Transaxillary dual-plane augmentation mammaplasty: experience with 98 breasts

The dual plane technique is a popular procedure for breast augmentation. However, traditional dual-plane augmentation mammaplasty usually requires incisions through the areola or inframammary crease, which produces a scar on the breast. Therefore, women may not favour this technique, especially Chinese women who are genetically susceptible to hyperplastic scars. In our institution, endoscopic transaxillary dual-plane augmentation mammaplasty was performed in patients under general anaesthesia. Incisions (4cm long) were designed to overlap the natural creases of the skin bilaterally behind the mid-transaxillary frontline. The space behind the pectoralis major muscle was separated conventionally. Assisted by a 10mm/30° endoscope, part of the ectopectoralis was excised. Through the transaxillary incision, the rough-surfaced silicone gel breast prosthesis was implanted. The volume varied from 185 to 315g, and a routine indwelling drainage tube was inserted. From March 2006 to May 2007, we performed 49 cases of augmentation mammaplasty applying endoscopic-assisted dual-plane technique. At 6- to 12-month follow up, the surgical outcomes were satisfactory. There were no complications, such as capsular contracture, bleeding, scar hyperplasia, or infection. We believe that the dual-plane augmentation mammaplasty can be performed via transaxillary incision using an endoscope. Since the surgical incision is far from the front of the breast with this method, no scarring of the breast develops. Furthermore, the adoption of the dual-plane technique provides superior form to the anatomical prosthesis in the breast, alleviates postoperative pain, and improves suppleness of the postoperative breast.