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High- and Extra-High-Profile Round Implants in Breast Augmentation: Guidelines to Prevent Rippling and Implant Edge Visibility

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  • Breast Surgery
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Abstract

Background

Rippling and implant edge visibility after breast augmentation depends on several factors. Among the most relevant are breast soft tissue thickness, particularly the retroareolar mammary parenchyma, and implant profile. They were correlates to prevent these occurrences.

Methods

Thirty patients underwent breast augmentation through subfascial dissection involving the pectoralis, serratus, external oblique, and rectus abdominis fascias. The thickness of the retroareolar mammary parenchyma distributed patients into two groups. Group I: patients with thickness equal to or greater than 4.0 cm received high-profile 85% fill round implants. Group II: patients with thickness up to 3.9 cm received extra-high-profile 100% fill round implants. MRI was performed preoperatively and 5 years after augmentation to evaluate breast tissue changes and implant contouring.

Results

Seventeen patients with high-profile implants and thirteen patients with extra-high-profile implants had noticeable improvement of the breasts without the occurrence of rippling or implant edge visibility. A natural appearance of the breast, increased mammary cone, balanced upper and lower pole contouring was maintained at 5 years postoperatively. MRI performed 5 years after breast augmentation validated patient clinical outcomes not evidencing implant deformities, or soft tissue thinning, parenchymal atrophy or chest wall deformities.

Conclusions

The adequate correlation between retroareolar mammary parenchyma thickness with high-profile 85% fill and extra-high-profile 100% fill textured round implants was of utmost importance in preventing rippling and implant edge visibility. The wide fascial support, width of the implant smaller than the breast diameter, and soft cohesive gel-filled implants were co-adjuvant factors in preventing rippling and implant edge visibility.

Level of Evidence IV

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Acknowledgements

“To the cadavers of selfless dedication”.

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Authors and Affiliations

  1. Post-Graduate Course of Plastic Surgery, ACA - Institute of Assistance in Plastic Surgery of São Paulo, Brazilian Society of Plastic Surgery and Brazilian Medical Association, Rua Afonso de Freitas 641, São Paulo, SP, 04006-052, Brazil

    Antonio Carlos Abramo, Marcio Scartozzoni, Thiago Walmsley Lucena & Romulo Grechi Sgarbi

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  1. Antonio Carlos Abramo
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  2. Marcio Scartozzoni
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Correspondence to Antonio Carlos Abramo.

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No financial support or benefits have been received by the author or any co-author to accomplish this manuscript.

Ethical Approval

All procedures performed in this study involving humans participants were in accordance with the ethical standards of the ACA - Institute of Assistance in Plastic Surgery of São Paulo research committee and with the 1964 Helsinki Declaration and Medical Research Involving Human Subjects and its latter amendments or comparable ethical standards.

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Abramo, A.C., Scartozzoni, M., Lucena, T.W. et al. High- and Extra-High-Profile Round Implants in Breast Augmentation: Guidelines to Prevent Rippling and Implant Edge Visibility. Aesth Plast Surg 43, 305–312 (2019). https://doi.org/10.1007/s00266-018-1264-1

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