Dr.Tarek Said's Scientific Publications
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Postpartum Involutional Hypomastia: Management by Augmentation Mammaplasty with Submuscular Textured Saline-Filled Implants

Tarek Ahmed Said (M.D.)

Department of Plastic Surgery, Faculty of Medicine , Cairo University

Kasr El-Aini Journal of Surgery, 2004; 5 (3) September: 77-86

One of the most common indications for augmentation mammaplasty is postpartum involutional hypomastia, with or without a varying degree of ptosis. The goal is to achieve a good and lasting aesthetically pleasing result, to preserve nipple sensation, and to avoid the most distressing and difficult to remedy complication; capsular contracture around the implant. To achieve these goals, several factors should be taken into consideration; the biochemical nature of the implant, the surface of implant envelope, the plane of implantation, the use of povidone-iodine irrigation, the use of postoperative compression and the prevention of early hematoma formation and infection. 20 cases of postpartum involutional hypomastia were managed by submuscular implantation of textured saline filled implant. The aesthetic result was satisfactory in 95% of cases. Inframammary approach allowed adequate medial pectoral fibre release in 39 sides (97.5%) with only one case needing correction of unilateral implant migration by adhesive strapping. The nipple sensation was preserved in all cases. There were no incidents of capsular contracture or late implant failure over a 1-year follow up period. The results suggest that the use of the submuscular plane, the textured surface and the saline filled nature of the implant greatly minimizes the risk of capsular contracture development and that the use of inframammary approach makes operation easier, allowing adequate pocket dissection and muscle medial release and under vision Hemostasis. It also allows preservation of lateral thoracic nerve responsible for nipple sensation.

Key words: Postpartum, involutional, hypomastia, breast atrophy, augmentation mammaplasty, submuscular

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