Tautrimas Astrauskas1, Tautvydas Urbonas2, Goda Astrauskaite2

1Kaunas Plastic surgey center, 2Kaunas medical University

 

INTRODUCTION: Current information about different methods of breast augmentation is controversial and to state which method gains an advantage over the others is hardly possible. It is also hard to predict the reasons of the complications. The aim of this paper was to compare different techniques of breast augmentation by evaluating the duration of the operation, the duration of the hospitalization and the incidence of postoperative complications. We also tried to find the relation between postoperative drainage productivity and the incidence of capsular contractures.

 

MATERIAL & METHOD: 168 patients underwent breast augmentation during the year 2006 to 2008 in the Center of Kaunas Plastic Surgery. 123 of them had chosen transaxillary incision: 92 submuscular and 31 subfascial placement of an implant; 27 had chosen priareolar incision: 12 submuscular and 15 subfascial placement of an implant; 18 had chosen inframammary incision: 15 submuscular and 3 subfascial placement of an implant. The duration of the operation, the duration of the hospitalization and postoperative complications of each method were evaluated and compared. The correlation between postoperative drainage productivity and the incidence of capsular contractures was calculated.

 

RESULTS: The average duration of the operation (minutes) using transaxillary submuscular technique was 35, transaxillary subfascial technique 42, periareolar submuscular 79, periareolar subfascial 83, inframammary submuscular 62, inframammary subfascial 89. The average hospitalization time (hours) using transaxillary submuscular technique was 50, transaxillary subfascial technique 47, periareolar submuscular 73, periareolar subfascial 52, inframammary submuscular 72, inframammary subfascial 49. There were 1 synmasty (1%) in transaxillary submuscular group; 2 grade III capsular contractures (6.4%) 1 synmasty (3.2%) and 2 seromas (6.4%) in transaxillary subfascial group (in total 16% complications); 1 grade III capsular contracture (8.3%) in periareolar submuscular group; no complication in periareolar subfascial group; 2 haematomas (13.3%) in inframammary submuscular group; no complications in inframammary subfascial group. The correlation coefficient between the postoperative drainage volume and the incidence of capsular contractures was 0.517.

 

CONCLUSION: The shortest operation time was achieved in transaxillary submuscular group. The patients spent least time in the hospital when the implant had been placed subfascial transaxillary still they had the highest risk of complications. The data on postoperative drainage volume shows that the higher postoperative drainage volume had a mildly expressed correlation with the higher incidence of capsular contractures.