Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: Understand why and when to use a round or anatomical implant

Introduction: Considering the great variability in shapes and tissue-conditions between different women there are a clear indications for both round and anatomical implants. The choice between these should be made on a patient by patient basis taken in to count patient desires, anatomy and surgical history. Considering the present knowledge related to BIA-ALCL (Breast implant-Associated Anaplastic Large Cell Lymphoma) and the fact that this mainly is related to textured implants this has effected the selection of round versus anatomical implants.

Materials / method: In the past most implants used by the presenter were anatomical because of their great variability in implant shapes and their benefits related to a more natural upper slope and shape. In the late 1990's more than 90% of implants used by the presenter were anatomical. Today, in part related to problems such as late seromas, ALCL, rotation and double capsules the number of anatomical implants used by the presenter has been reduced and account for approximately 1/3 of implants used

Results: This is also related to the fact that fat-grafting can compensate for some of the drawbacks for round implants shapes. Fat-grafting can be used to give a more natural upper slope and increase the width, height ratio. It should be remembered, however, that fat-grafting is an additional procedure with it´s possible morbidity and costs

Conclusion: It is the presenter clear opinion that both round and anatomical implant should be part of a complete surgical toolbox in performing breast augmentations. 

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): Consultant och share holder in breast implant Co - will be detailed on disclosure slide

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): motiva

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: - To show objective data which support the use of the axilla as approach for breast augmentation.
- To show reoperation rates and long term complications
- Data about microbiology of the axilla

Introduction: Many surgeons are uncomfortable with the axillary technique and do not familiarize themselves with it.
It has not been convincingly demonstrated that one incision is better than another; it is very possible that surgeon experience is key in this regard. I allow the patient to choose the incision; most prefer the axillary because it is hidden and there are no visible scars on the breast. However, I have studied several factors tha could be related to a poorer performance with transaxillary augmentation: reoperation rate, capsular contracture, rupture and microbiology and established a protocol

Materials / method: - Retrospective study for reoperation rate comparing transaxillary and periareolar incisions with Natrelle 410 implants
-10 years rate of complications
- Use of nipple shields in tranasaxillary breast augmentation and microbiologic study of the axilla

Results: Reoperation rate similar to published in CORE studies. The transaxillary incision seems to be safer and with less complications than periareolar, although the difference is not significant. Subfascial placement seemed to be more related to adherence problems (capsular contracture and rotation) and submuscular with rupture and seroma (friction ?). No statistical significance between antiseptics although ALCOHOLIC CLORHEXIDINE yields the best behaviour. Always prepp again before placing the implant and use a funnel for placing the implant

Conclusion: Transaxillary breast augmentation is a safe approach. Although it needs a learning curve, all the steps suugested by Adams et al can be followed to minimize complications

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability