A New Method for Breast Implant Insertion Using an Air Pressure Assisted Device

Purpose

Various methods for breast implant insertion have been developed to reduce time for implantation, skin contact and thus the risk of implant contamination.^1-3 But skin problem remains, such as maceration of the incision margin and long hypertrophic scar. We introduce a new method for breast implantation that requires minimal force and time, and reduces implant contamination, the friction of incision margin and finally to decrease surgical complications, particularly scar length.

Methods

From March to December 2017, 51 female patients underwent primary breast augmentation bilaterally with silicone gel implants using the air pressure assisted device designed for airbrushing which operates to maximum 35 psi working pressure. We approached 40 patients by IMF incision, 9 patients by axillary incision and 2 patients by intraareolar incision. Before the implantation, we prepared 1000ml of sterilized intravenous fluid infusion bag after discarding fluids inside to function similar as funnel. We cut along the top of the bag and trimmed the lower tip of the bag according to the size of the implant. Then we poured the breast implant in the bag after applying sterilized anesthetic gel. Another 500ml of IV bag was placed into the 1000ml of IV bag to deliver pressure to the implant after connecting to the air compressor with an oxygen tubing connector. We closed the opening of the 1000ml of IV bag and approached the lower tip of the bag to the entrance of breast pocket. And the air pressure from the air compressor advanced the implant through the IV bag and into the breast pocket.

Results

Our follow-up period was minimum 6 months and no complications such as infection and capsular contracture occurred. All patients had acceptable scars without keloids or hypertrophic scar formation.

Conclusion

Our method using an air pressure assisted device has advantages over other previous insertion methods including: (1) easier insertion with an even pressure; (2) requires less force and time; (3) shorter incisions and thereby shorter scars (2.5-3.0cm per 250-300cc of implant); (4) prevents implant rotation during insertion; (5) reduce implant contamination that may help avoid capsular contracture.

References

1. Moyer HR, Ghazi B, Saunders, N, et al. Contamination in Smooth Gel Breast Implant Placement: Testing a Funnel Versus Digital Insertion Technique in a Cadaver Model. Aesthetic Surgery Journal. 2012; 32(2) 194 –199.
2. Castello MF, Han S, Silvestri A, et al. A Simple Method to Inset and Position Polyurethane-Covered Breast Implants. Aesth Plast Surg. 2014; DOI 10.1007/s00266-014-0285-7.
3. Dessy LA, Fallico N, Serratore F, et al. The use of the Alexis® device in breast augmentation to improve outcomes: a comparative randomized case-control survey. Gland Surg 2016;5(3):287-294