title: New Design for Axillary Dual-Plane Endoscopic Breast Augmentation for Asians: the Feasibility of Two Types of Dual-Plane Implant Pockets in 70 Patients as Measured by the BREAST-Q.
abstract: BACKGROUND
  The design methods for dual-plane implant pockets for axillary endoscopic breast augmentation vary among different countries. We applied a modified approach for an Asian population.
  
  
  METHODS
  Seventy patients with micromastia underwent our modified approach between 2011 and 2014. Breasts were divided into two types according to the soft-tissue pinch thickness of the lower pole: type I (thickness >2 cm; Group I) and type II (thickness ≤2 cm; Group II). The levels at which the pectoralis major (PM) was severed were 6-6.5 cm and 3-4 cm below the nipple for type I and II pockets, respectively. Then, dissection of the retromammary space was continued from the severance level downward to the new inframammary fold for type I pockets, whereas no dissection was made for type II pockets. All patients completed the pre- and post-operative BREAST-Q augmentation modules.
  
  
  RESULTS
  During a mean follow-up of 10 months (range, 6-12 months), patients reported higher satisfaction with breasts after surgery than before surgery (satisfaction scores of 64.9 ± 5.6 vs. 14.7 ± 11.0). The mean satisfaction score for the overall outcome was 91.3 ± 17.3. However, there was no significant difference in physical well-being (87.1 ± 10.4 vs. 85.2 ± 11.7). No complications such as severe capsular contracture or displacement occurred.
  
  
  CONCLUSIONS
  Distinguishing the need for a type I or II dual-plane pocket can lead to good outcomes and optimal soft-tissue coverage. The higher satisfaction and quality of life reported by our patients indicate that our new design is feasible and safe for most Asians with a medium build.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors.affiliation: Plastic and Aesthetic Surgery Center, The First Affiliated Hospital of Harbin Medical University, 143 Yiman Street, Nangang District, Harbin, People's Republic of China.
authors.forename: Haiqian
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Breast Oncological Surgery, The Third Affiliated Hospital (Cancer Hospital) of Harbin Medical University, Harbin, People's Republic of China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Li
authors.affiliation: Plastic and Aesthetic Surgery Center, The First Affiliated Hospital of Harbin Medical University, 143 Yiman Street, Nangang District, Harbin, People's Republic of China.
authors.forename: Yida
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Plastic and Aesthetic Surgery Center, The First Affiliated Hospital of Harbin Medical University, 143 Yiman Street, Nangang District, Harbin, People's Republic of China.
authors.forename: Yangdong
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Plastic and Aesthetic Surgery Center, The First Affiliated Hospital of Harbin Medical University, 143 Yiman Street, Nangang District, Harbin, People's Republic of China. haolijundoctor@163.com.
authors.forename: Lijun
authors.initials: L
authors.lastname: Hao
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D001365:Axilla; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D055815:Young Adult
keywords: BREAST-Q; Breast augmentation; Dual-plane technique; Endoscope; Micromastia