The Reverse Dual Plane: A Novel Technique for Endoscopic Transaxillary Breast Augmentation.

Background: Quite a few Asian patients prefer axillary incision for breast augmentation. However, this surgery needs improvement.

Objectives: To introduce a reverse dual-plane technique through a transaxillary approach and compare it with a transaxillary dual-plane approach.

Methods: Eighty-two patients were divided into Group A ( = 40) and Group B ( = 42). Axillary incision and endoscope were utilized in the 2 groups. Tebbetts' dual plane was performed in Group A patients. Patients in Group B underwent our reverse dual-plane technique, in which the upper 70% was subfascial and the lower 30% was subpectoral, with the fascia of the external oblique and anterior serratus being elevated together with the pectoral muscle. The Numeric Pain Rating Scale (NPRS) scores were recorded daily for 7 days. Breast shape and softness, in both sitting and supine positions, were assessed by the patients, and complications were compared.

Results: The NPRS scores of Group B patients were significantly lower than those of Group A patients ( < .01). The satisfaction rate of shape and softness in the seated position was not significantly different ( > .05). However, in the supine position, only 20 patients (50.0%) in Group A and 32 patients (76.2%) in Group B were satisfied with their breast softness ( < .01), and the breasts of the others became stiffer. Breast animation deformity (BAD) occurred in 2 patients in Group A and in no patient in Group B ( < .01). Other complications were not significantly different.

Conclusions: Compared with Tebbetts' dual plane, this procedure significantly reduced pain, improved breast softness, and eliminated BAD, without increasing complications.