Approach in Breast Surgery


The approach in any surgical procedure relates to how the procedure will be performed, for example, a implant type breast surgery there are several types of approaches, which is where the implant is inserted:
  1. There is the sub-areolar region, which is a cut bordering the bottom of the areola.
  1. Fold or sub-mammary groove: a small cut is made in this area to introduce the implant.
  1. Armpit: this is another area where we can introduce the implant, making an incision in the axillary folds. this area is of utmost care because the armpit is considered a dirty area by the large amount of sweat and sebaceous glands, in that area coexist a number of bacteria that has to be eliminated when thinking about this placement.
Basically, these are the three most used approaches.
Other factor to consider in the approach it´s the colocation of the implant:
  1. Behind the gland: this location is behind all the glandular breast tissue and above the pectoral muscle and fascia.
  1. Behind the muscle: this location is below the major pectoral muscle respecting the minor pectoral muscle and protected by the fascia covering it.
  1. Sub-fascial: this location is more difficult to manage and a surgical training is needed to perform this technique, because the fascia is very thin, but this location preserves muscle integrity and isolation of glandular tissue.
  1. In some cases I tend to use the intra-abdominal route when breast augmentation and abdominoplasty without breast ptosis is combined, ie, that the breast has no fall. Placement is more laborious, but the advantage is that no cut is made in the breast. Independently it may be placed sub-glandular or sub-muscular through this way.
If the breast has little tissue, the best location is sub-muscular. The sub-glandular placement presents the advantage that the implant is noticed more defined earlier, but have the disadvantage that the weight of the implant has a greater effect on the skin, and the breast can fall more rapidly, because is added the weight of tissue plus the weight of the implant, which together with the force of gravity pulls the breast down.
When talking to your doctor of the prosthesis he is going to use, require to be a certified one.
Article by
Dominican Republic Plastic Surgeon