Is There a Breast Augmentation Outcome Difference Between Subfascial and Subglandular Implant Placement? A Prospective Randomized Double-Blinded Study
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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.
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.
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).
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
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KeywordsBreast augmentation Subfascial technique Subglandular technique Outcome Complication Prospective study Magnetic resonance imaging
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.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study, all the patients had signed the informed consent.
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