title: Safety, complications, and satisfaction of patients undergoing submuscular breast augmentation via the inframammary and endoscopic transaxillary approach.
abstract: BACKGROUND
  Since its introduction, augmentation mammaplasty has gained widespread popularity, as demonstrated by the fact that an estimated 2 million women in the United States have received implants. During recent decades, several surgical approaches have evolved in terms of implant placement or site of access to the surgical plane. Debate has existed concerning the questionable superiority of a particular technique for achievement of optimal results. Thus, the inframammary approach, an established and widely accepted technique for breast augmentation, and endoscopically assisted transaxillary breast augmentation were retrospectively compared in terms of safety and aesthetic outcome, as measured, respectively, by the rate of postoperative complications and patient satisfaction.
  
  
  METHODS
  This study analyzed 78 patients undergoing augmentation mammaplasty between 1997 and 2004. Only patients seeking primary augmentation mammaplasty solely for aesthetic reasons were included in the study. Previously performed breast surgery and simultaneously conducted ipsilateral mastopexy were among the exclusion criteria. Patient satisfaction was assessed using the client satisfaction questionnaire (CSQ-8) because of its easy applicability.
  
  
  RESULTS
  The complication rate was low in both patient subsets, thus confirming the safety of the transaxillary approach, as compared with the more common submammary technique. However, a higher level of satisfaction was detected in the former patient group, indicating a more favorable aesthetic outcome with the transaxillary augmentation mammaplasty.
  
  
  CONCLUSIONS
  Endoscopically assisted transaxillary augmentation mammaplasty is a safe method with predictable results associated with a high level of patient satisfaction. If applied in the setting of appropriate indications, it is an excellent tool for use with patients who prefer to have an incision at a distant site.
authors.affiliation: Department of Plastic and Hand Surgery, Hugstetter Strasse 55, 79095, Freiburg i. Br, Germany. arash_ali@yahoo.de
authors.forename: Arash
authors.initials: A
authors.lastname: Momeni
authors.forename: Nestor Torio
authors.initials: NT
authors.lastname: Padron
authors.forename: Matthias
authors.initials: M
authors.lastname: Föhn
authors.forename: Holger
authors.initials: H
authors.lastname: Bannasch
authors.forename: Jörg
authors.initials: J
authors.lastname: Borges
authors.forename: Seung-Min
authors.initials: SM
authors.lastname: Ryu
authors.forename: G Björn
authors.initials: GB
authors.lastname: Stark
mesh_terms: D000293:Adolescent; D000328:Adult; D001365:Axilla / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D008875:Middle Aged; D017060:Patient Satisfaction; D010369:Pectoralis Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*