Bilateral Transaxillary Subfascial Breast Augmentation with Smooth Saline Implants: A Retrospective Analysis of Short-Term Complications

Abstract

Introduction:

To determine, by means of a retrospective study, the short-term complication rate of primary, transaxillary, subfascial breast augmentation using smooth, high-profile, saline implants. Comments and comparisons on observations will be made.

Materials and Methods:

A retrospective, private practice, medical chart review of primary, transaxillary breast augmentation surgeries with smooth, high-profile, saline implants done from 2004 to 2008 was performed. A list of short-term complications was compiled. We reviewed 273 charts, and complications were assessed at 1 week, 1 month, 3 months, and 6 months. The patients' and surgeons' comments in the medical charts and full preoperative and postoperative photographic documentation were evaluated. Adverse events were noted. These included surgical wound infection, breast pocket infection, wound dehiscences, hematomas/seromas, clinically significant Baker grade III to IV capsular contractures (grade III to IV firm with visible/obvious spherical distortion), rippling, asymmetries, nipple/areola sensory losses or deficits, and reoperations.

Results:

The short-term complications for bilateral, transaxillary, subfascial breast augmentation with smooth saline implants in this private practice occurred in the following percentage of patients: breast asymmetry, 6.95%; reoperation, 4.76%; clinically significant Baker grade III to IV capsular contracture, 2.56%; wound dehiscence, 2.19%; rippling, 1.83%; hematoma/seroma, 1.83%; and wound infection, 1.09%. It should also be noted that bleeding from the incision site, galactorrhea, formation of a hypertrophic scar, breast ptosis, and a breast pocket infection rate occurred in less than 1% of the patients.

Conclusions:

Primary, transaxillary, subfascial breast augmentation with smooth saline implants is both safe and effective. It offers the advantage of fewer scarring problems, and it protects nipple/areola sensation. The patients in this study seemed to experience fewer complications from this procedure than patients in other studies, but more studies are needed.