Transabdominal Breast Augmentation With Silicone Gel Implants

Abstract

Background Breast augmentation is frequently performed together with abdominoplasty. Although breast augmentation incisions generally heal well, patients almost universally will appreciate having fewer scars; this is the basic rationale for transabdominal breast augmentation. In addition, a transabdominal approach may decrease the risk of implant contamination because there is no contact of the implants with skin. Methods A chart review of the senior author's private practice, from 2012 to 2020, was performed; 68 female patients who underwent abdominoplasty in association with transabdominal breast augmentation, with at least 1 year of follow-up, were included. All patients underwent liposuction, standard abdominoplasty with wide suprafascial abdominal flap undermining, and liposuction of the abdominal flap as needed. Round, silicone gel implants (Mentor Siltex, Santa Monica, CA) were used. Results A total of 68 patients were operated on. Mean age was 49 years (range, 25–68 years), mean body mass index was 25.7 kg/m2 (range, 22.3–29.5 kg/m2). The most commonly used implant volume (mode) was 270 mL (range, 225–395 mL). Implants were high (75%) or ultrahigh profile (25%). Eight patients (15%) had previously undergone breast augmentation. Seven patients (12%) underwent simultaneous breast fat grafting. There were no major complications. There were no complications related to the breast augmentation (ie, no extrusion or infection, malposition requiring revision, or capsular contracture). No patients requested upsizing or other revision of their implants. With regard to the abdominoplasty, there were 4 cases of well-circumscribed seroma treated with serial aspiration in the office. There were no cases of abdominoplasty site infection. Five patients required revision of abdominoplasty incisions. Two patients requested revision liposuction after weight gain. Conclusions Breast augmentation through an abdominoplasty incision may incur benefits beyond the obvious single surgical scar. Overall, transabdominal breast augmentation, in adequately selected patients, is an option which is safe, does not increase operative time, can lead to good results, and may potentially decrease some complications related to breast augmentation through other incision sites.

A Modification in Transabdominal Approach for Breast Augmentation (TABA) in Combined Surgery Patients

“…This technique was described by Hinderer in 1975 and it has been used and published with minor modifications or the same technique supporting the describing author [3][4][5][6][7] has been used. The main principle of this technique is the preparation of two different tunnels from the upper dissection border of the abdominoplasty, in inferomedial to superolateral direction to reach the implant pouch preparation area.…”

“…The main principle of this technique is the preparation of two different tunnels from the upper dissection border of the abdominoplasty, in inferomedial to superolateral direction to reach the implant pouch preparation area. [3][4][5] Following the implant insertion, the obliteration of the tunnels requires some fixation sutures to prevent implant migration and to restore the partially dissected submammary fold.…”

“…This hypothesis is also mentioned in previous TABA procedure performing authors. [1][2][3][4][5][6][7][8] The post operative antibiotics in addition to the implant wash with rifamycine +SF solution, as cephalosporine and an aminoglycozide for 48 hours IV, oral continuation with quinolone for 5 days more. 6,7 None of the cases had an infection de-…”