Three-dimensional Evaluation Of Breast Morphological Changes After Periareolar Dual-plane Augmentation Mammaplasty With Anatomic Implant

Background:Small breasts caused by congenital mammary dysplasia or breast atrophy after breastfeeding are very common in young and middle-aged women.The periareolar dual-plane augmentation mammaplasty with anatomic silicone implant are being widely used among these women,but there are few reports on how the breast morphology changes after this surgery.In addition,patients with breast atrophy and mild to moderate breast ptosis after breastfeeding are also common in plastic surgery.For these patients,prosthetic breast augmentation combined with internal suture mastopexy,are being advocated for correcting it.However,there is also lacking support for objective evaluation data on its clinical effect.Objective:Based on the above background,this study tracked the postoperative breast morphological changes in patients with periareolar dual-plane augmentation mammaplasty with anatomic implant using the three-dimensional scanning technology in order to clarify the changing pattern of breast morphology and its clinical significance.Besides,we analyzed the effect of periareolar dual-plane augmentation mammaplasty with anatomic implant combined with internal suture mastopexy on correcting the mild to moderate breast ptosis,and compared it with the effect of simple prosthetic breast augmentation,to provide objective evidence support for the clinical application of this operative method.Methods:1.3-D surface imaging of 21 patients underwent periareolar dual-plane augmentation mammaplasty with anatomic silicone implant were accomplished over five time periods(preoperative,15 3,6,12 months after surgery)and breast linear distance,breast projection,nipple position,breast volume and surface area changes over time were analyzed.2.Patients with breast atrophy were selected for undergoing periareolar dual-plane augmentation mammaplasty;Patients with breast atrophy and mild to moderate ptosis,were selected for undergoing periareolar dual-plane augmentation mammaplasty with internal suture mastopexy.Their preoperative and 6 months or more postoperative three-dimensional data changes were analyzed and compared with each other.Results:1.All the postoperative breast measurements had significant difference compared with preoperative ones.There was no significant change in breast basal width within 1 year after surgery.The nipple to midline(N-M)distance,the sternal notch to nipple distance and breast projection were relatively stable since 3 months after surgery.Postoperative breast surface area reduced gradually,but the difference was not statistically significant after 3 months(P>0.05).The distance from sternal notch to the level of inframammary fold and the nipple to inframammary fold distance gradually increased after surgery,while breast volume,the upper pole and lower upper pole volume decreased gradually.The percentage of upper pole volume gradually decreased while the lower pole’s proportion increased gradually.Above changes had no significant difference between 6 months and 12 months postoperative(P>0.05).The increases in breast volume and surface area after surgery were mainly distributed on the lower pole of breast.The postoperative breast volume and projections were 11.1%and 25%less than expected one,respectively.The lost volume were positively correlated with preoperative breast volume and implant volume while the lost projections were positively correlated with implant projections.2.Compared with preoperative ones,the nipple position lifted by 1.6cm in combined operation group and by 0.5cm in simple operation group;the level of the lower pole breast lifted by 1.0cm in combined operation group while lowered by 0.6cm for another group;the N-M distance increased slightly by 0.3cm in combined operation group and by 0.9cm for another group;the percentage of upper pole’s volume in the total breast volume increased from 38.1%to 48.4%in combined operation group and decreased from 48.6%to 45.4%in simple operation group.There were significant difference between the two groups’changes in measurements above.Conclusion:1.The breast morphology after peri areolar dual-plane augmentation mammaplasty with anatomic implant changed dynamically but stabilized after 6 months.2.The dual plane technology can optimize the appearance of the breast and increase the fullness of the lower pole of the breast.3.The breast volume and projection were less than the expected ones after prosthetic breast augmentation4.The operative method of periareolar dual-plane augmentation mammaplasty with anatomic implant combined with internal suture mastopexy can effectively correct mild to moderate breast ptosis and increase the upper pole fullness of the breast.