Since the government approved the application of cohesive silicone gel two years ago, surgery for augmentation mammaplasty has gradually enhanced. This is undeniable a great advancement of post-operative quality for patients with breast augmentation.

Nevertheless, the general public cannot disassociate augmentation mammaplasty with pain, bleeding and other pre-established perception within short period of time. Therefore, the editor hopes to introduce the contemporary augmentation mammaplasty in this article, thereby providing readers the accurate information of modern augmentation mammaplasty. With zero fear and no worries, enjoy the burden-less happiness and confidence!

Presently, the medical field primarily adopted surgery with low operation risk, minimal post-operative pain and short post-operative care for the enhancement of augmentation mammaplasty. The conventional subpectoral breast implant commonly causes bleeding during surgery, insufficient stripping space and severe post operative pain. Occasionally, application of drainage tubes is required to induce blood and fluid. Since the endoscopic surgeries are widely adopted in recent years, these drawbacks have been greatly improved. In addition, the degree of postoperative bleeding and pain are intensely reduced. The pros and cons of endoscopic augmentation mammaplasty are explained below:

Pros:
1. Field of vision during surgery is good with minimal dead angle. The adequate and uniform stripping space eases post-operative care.
2. Hemostasis during operation is possible, hence reducing complications such as post-operative hematoma. Additionally, the application of drainage tube after surgery is unnecessary.
3. Electrosurgical cautery is employed, thereby decreasing post-operative pain as compared to the surgery by conventional stripper devices.

Cons:
1. Longer duration of operation (averagely 2 to 2.5 hours) with high surgical cost.
2. Electrosurgical cauterization may destroy sensory nerves causing the slight reduction of nipple sensitivity.
3. Only professional surgeon of augmentation mammaplasty can implement the operation.

However, endoscopic is not omnipotent. According to the editor’s experience, subpectoral implant will cause pain in post-operative massage due to the pressing of implant on the muscle or rigidness of implant from exercising the arms or chest muscle. Furthermore, changes to the firmness may occur after a long period of time. Therefore, post-operative care for subpectoral augmentation mammaplasty is averagely extended to 6 months, which may become a huge burden for consumers who desire for rapid recovery.

Nevertheless, the previously mentioned subpectoral issues have gradually improved after the introduction of cohesive silicone gel. The current trend is to insert the implant on the subfascial (between the pectoralis major muscle and mammary gland tissue). So, what are the pros and cons of subfascial augmentation mammaplasty?

Pros:
1. There are less nerves and blood vessels distributed on the fascia layer. Therefore, bleeding during operation can be regulated to the lowest possible range. No-pain or minimal post operative pain.
2. Routine exercise of pectoral muscle will not cause pressing of implant to the fascia layer. Hence, less pain during post-operative massage. The post-operative massage and care can be reduced to less than 3 months which is suitable for those who are extremely fear of pain.
3. After operation, recovery is rapid to return for routine exercise. Exercise on the pectoral muscle will not affect the stability of implants. Post-operative exercise will not induce firmness or alteration to the breast. Hence, it is suitable for sports-lover, dancer and other groups.

Cons:
1. The fascia layer is thinner than the epidermis layer. Hence, saline-filled implant is not suitable as the edges or folds of the implant may be easily seen or touched.
2. It is not suitable for those naturally born with thin chest skin or underweight. Otherwise, the existence of silicone gel can be easily felt.
3. Candidates with under developed chest are not suitable for large size implant or it may feel unnaturally round and hard.
4. A large size implant may cause loosening of skin or sagging breasts in the future.

The traditional subfascial augmentation mammaplasty has incision through the areola which frequently induces decrease of nipple sensitivity or scars that will not easily fade away. In addition, the surgery will destroy the partial mammary gland tissue affecting the capability of consumers to breast fed in the future.

Presently, the editor has mostly implemented enhanced subfascial augmentation mammaplasty with incision through the axilla. The new endoscope can stripe and retain the complete thin layer of fascia. Besides avoiding the mammary gland tissue without damaging it, the scar can be hidden underneath the natural fold of axilla. In addition, the incision length can be reduced within 3.5 – 4cm. This surgery not only retains all the advantages of subfascial augmentation mammaplasty but also greatly decrease pain and recovery period. Furthermore, the scar can be utterly hidden. This near-to-perfect breast augmentation is believed to be the main future trend of augmentation mammaplasty.

Are you interested? Start consulting some plastic surgeons!