Monterrey, Nuevo Leon, Mexico.
Aesthetic Plast Surg. 2010 Feb;34(1):16-22. doi: 10.1007/s00266-009-9402-4. Epub 2009 Oct 22.
Throughout the years the female breast has been manipulated through aesthetic and reconstructive surgery. Since the 18th century there have been reports of techniques that have tried to increase the volume of the mammary gland. This article demonstrates a technique for increasing the volume of the mammary gland by dissection of the fascia of the pectoralis major muscle. This technique provides long-term results due to the optimized dynamics between the soft tissue and the implant. The subfascial technique is paramount to the subglandular method because primarily it offers better palpable firmness in the periareolar area, a significant decrease in the step effect produced by an excessive projection of the breast, a favorable gravitational pull of the breast, and a considerable reduction in the incidence of capsular contractures. The movement of the implant, postsurgical pain, and bleeding caused by the incision of the pectoralis muscle diminish with this technique. Because of the fascia's tendency to be preserved, this procedure has the advantage of being able to be applied where previous surgery has been performed; this concedes the subfascial technique a more versatile angle.
In the last 10 years 1000 patients were subjected to subfascial breast augmentation with soft-gel cohesive textured implants. An inframammary incision was used in 95% of the patients and the periareolar incision in 5%.
The patient does not suffer from immediate postsurgical pain. Recovery time and the ability to start daily activities is briefer than after the submuscular procedure. A better projection is obtained without the need to use a bigger implant to get the same result because there is no pressure on top of the implant as in the submuscular technique.
The subfascial procedure offers a high-grade result for the short and long term and has fewer disadvantages than the submuscular or subglandular technique. Likewise, there are fewer immediate postoperative symptoms and patients have a much better and less painful recovery. The morbidity in these patients is less than with the subglandular and submuscular methods.
多年来，女性乳房一直通过美容和重建手术进行操作。自 18 世纪以来，已经有报道称已经尝试过各种技术来增加乳腺的体积。本文展示了一种通过解剖胸大肌筋膜来增加乳腺体积的技术。由于软组织和植入物之间的优化动力学，该技术提供了长期的效果。皮下技术比胸肌下方法更为重要，因为它主要在乳晕区域提供更好的可触及的坚实度，显著减少因乳房过度突出而产生的台阶效应，乳房的有利重力吸引力，以及包膜挛缩的发生率大大降低。随着这种技术的应用，植入物的运动、术后疼痛和胸大肌切口引起的出血都会减少。由于筋膜有保留的趋势，因此该手术具有能够在先前手术部位应用的优势；这使得皮下技术具有更通用的角度。
在过去的 10 年中，1000 名患者接受了软凝胶粘性纹理植入物的皮下乳房增大手术。95%的患者采用了乳晕下切口，5%的患者采用了乳晕周围切口。
患者不会遭受术后立即疼痛。与胸肌下手术相比，恢复时间和开始日常活动的能力更短。获得更好的突出效果，而无需使用更大的植入物来获得相同的效果，因为植入物顶部没有压力，而在胸肌下技术中则有压力。
皮下手术提供了短期和长期的高质量效果，并且比胸肌下或胸肌下方法的缺点更少。同样，术后即刻症状较少，患者的恢复情况更好、疼痛更少。这些患者的发病率低于胸肌下和胸肌下方法。
