mammoplasty

Introduction

Case Reports

Discussion

Conclusion

References

Complications of Silicone Gel Implants

Introduction

Seroma

Hematoma

Infection

Capsular Contracture

References

Aesthetic Management of the Breast Capsule After Explantation

Introduction

Histology

Discussion

Conclusions

References

Complications of the Transumbilical Approach

Introduction

Incorrect Implant Pocket Position

Reports of Complications

References

Implant Postoperatively too High

Capsule Contracture

Subfascial Breast Augmentations: Complications

Introduction

Reported Complications

Difficulty Dissecting the Pocket

Incorrect Pocket

Discussion

Conclusions

References

Complications of Autologous Fat Transfer to the Breast

Introduction

Discussion

Reported Complications

References

Miscellaneous

Breast Conservation Therapy After Augmentation Mammaplasty

Introduction Definition

Oncologic Consultation: Treatment Alternatives

Lumpectomy: Effect of Breast Implants on Mammography

Lumpectomy: Effect of Radiation on Rate of Capsular Contracture

Lumpectomy and Radiation Versus Glandular Replacement Therapy

Breast Conservation Therapy in the Augmented Patient: Clinical Experience

Conclusions

References

Serologic and Histologic Findings in Capsule Contracture Patients with Silicone Gel Implants

Introduction

Investigations, Results, and Discussion

Conclusions

References

Medical-Legal Aspects of Breast Augmentation

Introduction

Requirements for Medical Negligence

Standard of Care

Informed Consent

Complications

The Angry Patient

Patient Rapport

Medical Record

Legal Aspects

Legal Cases

The Misinformed Expert Witness

Discussion

References

Editor’s Commentary

Introduction

Retropectoral Versus Retromammary Breast

Implantation

Capsulectomy Versus Capsulotomy for the Treatment of Capsular Contraction

Capsule Contracture After Breast Irradiation for Cancer

Antibacterial Irrigation in Pocket Under or Over the Pectoralis Major Muscle: Before Insertion of Prosthesis Capsule Contracture Rates

Umbilical Approach to Breast Augmentation

Textured Versus Smooth Implants

Treatment of Implant Pocket Infection

Comparison of the Mentor Siltex Textured Implant and the McGhan BioCell Textured Implant

Autologous Fat Augmentation of the Breast

The Perfect Breast

References

Subject Index