Can the Integrity of the Pectoral Fascia Be Preserved During the Subfascial Breast Augmentation Through Axillary Approach?

Abstract

Although many authors recently have reported good results with subfascial breast augmentation, it is still under controversy whether the integrity of pectoral fascia can be preserved. Some authors think that the pectoral fascia will be avulsed during the operation because it is thin and weak. Ten patients underwent subfascial augmentation mammaplasty. In 11 pectoral fascias (55 %) among 20 pectoral fascias in ten patients, the integrity could be preserved during the surgery. Four fascias (20 %) were avulsed at about the fourth intercostal space or the fifth intercostal space. In five breasts (25 %), the superficial layer of the pectoral muscle was split, but the integrity of the fascia was maintained. All patients achieved satisfactory effects except one patient with asymmetric breasts. There were no active bleeding, hematoma, infection, and fibrous capsule contracture during the follow-up period. Most of pectoral fascia integrity can be preserved through axillary approach during subfascial breast augmentation without endoscopic assistance. Even if the lower part of the pectoral fascia is avulsed, it does not interfere with the aesthetic outcome or the normal postoperative recovery.