Comments on “A Four-Layer Wound Closure Technique with Barbed Sutures for Stable Reset of the Inframammary Fold in Breast Augmentation”

Atiyeh, Bishara S.; Chahine, Fadel

doi:10.1093/asj/sjw122

Cited by 8 publications

(5 citation statements)

References 2 publications

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“…It is interesting to note that some surgeons have excluded patients with hypotonic airway conditions from undergoing MDO, as they assumed it would not sufficiently address the multifactorial nature of the airway obstruction in such patients. 5 Thus, the current study's results may challenge this paradigm, although further investigation and long-term follow-up are necessary to confirm their results.…”

Section: Roisin T Dolan MDmentioning

confidence: 70%

“…Moreover, this technique creates a valve-like closure that is reinforced by normal implant pressure against the suture line; it minimizes the risk of wound dehiscence and implant extrusion. 5 Letter to the Editor: Comment onEl-Gammal W e read with great interest the article entitled "Long-term outcome of phrenic nerve transfer in brachial plexus avulsion injuries" by El-Gammal et al 1 The authors summarized their experience using phrenic nerve transfer to coapt axillary, spinal accessory nerve, and posterior division of upper trunk to restore shoulder abduction and external rotation in patients with traumatic brachial plexus avulsion injuries. 1 We applaud the authors' superior functional outcomes.…”

mentioning

confidence: 99%

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Letter to the Editor: Comment onEl-Gammal TA, et al. Long-Term Outcome of Phrenic Nerve Transfer in Brachial Plexus Avulsion Injuries (Ann Plast Surg 2021;86:188–192)

Dolan

Cronin

2021

Ann Plast Surg

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Section: Roisin T Dolan MDmentioning

confidence: 70%

mentioning

confidence: 99%

Letter to the Editor: Comment onEl-Gammal TA, et al. Long-Term Outcome of Phrenic Nerve Transfer in Brachial Plexus Avulsion Injuries (Ann Plast Surg 2021;86:188–192)

Dolan

Cronin

2021

Ann Plast Surg

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“…Modifications by Atiyeh and Chahine27 include the generation of a flap based on the cephalead skin flap and suturing this down to the fascia for more support whereas Ho et al28 use a retromammary adipofascial flap. All these steps help to keep the IMF as the keystone of esthetic breast augmentation in place.…”

Section: Discussionmentioning

confidence: 99%

Multiplanar (4-Dimension) Breast Augmentation—A Personal Surgical Concept for Dynamic Implant-Tissue Interaction Providing Sustainable Shape Stability

Vogt

Mackowski²,

Dastagir

2023

Journal of Craniofacial Surgery

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Background: In esthetic breast augmentation long-term shape stability and natural appearance remain an ongoing challenge. The authors found that to reduce the incidence of secondary deformity and increase the natural feel and appearance, a standard multiplanar procedure combining a subfascial and dual plane approach with fasciotomies will provide long-term stability and esthetic quality. Patients and Methods:The technique involves a submuscular dissection, release of the infranipple portion of the pectoralis muscle combined with the wide subfascial release of the breast gland, and scoring of the deep plane of the superficial glandular fascia. For long-term stability, a firm fixation of the glandular fascia at the inframammary fold to the deep layer of the abdomino-pectoral fascia is critical. Long-term results were analyzed for up to 10 years. Results: Postoperative measurements proved the intrinsic balance of the breasts without significant changes over time. The overall complication rate was <5%. Shape stability was observed over 10 years in more than 95% of the patients. Unsightly muscular animation could be avoided in almost every patient. Conclusions: Our results indicate that a technique of multiplane breast augmentation provides long-term stability and esthetic quality. By combining the benefits of well-established techniques of a submuscular dual plane, additional shaping through a controlled deep fasciotomy and stable inframammary fold fixation some of the existing tradeoffs of the different methods can be avoided.

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“…Modifications by Atiyeh [23] include the generation of a flap based on the cephalead skin flap and suturing this down to the fascia for more support or from the retgroglandular plane while Ho et al [24] employ a retromammary adipofascial flap. All these steps help to keep the IMF as the keystone of aesthetic breast augmentation in place.…”

Section: Discussionmentioning

confidence: 99%

Implant-based multiplane breast augmentation—a personal surgical concept for dynamic implant–tissue interaction providing sustainable shape stability

Vogt

Mackowski²,

Dastagir

2021

Eur J Plast Surg

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Background The aesthetic long-term stability in shape, symmetry, and natural appearance of an aesthetically augmented breast remains a constant challenge. It has become clear that the results depend strongly on the technique applied and the experience of the surgeon. An ongoing controversy concerns the positioning of the implants. Subglandular, submuscular, partial submuscular, and subfascial pockets have different tradeoffs and advantages. However, secondary deformity, unnatural feel, and appearance are not addressed uniformly. The aim of the following study was to establish a standard procedure allowing for the desired and reproducible results to provide long-term stability and aesthetic quality. Methods The authors have developed a standardized dissection of a dynamic implant pocket. In this approach, a submuscular dissection with lower and medial release of the pectoralis muscle is combined with a wide subfascial release of the breast gland and a scoring of the deep plane of the superficial glandular fascia. In the final step, the deep layer of the glandular fascia is sutured tightly and firmly to the deep layer of the abdomino-pectoral fascia. A total of 867 patients received a 4D pocket–based breast implant by the authors. A subset of 33 patients was further analyzed for long-term results. Retrospectively, all data were analyzed from the electronic patient information system and files of patients using GraphPad 8. For comparison of multiple experimental groups, one-way ANOVA was performed where indicated. Results The concept not only addresses the biplanar approach of submuscular implant placement (3D) but adds the 4th dimension (4D) of an aesthetically pleasing dynamic shape of the augmented breast providing long-term stability. Measurements—taken at 3 months, and 1, 2, 3, 5, and ≥ 7 years post augmentation—for SN-N, N-IMF, N-ML, and MC-N distances did not show any significant changes over time. In the patient cohort of 867 patients (1734 implants), the overall complication rate was < 5%. Revisions for bleeding were below 0.5%. Shape stability was observed over 7 years in more than 95% of the patients. Conclusions Our results indicate that our technique of multiplane breast augmentation provides long-term stability and aesthetic quality. It may solve some of the existing tradeoffs of the different methods by combining the benefits of each technique supported by an additional shaping through a controlled deep fasciotomy. Level of evidence: Level IV, therapeutic study.

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Comments on “A Four-Layer Wound Closure Technique with Barbed Sutures for Stable Reset of the Inframammary Fold in Breast Augmentation”

Cited by 8 publications

References 2 publications

Letter to the Editor: Comment onEl-Gammal TA, et al. Long-Term Outcome of Phrenic Nerve Transfer in Brachial Plexus Avulsion Injuries (Ann Plast Surg 2021;86:188–192)

Letter to the Editor: Comment onEl-Gammal TA, et al. Long-Term Outcome of Phrenic Nerve Transfer in Brachial Plexus Avulsion Injuries (Ann Plast Surg 2021;86:188–192)

Multiplanar (4-Dimension) Breast Augmentation—A Personal Surgical Concept for Dynamic Implant-Tissue Interaction Providing Sustainable Shape Stability

Implant-based multiplane breast augmentation—a personal surgical concept for dynamic implant–tissue interaction providing sustainable shape stability

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