Revisionary Surgery Following Primary Augmentation Mammoplasty in Muscle Splitting Biplane Pocket: An Appraisal of 93 Revisionary Surgeries.

[BACKGROUND] Muscle splitting augmentation mammoplasty is the creation of a submuscular pocket which is gaining attention and acceptance by plastic surgeons worldwide. First introduced in 2007, muscle splitting augmentation mammoplasty has since been used for primary and secondary augmentation mammoplasty and augmentation mastopexy procedures. A personal experience of revision surgeries following muscle splitting augmentation mammoplasty is presented.

[METHODS] A retrospective data analysis for revision surgeries, following muscle splitting primary augmentation mammoplasties, performed between October 2005 and October 2018 was carried out.

[RESULTS] A total of 1511 primary augmentation mammoplasties were performed. Of these 1511 patients, 93 (6.1%) patients had revisionary or secondary surgery. The mean age of the patients was 33.8 + 9 years (range 20-60). Of the 93 patients, 78 patients had same size implants, mean 337 cc + 53.5 (range 230-495), and 14 had different size implants. Of these 14 patients, mean implant size on right and left was 331 cc + 59.4 (range 225-425) and 351 cc + 61.7 (range 260-450), respectively. Of the recorded texturing in 1495 patients, only 3.1% had smooth implants. Leading causes for revision were implant exchange for various reasons, in 33 (35.4%); 25 (26.8%) wanted larger implants, revisionary surgery for capsular contracture in 18 (19.3%), implant rupture was seen in 9 (9.6%), 4 (4.3%) patients had surgery for recurrent back-to-front flipping, 2 (2.1%) patients wanted a smaller size, 1 (1.07%) patient had fold flaw failure, and in 1 (1.07%) the cause was not recorded. There were no haematoma and breast implant-associated anaplastic large cell lymphoma (BIA ALCL) recorded in the series.

[CONCLUSION] The incidence of revisionary surgery following muscle splitting primary augmentation mammoplasty is acceptable and can be corrected using the described techniques.

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