In June 2007 your paper “Composite Plane Breast Augmentation: A new Concept” was awarded in Berlin, among 500 papers from around the world during the International Plastic Surgery Conference . In this paper, you present a brand new technique for breast augmentation.
This technique is in reality a modification of the technique first presented by Dr Tebbets from Texas, the guru and great teacher in breast augmentation.
What exactly does this technique involve?
Until now we knew of two techniques in breast augmentation: the subglandular and submuscular implant placement techniques. In 2002, the subfascial technique was also introduced. Our technique combines the two last techniques. I.e., silicone implant is placed both underneath the muscle and underneath the muscle fascia.
I believe this sounds a bit complex.
In reality it is not. Look at figure 1. The above part of the silicone implant is covered by the pectoralis major muscle and the lower part by the muscle fascia (a thin tissue that covers the muscle).
And why should we stop using the old techniques?
Because no technique is perfect. Each new technique is launched in order to offer something new.
So, which are the advantages and disadvantages, if any, of the new technique.
There are many advantages:
1. Less complications, such as the formation of capsular contracture. A complication that concerns 1-20% of women who have been submitted to breast augmentation surgery. By placing the implant below the muscle and the fascia we minimise the implant’s contact with the mammary gland. This is a manoeuvre that can possibly minimise the formation of capsular contracture.
2. A natural result particular for thin patients with very small breasts. This can be achieved as the upper part of the implant is covered by the muscle.
3. The possibility of implant dropping is reduced. The muscle and fascia secure the implant and keep it in the right position.
4. We avoid malformations to the implant due to the strength exercised by the pectoralis major (as is the case in the submuscular technique). The so-called “open breast” abnormality.
5. The possibility of palpating the implant’s borders is reduced.
6. No wrinkles are formed on the upper part of the body.
What about the disadvantages:
There are no actual disadvantages, apart from the fact that the doctor has to have more experience in performing this technique.
Does surgery last longer compared to other techniques?
No. An experienced surgeon can perform the procedure within 30-45 minutes.
Are there any drains placed on the breast?
No, no drains, no bandages, no suffocating compression garments around the breasts.
Why?
This is where the first part of the title applies.
So, what does the “non-touch, no pain” mean?;
It literary means no touching of the breast and no pain. To elaborate: In surgery, the way you treat tissues is of outmost importance. If you “respect” tissues, i.e. avoiding abuse and following the advised anatomical and non-blood techniques, the problems that may appear after surgery will be minimised. In our fast-paced society, patients ask for fast recovery. Our goal is to allow patient to go out to a restaurant or to the movies on the same day, after surgery.
And how can this be achieved?
By using 1) special tools 2) fully atraumatic techniques and 3) special exercises after surgery.
With the above combination we can achieve,
1. Speedy recovery
2. In 90% of patients, pain is minimum. They can even go out for a dinner on the same night
3. No drains
4. No bandages
5. No compression garments around the breasts
6. No bruising after surgery
7. Dramatic reduction of complications such as haematomas or inflammations.
Can the combination of this atraumatic technique and the dual plane technique further minimise the problems that may appear after surgery?
Dramatically. Complications and revision surgery are currently below one percent (1%). On the other hand, among women, the level of satisfaction from this operation reaches 98-99%, and this is what we are aiming for.