The effect of clinical application of modified dual-plane implant augmentation mammoplasty through areola incision
10.3760/cma.j.cn114453-20241208-00315
- VernacularTitle:经乳晕切口改良双平面假体隆乳术的临床应用效果
- Author:
Zumeng YA
1
;
Luheng ZHOU
1
;
Guangzhi YANG
1
;
Lin XIAO
1
Author Information
1. 重庆当代整形外科医院外科，重庆 400021
- Publication Type:Journal Article
- Keywords:
Breast;
Augmentation mammoplasty;
Breast implant;
Dual plane;
Modification;
Patient satisfaction;
Complications
- From:
Chinese Journal of Plastic Surgery
2025;41(6):591-598
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of a modified dual-plane implant augmentation mammoplasty via periareolar incision.Methods:The patients undergoing primary breast augmentation at Vcharm Plastic & Aesthetic Surgery Hospital of Chongqing from October 2018 to June 2023 were enrolled in this prospective cohort study. Participants were alternately assigned to Group A (traditional Tebbetts dual-plane implant augmentation mammoplasty) and Group B (modified dual-plane implant augmentation mammoplasty) based on admission sequence. The modified technique included sharp subfascial dissection above the 5th rib, oblique muscle dissection below the 5th rib to create a subpectoral pocket, and elevation of the serratus anterior and external oblique fascia to the newly defined inframammary fold. Implants were positioned with 70% in the subfascial plane superiorly and 30% in the submuscular-fascial plane inferiorly. Postoperative pain was assessed using the numerical rating scale (NRS, 0-10) during days 0-7. Patient satisfaction (breast morphology, breast softness in sitting and supine positions) and complications were evaluated at 12-month follow-up. Statistical analysis was performed using SPSS 24.0. The measurement data were expressed as Mean ± SD, and the inter-group comparisons were performed by t-test. The enumeration data were expressed as examples and (or) percentages, and the inter-group comparisons were performed by χ2 test or Fisher exact probability test. P<0.05 was considered to be statistically significant. Results:Forty-eight female patients were included in Group A with age of (34.0±5.0) years and body mass index of (20.6±3.1) kg/m 2. Forty-three cases were received anatomical implants, and 5 cases rough round implants. The volume of implants was (265.0±12.5) cc. Fifty female patients were included in Group B with age of (35.0±4.5) years and body mass index of (21.5±3.7) kg/m 2. Forty-two cases were received anatomical implants and 8 cases rough round implants. The volume of implants was (262.0±15.0) cc. Baseline characteristics (age, body mass index, implant type, volume) showed no intergroup differences ( P>0.05). Group B demonstrated significantly lower NRS scores than Group A at all timepoints ( P<0.05). The immediate postoperative scores were 8.0±1.6 vs. 4.8±0.8, decreasing to 4.4±0.7 vs. 2.2±0.3 on Day 7. At 12 months, satisfaction rates for breast morphology[91.7%(44/48) vs. 92.0%(46/50)] and breast softness in sitting position [85.4%(41/48) vs. 86.0%(43/50) ] were comparable (both P>0.05). However, superior breast softness satisfaction in supine position was achieved in Group B [64.0%(32/50) vs. 43.8%(21/48), P<0.01] and fewer patients reported marked softness deterioration in supine position [28.0%(14/50) vs. 54.2%(6/48), P<0.01]. No hematoma, infection, delayed wound healing, implant malposition or wavy breast occurred in two groups. Capsular contracture occurred in 1 case per group. The implant was easy to be touched in 5 and 6 cases of Groups A and B, respectively ( P>0.05), while dynamic distortion was observed only in Group A (1 vs. 0, P<0.01). Conclusion:The modified dual-plane implant augmentation mammoplasty via periareolar incision significantly reduces postoperative pain, enhances breast softness in supine position, and prevents dynamic distortion without increasing complication risks, representing an optimized approach for implant-based augmentation.
