breast augmentation

What is the SubFascial technique?

The subfascial technique is new and refers to breast augmentation. It was first presented in 2000 by Miss Craf , a Plastic Surgery Professor in Brasil. The presentation was made in the Aesthetic Plastic Surgery journal and in 2003 it was also published in the American journal of Plastic and Reconstructive Surgery.

Where is the silicone implant placed?

In the subfascial technique, the silicone implant is placed under the fascia of the pectoralis major. As you may see in the figure, the fascia is a very thin hymen that covers the pectoralis major.

What are the advantages of the procedure?

1. Minimum or no pain.
2. Much faster recovery
3. Performed with local anaesthesia and sedation.
4. More natural shape of the breast, since the fascia is covering the implant and smoothes out the roundness that develops on the upper part of the breast
5. Minimisation of capsular contracture, possibly due to the fact that the implant is not in contact with the breast (the fascia separates the implant from the breast).
6. It may possibly limit the possibility of implant dropping in the future since the implant is well secured as is the breast.
7. In selected patients, it minimises the possibility of wrinkle formation mostly on the upper part of the breast.

As in all breast augmentation techniques, we perform the non touch, no pain technique in surgery.

In this technique we create the pocket in fully non-blood procedure.

What is your experience with this technique?

We are currently among world leading practices with more than 800 surgical cases.

Where have you presented this technique?

This technique is very popular and has been enthusiastically accepted by the most established conferences of our specialty. It has been presented in the following meetings:

1. 10th European Societies of Plastic, Reconstructive and Aesthetic Surgery Congress, Vienna, August 30th  - September 3rd, 2005
2. 7th Congress of Hellenic Society of Plastic Reconstructive and Aesthetic Surgery, October 27th – 29th, 2005, Loutraki.
3. 9th Congress of Pan Arab Association of Burns & Plastic Surgery, April 10th -13th, 2006.
4. 14th Congress of the International Confederation of Plastic, Reconstructive and Aesthetic Surgery (IPRAS) Berlin, October 26th - 29th, 2007.
5. IMCAS meeting in Paris, January 2009 (International Master Course on Aging Skin).
6. At 11th European Society of Plastic Reconstructive and Aesthetic Surgery Congress, Rhodes 2009.

We have also published our experience with this technique in the two most prominent international journals of Plastic Surgery: “Plastic and Reconstructive Surgery” and “Aesthetic Plastic Surgery”. In 2008 the procedure was broadcasted live in television for the first time.

Where?

In “Extreme Make Over” show by Mega Channel.

Is this when the technique was first applied?

We were among the first to perform it. We first started using this technique in London, in 2003.

What are your conclusions after so many cases, publications and presentations on this technique?

1. It yields the best possible results in selected patients
2. Complications have been drastically reduced. It would be interesting to see a slide presentation with comparisons of complications as presented in the Paris Meeting in January 2009, in Rhodes, in September 2009, in Berlin, in 2007 and in Vienna, in 2005. In Paris and Rhodes there were 800 cases, in Berlin, in 2007 575 cases and in Vienna 2005 190 cases. Complications and revision surgery has reduced dramatically.

Is this reduction in complications due to the Subfascial technique?

It is due to the Subfascial technique but also to the so-called non–touch, non-pain technique for pocket preparation.

What is this technique?

Lets just say that we are able to prepare the pocket without causing haemorrhage.  This way we avoid the use of drains, we do not use bandage or compression garments or bras on the breasts and no special massage is required. Research has shown that the average quantity of blood lost during surgery was 4 cc, which is equal to 0. Surgery time was between 75 and 22 minutes, with average of 40 minutes. Patient satisfaction was nearly 99 %.

What happens with older techniques such as the subglandular and submuscular procedures?

Personally, I perform two techniques. The subfascial and the dual plane technique. This is because these techniques have minimum complications and, particularly, I am able to prevent the formation of capsular contracture and displacement of the implant underneath the muscle.