A Modified Dual-plane Technique Using the Serratus Anterior Fascia in Primary Breast Augmentation

Hwang, Dong Yeon; Park, Sang Hoon; Kim, Sang Wha

doi:10.1097/gox.0000000000001213

Cited by 6 publications

(4 citation statements)

References 19 publications

(34 reference statements)

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“…Prior to surgery, the participating patients were randomized into one of two study groups (Scheme 1). The two groups were: Group 1 (the “standard control group”): These patients received standard postoperative pain control with IV opioids, NSAIDs and acetaminophen (paracetamol).Group 2 (the “block group”): Immediately after induction of anesthesia and positioning for surgery, these patients received ultrasound-guided SAP block (a single injection of 0.25% bupivacaine hydrochloride 2 mg/kg plus dexamethasone 8 mg) 11–13. These patients also received the standard postoperative pain control regimen.…”

Section: Methodsmentioning

confidence: 99%

“… Group 2 (the “block group”): Immediately after induction of anesthesia and positioning for surgery, these patients received ultrasound-guided SAP block (a single injection of 0.25% bupivacaine hydrochloride 2 mg/kg plus dexamethasone 8 mg). 11 – 13 These patients also received the standard postoperative pain control regimen. We used the Linear 6–13 MHz probe for ultrasound-guided block.…”

Section: Methodsmentioning

confidence: 99%

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<p>Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery</p>

Semyonov¹,

Fedorina²,

Grinshpun³

et al. 2019

JPR

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BackgroundPatients who undergo surgical procedures that impair the integrity of the chest wall frequently experience extremely severe postoperative pain. Opiates and weaker analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are not sufficiently effective in achieving control of severe pain and might cause respiratory and gastrointestinal complications. In the past decade, there has been an increased interest in the use of regional nerve blocks for post-thoracoscopy and post-thoracotomy analgesia.MethodsThis is a prospective, randomized, double-blind and single-center study. We recruited 104 patients who underwent elective thoracoscopy. Prior to surgery, the participating patients were randomized into one of two study groups: Group 1- the “standard control group” that received standard postoperative pain control with intravenous opioids, NSAIDs and acetaminophen (paracetamol) and Group 2- the “block group” that was treated by ultrasound-guided serratus anterior plane (SAP) block (a single injection of 0.25% bupivacaine hydrochloride 2 mg/kg plus dexamethasone 8 mg) with standard postoperative pain control regimen. We compared the clinical, laboratory, and postoperative pain assessment data of both groups.ResultsPatients in the SAP block Group 2 reported significantly lower levels of pain after thoracic surgery as assessed by their visual analog scale scores, as compared to the patients in the standard pain control Group 1 (P<0.001). The total dosage of morphine and tramadol required for pain relief during the first hours after surgery was significantly lower in the patients who received SAP block. Also, the incidence of vomiting after surgery was significantly lower among the patients who received SAP block than among the patients who received standard pain control.ConclusionThe results of the present study suggest that SAP block is an effective adjuvant treatment option for post-thoracic surgery analgesia. Compared to the current methods used for post-thoracic surgery pain relief, SAP block has some significant merits, particularly its ease of use and its low potential for side effects.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

<p>Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery</p>

Semyonov¹,

Fedorina²,

Grinshpun³

et al. 2019

JPR

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“…This reverse dual plane ensures the thickness and supports the strength of the soft tissue that covers the lower pole of the implants. 21 , 22 Some adverse consequences of subfascial or subglandular implant placement may decrease, such as increased mastoptosis, enlargement of the areolas, palpability of the implants, and capsular contracture. 19-22 …”

Section: Discussionmentioning

confidence: 99%

The Reverse Dual Plane: A Novel Technique for Endoscopic Transaxillary Breast Augmentation

Ya,

Xiao,

Zhou

2024

Aesthetic Surgery Journal Open Forum

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Background Quite a few Asian patients prefer axillary incision for breast augmentation. However, this surgery needs to improve. Objective To introduce a reverse dual-plane technique through a transaxillary approach and compare it to a transaxillary dual-plane approach. Methods Eighty-two patients were divided into group A (n = 40) and group B (n = 42). Axillary incision and endoscope were utilized in the two groups. Tebbetts’ dual-plane was performed in group A. Patients in group B underwent our reverse dual-plane technique, in which the upper 70% was subfascial and the lower 30% was subpectoral, with the fascia of the external oblique and anterior serratus being elevated together with the pectoral muscle. The Numeric Pain Rating Scale (NPRS) scores were recorded daily for 7 days. Breast shape and softness, in both sitting and supine positions, were assessed by the patients, and complications were compared. Results The NPRS scores of group B were significantly lower than group A (P < .01). The satisfaction rate of shape and softness in the seated position was not significantly different (P > .05). However, in the supine position, only 20 patients (50.0%) in group A and 32 patients (76.2%) in group B were satisfied with their breast softness (P < .01), the others breasts became stiffer. Breast animation deformity (BAD) occurred in 2 cases in group A and none in group B (P < .01). Other complications were not significantly different. Conclusions Compared to Tebbetts’ dual-plane, this procedure significantly reduced pain, improved breast softness, and eliminated BAD, without increasing complications.

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“…Aesthetically a muscular layer camouflages implant edges and minimises the appearance of rippling particularly in leaner patients but an underdeveloped pocket may compress the implant and create a more pronounced rippling effect. The pectoralis muscle would often not be adequate to completely cover the implant and recruiting either serratus anterior or rectus abdominis would be required to provide lower pole coverage [38]. Importantly a submuscular plane was shown to have the lowest incidence of capsular contraction when compared to other implant pocket positions [39].…”

Section: Intraoperative Techniquementioning

confidence: 99%

Immediate Breast Reconstruction with Implants

Lok,

2024

Breast Reconstruction - Conceptual Evolution

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Immediate breast reconstruction following mastectomy improves quality of life with benefits observed in body image and psychological health. An implant based reconstruction is one of the most common options utilised and a successful outcome relies on careful patient selection and technical decisions made intraoperatively. Significant technological adjuncts has advanced the role of direct to implant reconstruction by reducing rates of complications and implant failure. Understanding past techniques and variables in current practices facilitates operative management to provide an optimal implant based reconstructive outcome.

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A Modified Dual-plane Technique Using the Serratus Anterior Fascia in Primary Breast Augmentation

Cited by 6 publications

References 19 publications

<p>Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery</p>

<p>Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery</p>

The Reverse Dual Plane: A Novel Technique for Endoscopic Transaxillary Breast Augmentation

Immediate Breast Reconstruction with Implants

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