Alternative technique for breast augmentation in patients with a small transthelial incision

Background. The selection of skin incision location for augmentation mammaplasty is very important. Up till now, there are no established standards for skin incision. Convenient and less invasive operating procedure with minimal postoperative scar formation are the developing directions. Objective. To describe a simple procedure for breast augmentation in patients with a small transthelial incision to produce an inconspicuous scar. Methods. All patients underwent surgery under either general or local anesthesia. We utilized the transthelial incision, which was 2 mm higher than lower nipple margin. It could be extend using a back cut within the pigmented areolar skin bilaterally. Total incision length was about 2 cm. The dissection was made through the mammary parenchyma or subglandular for implant placement. A saline breast implant with diaphragm valve was inserted and injected 200-300 ml saline, which was followed by sealing in layers and wrapping up the incisions after confirming the symmetrical size and shape for both breasts. Results. Between January 2000 and December 2007, we used this incision technique in thirty patients, who requested primary or secondary breast augmentation with saline breast implants. All the patients displayed excellent satisfaction postoperatively and at final follow-up with minimal scar formation as well as scar color and quality of healing. There were no deformation of nipples and capsular contracture of implants, and no implant asymmetry bilaterally. Mild post-operative sensory loss was present in 1 up to 3 months postoperatively in 5 patients which was resolved ultimately. Ten patients had rippling and two patients required insertion of new implants because of rupture of implants. Conclusions. This simple procedure is an effective technique for augmentation mammaplasty with saline-filled implants, which has less complication rate with minimal scar formation. Wide spread application of this implant is recommended to establish its acceptability.