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Objectives: what is the best approach for insertion of breast implants?

Introduction: The axillary approach is not the usual choice by the majority of pratcibng durgeons in France: only 6% of us are using it

Materials / method: The axillary incision is along the folding lines of the upper arm;the dissection is done without cutting tissues and lymphatic ducts, just by recclining the tissues in order to approach the prepectoral fascia; then the dissection is performed by finger and a special curving elevator above or beneath the pectoralis muscle, as decided prior to the operation; hemostasis is performed but bleeding is minimal; the use of an endoscopre is unecessary in most cases; inesertion of the implant may become difficult above 500cc; then the wound is closed in one plane ;drainage is recommanded for one night

Results: Since the decription of this method by the french author , Rodolphe Troques in 1972,; many surgeons perform this approach with rewarding results; minimal scarring, quick procedure, and possibility to redo it when the implants have to be removed or changed. The complications are exactly on the same level in percentage than these of other incisions.Endoscopy has been a trend for some years in order to bring more security; more with experience forwarding, it became not mandatory.

Conclusion: The axillary approach for breast insertion remains a good choice but very well considered by most plastic surgeons.

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Objectives: 1. What is a Complex Revision Breast Surgery?
2. Analysis of the Complex Breast
3. Treatment Strategies for the Complex Breast

Introduction: Revision breast is rarely straightforward - there is usually at least one complicating factor. Complex revision breasts have multiple concerns that need to be addressed at the same time. Surgical management is complicated and requires extreme attention to detail and planning.

Materials / method: A single author review of complex revision patients and their outcomes. Surgical decision making and techniques are discussed.

Results: Aesthetic results with low complications can be achieved in the complex revision breast patient.

Conclusion: Aesthetic results can be excellent in the revision breast patient, provided that there is appropriate surgical planning and attention to detail.

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