Procedure: The line of the incision is marked for all approaches before the forceps and other surgical instruments are used.
After placing the implant in the breast in the proper area, epinephrine solution 1:10,000 should be squirted inside the pectoral muscle; but, to avoid penetration of the chest wall, extra care must be taken.
Final adjustment in the placement of the prostheses may be made after placing the patient in a sitting position to assess size, contour and symmetry.
Inframammary: A 3-4 cm cut is positioned just on top of the inframammary crease.
A flap is developed inferiorly to the pectoralis fascia.
A plane is created between the pectoralis fascia and the posterior capsule of the breast (sub glandular approach).
to accommodate the implant, a pocket is made by blunt dissection.
Care is taken to avoid intercostals nerve damage.
Meticulous hemostasis is obtained before to implant inserted.
If you have a fiber-optic retractor than you may want to use it.
This process should be repeated bilaterally.
The patient may be placed in a sitting stance following insertion of the implants to assess the symmetry and size of the augmentation.
Using a running subcuticular closure the skin may be closed.
Preparing the patient: With conscious sedation, anesthesia may be either local or general.
with a supine position and on arms extended, you should place the pateint on the table in a symmetrically fashion, The patient should be secured in position sitting at a 80 degree angle.
During the procedure, the patient will be put in a sitting position to assess breast size and symmetry.
(without distortion, as breast distortion could appear in the supine position).
A pillow may be flexed for comfort.
All bony prominences and areas vulnerable to skin and neurovascular pressure or trauma are padded.
Using surgical instrument sets, an electrosurgical dispersive pad is applied.