Endoscopic Primary Breast Augmentation With Loco-Regional Anesthesia: Preliminary Experience of 200 Consecutive Patients.

Background: Breast augmentation with implants recorded over 1.6 billion procedures globally in 2022. To reduce surgical trauma and complications and facilitate a fast recovery, we employ an ultrasound-guided local-regional anesthesia technique, the creation of a partial submuscular implant pocket by direct endoscopic visualization and minimal skin access on the mammary fold.

Objectives: The aim in this study is to evaluate whether breast augmentation performed in endoscopy under local-regional anesthesia reduces postoperative recovery time, reduces complications, and increases patient satisfaction.

Methods: Patients provided their consent through a signed form. We set strict inclusion and exclusion criteria. We prospectively evaluated postoperative pain and recovery times, the rate of complications, and patient satisfaction at 12 months postsurgery.

Results: Between January 2021 and September 2022, 200 patients met the inclusion criteria. The average operation time was 54.2 min. Patients were discharged from the hospital within 2 to 3 h. Eighty-nine percent of patients expressed great satisfaction with the result. None of the patients experienced postsurgical complications.

Conclusions: In our initial study, we showed that endoscopic breast augmentation conducted under localized anesthesia is safe. It allows for quick recovery postsurgery and swift resumption of everyday activities. The overall complication risk is less than what has been reported in scientific studies for the classic dual-plane technique. Moreover, this approach yields excellent patient satisfaction. Additional prospective and randomized studies will be required to enhance the scientific validity of this technique. Moreover, a larger patient cohort will be essential to stratify the risks associated with varying prosthetic volumes.

Level of evidence 4: