Transaxillary Non-Endoscopic Subpectoral Augmentation Mammaplasty: A 10-Year Experience with Gel Versus Saline in 2,000 Patients with Long-Term Patient Satisfaction Measured By the Breast-Q

Monday, April 28, 2014: 12:16 PM
Joe Gryskiewicz, MD, FACS, University of Minnesota, Burnsville, MN
Goals/Purpose: Transaxillary augmentation mammaplasty (TAM) gives surgeons an option to offer patients wishing to avoid a breast incision. The author measures outcomes data from gel compared to saline implants and summarizes a cross-sectional survey using the BREAST-Q (BQ).

Methods/Technique: This ten-year retrospective comparative and cross-sectional study reviewed results of saline implants placed with TAM in a single surgeon’s practice during the final five years of the FDA moratorium (Phase 1) compared to both gel and saline implants placed during the five years after the moratorium (Phase 2). The entire BA patient cohort (n=2,430 for primary BA – 4,860 implants) was assessed for outcomes and (n=670) postoperative satisfaction with the BQ.

Results/Complications: Responses showed a high rate of patient satisfaction with outcomes comparable to other studies. The differences between the medians in the axillary (n=543) and non-axillary (n=127) surgical groups for BQ breast satisfaction and outcome satisfaction scores were statistically significant (W=32894.5 p<0.0001, W=31201.5 p<0.0001, respectively), favoring axillary over non-axillary.  There was a marginally significant difference in mean satisfaction scores between the two implant types favoring silicone (p = 0.046). The entire cohort incidence of revisions was 7.5 % (95% confidence interval [CI]: 6.4, 8.6) versus 6.8% for TAM CI: (5.7, 7.7).

Conclusion: TAM produces long-term patient satisfaction as measured by the BQ with complication rates comparable to other series. Patients in this series are more satisfied following TAM with a hidden incision than those patients who have a visible incision on their breasts (p<0.0001). BQ results show patient satisfaction with augmentation is stable over time.