Subfascial Mini-Muscle Release Dual-Plane Technique: A Modified Procedure for Breast Augmentation.

Background: Each breast augmentation technique has advantages and indications, and the quest for the perfect implant pocket plane is ongoing. An ideal dual plane should meet 3 requirements: adequate implant coverage, optimal control of breast shape, and maximal muscle preservation. The authors report a modified procedure for breast augmentation: the subfascial mini-muscle release dual-plane technique.

Methods: From an inframammary or periareolar approach, the implant pocket is dissected in a subfascial plane up to the pectoralis major muscle. The muscle is split 3 cm above the lateral margin, and then pocket dissection proceeds in the submuscular plane. A small portion of the costal origin is divided inferomedially to create a dual plane.

Results: This study included a total of 178 patients with hypoplasia or breast atrophy, among whom 34 had breast ptosis and 20 had tubular breast deformity. The median follow-up period was 20 months. The average implant volume was 268.8 mL, and a smooth implant was used in 85.4% of cases. There was 1 case of hematoma, 2 cases of wound-healing issues, 2 cases of rippling, 2 cases of grade III or IV capsular contracture, 5 cases of implant malposition, and 12 cases of mild muscle contraction-associated deformity. Revision procedures were performed on 2 patients.

Conclusions: The subfascial mini-muscle release dual-plane technique is an easy method of breast augmentation, and it is especially indicated for ptotic breasts and tubular breast deformities. This technique combines the advantages of traditional dual-plane and muscle-splitting techniques, yielding a satisfactory aesthetic outcome.

Clinical question/level of evidence: Therapeutic, IV.