Breast Lift and Reduction

Abstract

A technique of endoscopic surgery for subcutaneous tissue has been developed. This method takes advantage of available endoscopic technology and uses the ability of the skin to retract,¹ so plastic surgery can be performed through small incisions, under monitor view.² Laparoscopic procedures use CO₂ gas to create a space between the optical fiber and the tissues, “the optical space,” to generate suitable images. Pressurized gases are not recommended in subcutaneous tissues. To circumvent this risk I have developed a “subcutaneous tomoscope”,³ an instrument that transfers the needed space to an acrylic capsule, a type of “windshield” device. The wedge-shaped capsule simultaneously serves as a blunt dissector. Punctiform retractors were specially designed to increase the working space, as well as needles and needle holders adapted to work through minimal incisions. With these new instrumets,techniques have been developed in aesthetic surgery for endoscopic abdominoplasty,⁴ mastopexy, and breast reduction,^5,6 as well as in reconstructive surgery to aid in flap harvesting, placement of tissue expanders, and endoscopic study of axillary and inguinal lymph nodes.