From the Department of Plastic Surgery, Kaplan Medical Center.
Plast Reconstr Surg. 2020 Feb;145(2):330-332. doi: 10.1097/PRS.0000000000006445.
Dual-plane breast augmentation offers the advantages of a subpectoral implant location with the ability to expand its use to glandular ptotic and constricted lower pole breasts. Alas, high implant position or very loose breast tissue can lead to a notorious breast shape known as the "waterfall deformity." To prevent many of these undesired deformities, the authors introduce a novel pectoralis major median myotomy they call the "median cut." From all of the dual-plane breast augmentations that were performed by the two authors between the years 2011 and 2017, a total of 605 included a median cut to resolve an apparent waterfall deformity. Without this procedure, a shift to subglandular augmentation would have been performed. The authors strongly believe that the median cut is a powerful and effective way to avoid intraoperative waterfall deformities and to have more women benefit from a submuscular approach. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.
双平面隆乳术具有胸肌下假体位置的优点，并且能够将其应用扩展到腺体下垂和下极收紧的乳房。遗憾的是，高假体位置或非常松弛的乳房组织可能导致一种称为“瀑布畸形”的明显乳房形状。为了预防许多这些不理想的畸形，作者引入了一种新的胸大肌正中肌切开术，他们称之为“正中切开术”。在两位作者 2011 年至 2017 年进行的所有双平面隆乳术中，共有 605 例采用正中切开术来解决明显的瀑布畸形。如果没有这个手术，就会转为胸肌下隆乳。作者强烈认为，正中切开术是一种避免术中瀑布畸形的有效方法，可以让更多的女性受益于胸肌下入路。临床问题/证据水平：治疗性，IV。
