Introduction
dominant trend is visible in all branches of surgery Minimal Access idea incisional surgery to achieve the desired results with the effects of surgical reduction and Articles to facilitate faster patient recoveries. Plastic Surgeons not dealt with this issue over a longer time than other treatments have disciplines. The intention was to get the cosmetic benefit for patients by reducing and masking the scars.
in breast augmentation, one of the methods for the Achievement Through remote access incision placement, as exemplified by endoscopic transaxillary mammaplasty extensions and enhancements transumbilical endoscopy (tube) mammaplasty procedures. With these procedures, incisions are hidden first in the axillary crease and umbilicus, respectively, so scarring as a result of very hard to recognize. For this reason, methods are preferred by many physicians and patients alike.
acts with fiberoptics and endoscopic remote manipulation, combined with the progress of technology, which resulted in consistently good results the hands of doctors trained. Reticulating endoscopes and high definition camcorder offers new possibilities for visualization. These advances continue to strengthen over the enthusiasm for these endoscopic methods.
History
Transaxillary endoscopic procedure mammaplasty extensions
Transaxillary approach to breast augmentation was described by Troques in 1972 and Hoehler 1973.1,2 in addition to the obvious benefits of the hidden incision approach to facilitate direct access to subpectoral aircraft. With this technique, the inframammary crease and changed the origin of the pectoralis muscle dissected blindly, which is much higher rate of implant malposition. Limited exposure of the blind technique does not allow a complete breakdown of prepectoral fasciitis, which causes the high-riding implants Trends Or double-bubble appearance of the inframammary crease.
appearance Endoscopic surgery in 1990 allowed the use of an endoscope to breast surgery. Emory group reported their experience with endoscopic breast augmentation incision through the underarms in 1993, using a specialized retractor and air-filled optical cavity.3 Ho reported glycine irrigation technique used to create a fluid-filled cavity of the optical, although now also specialist applications and optical retractor air-filled cavity.4 increased control resulting from the direct visualization of dissection prevents many previous failures, the blind approach Pacha. Howard demonstrated benefits of an endoscope with lateral approach reduces the incidence of implant malposition from 8.6% to 2% in the case of endoscopes was used.5
Endoscopic transaxillary mammaplasty expansion is now widely used technique and has stood the test of time. However, experience is essential, more simple cases should be considered during the initial experience. Axillary approach has limited application in secondary matters.
Transumbilical endoscopic mammaplasty Extensions (tuba)
Transumbilical approach came into force in 1991 by Johnson and Christ and described in detail in 1993.6 technique is unique because it does not employ Regional or local incision, but rather uses a remote incision in the navel. TUBA endured criticism, but significant beginning has gained popularity as has been shown to be safe and reliable. TUBA Although technically more difficult, an increasing number of plastic surgeons gain knowledge of the procedures. Criticism has been the lack of basic operational control part, especially with regard to bleeding and the plane of dissection. With improved instrumentation and overall improvement in endoscopic skills these allegations have been proven invalid. The original study reported a lower level of Johnson less bleeding complications than other methods.6
Presentation
Importance initial consultation can not be overestimated. Talk to the four possible access to the patient's incision. Periareolar Current, ripple inframammary, axillary, and umbilical cord in the notches nonbiased way and assess the patient's enthusiasm axillary incision umbilical Or. Discuss the potential complications of breast augmentation, endoscopic complications emphasizing the unique methods. Discuss implant malposition, hematoma, underarms and lymph nodes. Finally, discuss the need for additional incisions inframammary crease to treat some complications of both approaches. All potential complications of breast augmentation should be discussed, including loss of nipple sensation, bleeding, infection, capsule contracture, asymmetry, unsatisfactory results, the need for revisionary Operations, and so on.
Perform a physical examination. Describe the location of the proposed cut and return the items and size of the surgical cutting of the tag. Pay particular attention to the distance from the areola is not inframammary crease and the transverse diameter of the breast. Assess the diameter of the breast, and then select the size and the implant immediately correct fold. The need for inframammary fold reduction in common is 1-2 cm but more than 3 cm should alert the doctor to the presence of constricted lower pole parenchyma and the need for Change, which can be a more direct approach to others. The ideal patient distances 5-6 cm from the areola is not inframammary crease, therefore requires less dissection worse.
Indications Indications for endoscopy to the patient's desire for breast augmentation incision remote and lack a well-developed inframammary crease to hide the crease incision below the horizontal axis of Visual. Contraindications
Zwæýenie lower pole
narrowed lower pole of the small distances from the inframammary crease to the areola is much more difficult and may require a radial scoring breast parenchyma. There is potential for implant displacement below overdissection (decrease) from the inframammary crease and the superior displacement of the implant underdissection the inframammary crease. In experienced hands and umbilical transaxillary approach can be used for this type of anatomy. Tubular breast
need herniated areola correction and scoring narrowed lower pole parenchyma makes perfect periareolar incision access tubular breast deformities.
the loss of
endoscopic breast augmentation can be performed in pseudoptosis and the degree of a drooping eyelid, but the anatomy of the inframammary crease required to reduce the base of vertical descent breast. Ptosis is considered not ideal for the inexperienced surgeon is, and I overdissection concern underdissection the inframammary crease.
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