#AB Plastic Surgery #AB Plastic Surgery #Breast Surgery #Implant Insertion #Implant Placement Space #AB #Gangnam Station Breast Surgery #AB

#SubfascialInsertion #DualPlane #Subfascial #Subglandular #AB #PlasticSurgerySpecialist

Hello, this is AB Plastic Surgery.

I will answer the questions you have been curious about.

Q.

Hello. I am scheduled for breast surgery.

I understand that there are muscles in the chest when placing an implant.

I understand the difference between placing it above the pectoral muscle or below it,

but I also learned that there are subfascial and subglandular placements when putting it above the muscle.

I would like to know what the difference is and which one is better.

AB.

Hello. That is a good question.

First, among the various terms used in breast augmentation surgery,

terms such as "subfascial," "dual plane," "above the muscle," "below the muscle," and "subglandular" refer to the layer (= plane) where the breast implant is placed.

Among these terms, the subglandular insertion and subfascial insertion you asked about are both above-the-muscle (supra-muscular) spaces. In contrast, the dual plane procedure, which is also commonly used in breast augmentation, is a surgical method in which the implant is placed in the sub-muscular space.

[Image source] Augmentation mammoplasty by subfascial technique - Rev. Bras. Cir. Plást. 36 (3) • Jul-Sep 2021

[Subglandular insertion] (the second image from the left)

This is a method of placing the implant below the glandular tissue of the breast.

It was widely used in the early days of breast augmentation, but it is not commonly used now.

[Subfascial insertion] (the far-right image)

At first glance, it may seem that the implant is in the same position as in subglandular insertion, but the crucial difference from subglandular insertion is that the fascial layer (the thin blue layer in the image) covers the implant.

Fascia is a thin, tough tissue that wraps around the surface of the muscle layer.

Although it is not bulky, there is a significant difference between having this tissue cover the implant and not having it cover the implant.

By wrapping the implant, the fascia has the advantage of making the implant edge less noticeable.

Reference : Graf RM et al. : Subfascial endoscopic transaxillary augmentation mammaplasty. Aesth Plast Surg 24:216, 2000

Reference: Graf RM et al. : Subfascial breast implant: A new procedure. Plast Reconstr Surg 111:904, 2003

There has also been a report that by lifting the fascial layer and dissecting it (separating the tissue), local blood vessels retract (draw back) into the pectoralis major muscle, resulting in less bleeding.

These days, the dual plane technique and the subfascial technique are the most commonly used methods for breast augmentation with implants.

(Of course, in some cases, submuscular surgery that does not dissect the pectoralis major at all is also necessary.)

There is no single method that is absolutely superior and can be said to be the best.

The best results come from choosing the appropriate method according to the characteristics of the patient’s breast tissue.

I will also cover the dual plane technique in a future blog post.

If you have any other questions, please feel free to leave a comment and I will answer.

Thank you.