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Application of "CD-4" theory for determining the width of implant in breast augmentation.

Cai J, Zhou Y - Chin. Med. J. (2015)

Bottom Line: From January 2006 to June 2014, the authors have found and applied "CD -4" theory to determine the width of breast implant (W) in dual plane I or II breast augmentation cases through transaxillary or periareolar incision for 560 patients. "CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold.Their new intermammary cleavages without bras are between 1 cm and 2.5 cm, and lateral borders of the breast are on the area of the AAL.For the very thin patient, 4 should be 3.5.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.

ABSTRACT

Background: The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation. The aim of this study was to introduce a new method to determine the width of the implant (W) and explain the reasons to do so in details.

Methods: From January 2006 to June 2014, the authors have found and applied "CD -4" theory to determine the width of breast implant (W) in dual plane I or II breast augmentation cases through transaxillary or periareolar incision for 560 patients. "CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold. W = CD - 4 (or 3.5) cm.

Results: The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm. Their CDs are from 14.5 cm to 17 cm. About 78% of the patients have got followed up from 1 month to 5 years postoperatively. Except for four patients who got unilateral capsular contractions, all the other patients are satisfied with their nature new breast shapes and volumes. Their new intermammary cleavages without bras are between 1 cm and 2.5 cm, and lateral borders of the breast are on the area of the AAL.

Conclusions: W (width of the implant) = CD - 4 (cm) when doing dual plan I or II breast augmentation. For the very thin patient, 4 should be 3.5.

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Endoscopic view: The vessels are not broken after blunt dissection on medium part of implant pocket.
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Figure 6: Endoscopic view: The vessels are not broken after blunt dissection on medium part of implant pocket.

Mentions: Most of women like to have their two breasts contacting with each other when they are wearing bra. If we suppose the soft tissue in NTZ is very flat and thin like a piece of paper, the narrowest intermammary distance should be 3 cm. To produce the best intermammary cleavage, the only thing that the doctor could do is to let the medium border of the implant reach the point 1.5 cm away from the middle line, in spite of the existing “b” part. The more soft tissue around the NTZ, the narrower intermammary distance will be, and the more likely the two new breasts would contact with each other postoperatively. The doctor could not totally control it and should let their patients know the fact. If you do this kind of communication with your patients preoperatively, it will greatly improve your patients’ postoperative satisfaction rates. Sometimes in order to get narrower intermammary cleavage, the authors had to use blunt dissecting technique to surpass the limit of NTZ about 0.5 cm and found that under endoscope some perforators remain intact [Figure 6]. But for young surgeons, this should not be encouraged. We also recommend using blunt dissecting technique on the lateral side of the pocket to avoid the damage of the intercostal nerves.[12] The more you dissect the lateral side of the pocket, the more likely you will damage the intercostal nerves.[13] This is another reason why we choose the AAL as the lateral border of the new breast.


Application of "CD-4" theory for determining the width of implant in breast augmentation.

Cai J, Zhou Y - Chin. Med. J. (2015)

Endoscopic view: The vessels are not broken after blunt dissection on medium part of implant pocket.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836252&req=5

Figure 6: Endoscopic view: The vessels are not broken after blunt dissection on medium part of implant pocket.
Mentions: Most of women like to have their two breasts contacting with each other when they are wearing bra. If we suppose the soft tissue in NTZ is very flat and thin like a piece of paper, the narrowest intermammary distance should be 3 cm. To produce the best intermammary cleavage, the only thing that the doctor could do is to let the medium border of the implant reach the point 1.5 cm away from the middle line, in spite of the existing “b” part. The more soft tissue around the NTZ, the narrower intermammary distance will be, and the more likely the two new breasts would contact with each other postoperatively. The doctor could not totally control it and should let their patients know the fact. If you do this kind of communication with your patients preoperatively, it will greatly improve your patients’ postoperative satisfaction rates. Sometimes in order to get narrower intermammary cleavage, the authors had to use blunt dissecting technique to surpass the limit of NTZ about 0.5 cm and found that under endoscope some perforators remain intact [Figure 6]. But for young surgeons, this should not be encouraged. We also recommend using blunt dissecting technique on the lateral side of the pocket to avoid the damage of the intercostal nerves.[12] The more you dissect the lateral side of the pocket, the more likely you will damage the intercostal nerves.[13] This is another reason why we choose the AAL as the lateral border of the new breast.

Bottom Line: From January 2006 to June 2014, the authors have found and applied "CD -4" theory to determine the width of breast implant (W) in dual plane I or II breast augmentation cases through transaxillary or periareolar incision for 560 patients. "CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold.Their new intermammary cleavages without bras are between 1 cm and 2.5 cm, and lateral borders of the breast are on the area of the AAL.For the very thin patient, 4 should be 3.5.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic Surgery, China-Japan Friendship Hospital, Beijing 100029, China.

ABSTRACT

Background: The determination of the width of the implant is the first key step to select shape and volume of the implant in breast augmentation. The aim of this study was to introduce a new method to determine the width of the implant (W) and explain the reasons to do so in details.

Methods: From January 2006 to June 2014, the authors have found and applied "CD -4" theory to determine the width of breast implant (W) in dual plane I or II breast augmentation cases through transaxillary or periareolar incision for 560 patients. "CD" is defined as the curved distance on skin from the midline of the sternal bone to the anterior axillary line (AAL) on the lateral chest wall through the horizontal level on inferior mammary fold. W = CD - 4 (or 3.5) cm.

Results: The 560 patients used both round and anatomic implants with W from 10.5 cm to 12.5 cm. Their CDs are from 14.5 cm to 17 cm. About 78% of the patients have got followed up from 1 month to 5 years postoperatively. Except for four patients who got unilateral capsular contractions, all the other patients are satisfied with their nature new breast shapes and volumes. Their new intermammary cleavages without bras are between 1 cm and 2.5 cm, and lateral borders of the breast are on the area of the AAL.

Conclusions: W (width of the implant) = CD - 4 (cm) when doing dual plan I or II breast augmentation. For the very thin patient, 4 should be 3.5.

Show MeSH
Related in: MedlinePlus