Kosmetische Medizin 1-2011: 12-17
The secret of the combined pocket – or why epimuscular augmentation is not up-tp-date
MARIAN S. MACKOWSKI
KEY WORDS: Breast = non verbal aesthetic communications unit no. 1, surgical concept for a stable result, state of the art augmentation, combined pocket technique, pre operative result visualization
Since introduction of breast implants by the company Dow Corning in 1961, augmento-plasty has advanced to the most popular and most commonly used aesthetic correctional operation. In the course of time different views have been represented on how to position the implants and which approach to take. The for the advancement needed longterm evaluation of results of patients and partners is clear. The epimuscular positioning of implants leads in the long-tem to poor aesthetic results. A pure submuscular pocket can, only in the rarest cases of a extremely distal far reaching provenance of the M. pectoralis major, be made shown. The trueth lies as so often in between. Prerequisite for a natural looking form and also long-term results can be provided with the described mixed pouch in this paper. The natural grace of a décolleté is not comparable with any other positioning of implants. Modern augmento-plasty – through the multitude of available implant forms – provides highest variability with regard to the patients desire for individual solutions, because here, the implant is not determined through the volume, but based on biodimensional measurements. Meanwhile, studies have confirmed, that patients with highly cohesive and form stabile implants of the 5th generation, show the least rates of complications and the highest rates of satisfaction [4, 5, 6, 7, 8]. In these studies 85% of the implants where placed in combined pocket. Considering all described benefits, the here disclosed secret of the combined pocket in modern augmento-plasty as “state of the art” is without any real alternative.
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