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Aesthetic Plastic Surgery

, Volume 43, Issue 6, pp 1429–1436 | Cite as

Is There a Breast Augmentation Outcome Difference Between Subfascial and Subglandular Implant Placement? A Prospective Randomized Double-Blinded Study

  • Ivan Maluf JuniorEmail author
  • Ruth Maria Graf
  • Adriana Sayuri Kurogi Ascenço
  • Willian Itikawa
  • Priscilla Balbinot
  • Alexandre Mendonça Munhoz
  • Marlon Câmara Lopes
  • Isis Juliane Guarezi Nasser
  • Linei Augusta Brolini Dellê Urban
  • Renato da Silva Freitas
Original Article Breast Surgery
  • 165 Downloads

Abstract

Introduction

Subfascial breast augmentation is gaining popularity because of no distortion when the pectoral muscle is contracted and minimizing visualization of the edges of the implant. Although some studies have reported a satisfactory outcome with subfascial technique, it still is controversial the influence of the pectoral fascia and outcome compared to the subglandular technique. Therefore, this prospective randomized study aimed to investigate whether there are clinical/radiological differences between subfascial and subglandular pockets following primary breast augmentation.

Methods

Twenty patient candidates for primary breast augmentation were recruited. Each patient was selected for subfascial or subglandular pockets in a randomized fashion. Both patient and surgeon were blinded. Clinical and radiological differences were evaluated through five independent surgeons and MRI (capsule, folds, fluids, base and projection). Median follow-up was 12 months.

Results

Breast consistency (p = 0.24), implant pocket (p = 0.52), symmetry (p = 1), contour, and shape (p = 0.09) demonstrated no statistically significant difference after the surgeons’ assessments at 3 and 12 months after surgery. MRIs demonstrated a larger implant base in the subfascial group (p = 0.024). No differences were observed in capsule thickness (p = 0.42), folds (p = 0.51), fluids (p = 0.28), or projection (0.20).

Conclusion

The choice between subfascial and subglandular planes shows no clinical differences and can be selected according to individual professional experience, not evidencing any advantages of one over the other.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

Breast augmentation Subfascial technique Subglandular technique Outcome Complication Prospective study Magnetic resonance imaging 

Notes

Compliance with Ethical Standards

Conflict of interest

Breast implants were donated by Silimed. MRIs were freely held at DAPI (Diagnóstico Avançado por Imagem—Center of Advanced Imaging Diagnosis). None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, all the patients had signed the informed consent.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  • Ivan Maluf Junior
    • 1
    Email author
  • Ruth Maria Graf
    • 2
  • Adriana Sayuri Kurogi Ascenço
    • 1
  • Willian Itikawa
    • 1
  • Priscilla Balbinot
    • 1
  • Alexandre Mendonça Munhoz
    • 4
    • 5
  • Marlon Câmara Lopes
    • 1
  • Isis Juliane Guarezi Nasser
    • 1
  • Linei Augusta Brolini Dellê Urban
    • 3
  • Renato da Silva Freitas
    • 2
  1. 1.Aesthetic and Reconstructive Plastic Surgery Service at Hospital de ClínicasUniversidade Federal Do Paraná (UFPR)CuritibaBrazil
  2. 2.Plastic Surgery Service at Hospital de ClínicasUFPRSao PauloBrazil
  3. 3.Diagnóstico Avançado Por Imagem (Center of Advanced Imaging Diagnosis), DAPICuritibaBrazil
  4. 4.Hospital Sírio-LibanêsSão PauloBrazil
  5. 5.Hospital MoriahSão PauloBrazil

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