Goals/Purpose: The goal of this study was to analyze the influence on breast projection of different implant sizes, shape, insertion pocket and after gradual release of pectoralis major insertion.
Methods/Technique: A total of 17 breasts were analyzed over the course of 5 days. Six different augmentation techniques were performed: Subpectoral dissection with 50% release of inferior pectoralis major muscle insertion using round implant, subpectoral dissection with 100% release of inferior pectoralis major muscle insertion using round implant, subpectoral dissection with 100% release of inferior pectoralis major muscle insertion using contoured implant, subpectoral dissection with 100% release of inferior pectoralis major muscle insertion and 30% release of medial pectoralis major muscle insertion using round implant, subglandular dissection using round implant, subglandular dissection using contoured implant. All augmentation techniques included volumes of 200, 300, 400, 500 and 600mL, total of 30 procedures per breast, and approximately 200 measurements. Collected data was analyzed using Student's T-test for paired samples. Power of all analyses was above 80%.
Results/Complications: Projection was greater when patient received contoured implants versus round implants (p<0.001) in all volumes both in subpectoral and in subglandular pockets. When implants bigger than 200mL were used, projection was greater when patients received either round or contoured implants on subglandular pocket versus subpectoral (p<0.02). Projection was greater with 50% inferior muscle release versus 100% inferior muscle release with 200, 300 and 400mL implants (p<0.05). Projection was greater with 50% inferior muscle release versus 100% inferior plus 30% medial muscle release with 200, 300mL implants (p<0.05).
Conclusion: Implant shape, pocket location and volume influence projection, as well as pectoralis major release in certain situations. Proportionally, IMF to nipple distance increase more than notch/midclavicular to nipple distance per 100mL increase in implant volume, therefore, in our population, as projection increase with augmentation, mild ptosis is corrected.
