The technology of installation of breast implants in the subpectoral space while preservation attachment of the abdominal part of the pectoralis major muscle

Abstract

The paper describes the technology of installing breast implants in the subpectoral cellular space while maintaining the attachment of the abdominal part of the pectoralis major muscle and evaluate the results of its application. A retrospective analysis of the results of primary breast augmentation in 762 patients operated by the authors in 2010–2020 was carried out.The space for the breast implant was formed following a certain sequence of actions. The boundaries of the receptacle were: inside – the place of attachment of the pectoralis major muscle to the sternum, outside – the abdominal part of the pectoralis major muscle and the pectoral fascia, passing to the bundles of the anterior serratus muscle, at the top – thoracoacromial vascular bundle, below – VI rib and fascial node, formed by the transition of the thoracic fascia and the aponeurosis of the abdominal part of the pectoralis major muscle to the anterior wall of the sheath of the rectus abdominis muscle. Conclusions. 1. The technology of installing implants in the subpectoral cellular space, while maintaining the distal attachment of its abdominal part, allows achieving the stability of the position of the implants and avoiding rotation and malposition of the implants. 2. In terms of up to 3–4 months after surgery, a higher location of implants on the chest is often observed. 3. The decision on the need and degree of mobilization of the abdominal part of the pectoralis major muscle should be made individually. 4. The technique cannot be used when the width of the implant base exceeds the width of the pectoralis major muscle at the level of the IV rib, and, therefore, limits the choice of larger implants.