Augmentation Mammaplasty in Asian Women

ABSTRACT

With the rapid economic development of Southeast Asia, the demand for cosmetic surgery has increased rapidly. Breast augmentation is among the most frequently performed cosmetic procedures. However, breast augmentation still has “bad press” in Southeast Asia because of not so distant catastrophes caused by direct liquid silicone injection and “Amazing Gel” augmentations. Asian patients have special characteristics that need to be taken into consideration when performing breast augmentation. The patients are usually thin and small with proportionally smaller breasts. The areola is often small with a large nipple. Because of poor scar healing, incisions need to be hidden. The transaxillary approach is therefore favored. A frequently performed adjunctive procedure is nipple reduction. In this article, the authors present their preferred technique for augmentation mammaplasty: endoscopically assisted subpectoral placement of smooth saline-filled implants via a transaxillary approach. Simultaneously, nipple reduction with the “modified top-hat flap” procedure is presented. Complications and their management are also discussed.

KEYWORDS

Breast augmentation - Asian - endoscopically assisted - aesthetic surgery

REFERENCES

• 1 American Society of Plastic Surgeons .2000/2005/2006 National Plastic Surgery Statistics, Cosmetic and Reconstructive Procedure Trends. Available at: http://www.plasticsurgery.org/media/statistics/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=23628 Accessed December 8, 2008
• 2 Mizuno H, Hyakusoku H, Fujimoto M, Kawahara S, Aoki R. Simultaneous bilateral breast reconstruction with autologous tissue transfer after the removal of injectable artificial materials: a 12-year experience.  Plast Reconstr Surg. 2005;  116 450-458
• 3 UPI .Amazing gel woes may be “enormous.” The Post Chronicle 2006;May 31. Available at: http://www.physorg.com/news68374349.html Accessed December 8, 2008
• 4 Macarthney J. Thousands maimed by “miracle” implants gel. Times of London, 2006;May 31. Available at: http://www.timesonline.co.uk/tol/news/world/asia/article669884.ece Accessed December 8, 2008
• 5 Baxter R A. Nipple or areolar reduction with simultaneous breast augmentation.  Plast Reconstr Surg. 2003;  112 1918-1921
• 6 Cheng M H, Smartt J M, Rodriguez E D, Ulusal B G. Nipple reduction using the modified top hat flap.  Plast Reconstr Surg. 2006;  118 1517-1525
• 7 Sevin A, Sevin K, Senen D, Deren O, Adanali G, Erdogan B. Augmentation mammaplasty: retrospective analysis of 210 cases.  Aesthetic Plast Surg. 2006;  30 651-654
• 8 Lee E J, Jung S G, Cho B C, Kim Y B. Submuscular augmentation mammaplasty using a perinipple incision.  Ann Plast Surg. 2004;  52 297-302
• 9 Price C I, Eaves III F F, Nahai F, Jones G, Bostwick III J. Endoscopic transaxillary subpectoral breast augmentation.  Plast Reconstr Surg. 1994;  94 612-619
• 10 Ho L C. Endoscopic assisted transxillary augmentation mammaplasty.  Br J Plast Surg. 1993;  46 332-336
• 11 Momeni A, Padron N T, Föhn M et al.. Safety, complications, and satisfaction of patients undergoing submuscular breast augmentation via the inframammary and endoscopic transaxillary approach.  Aesthetic Plast Surg. 2005;  29 558-564
• 12 Ulusal B G, Cheng M H, Wei F C. Simultaneous endoscope-assisted contralateral breast augmentation with implants in patients undergoing postmastectomy breast reconstruction with abdominal flaps.  Plast Reconstr Surg. 2006;  118 1293-1302
• 13 Codner M A, Cohen A T, Hester R. Complications in breast augmentation: prevention and correction.  Clin Plast Surg. 2001;  28 587-595
• 14 Hodgkinson D J. The management of anterior chest wall deformity in patients presenting for breast augmentation.  Plast Reconstr Surg. 2002;  109 1714-1723
• 15 Spear S L, Pelletiere C V, Lee E S, Grotting J C. Anterior thoracic hypoplasia: a separate entity from Poland syndrome.  Plast Reconstr Surg. 2004;  113 69-77