FIELD:
plastic surgery.SUBSTANCE: under aseptic conditions and endotracheal
anesthesia, hydropreparation of the
subcutaneous fat tissue is performed with 0.04%
ropivacaine solution 60.0 ml with adrenaline 1:100000, a
skin incision in the area of the submammary groove of the
mammary gland of 3.5–4.0 cm in length is made, the tissues are dissected layer by layer to the
fascia of the
pectoralis major muscle. A
dissection is performed in the Chassignac space to the level of the
lower pole of the
areola or an incision is made in the
skin in the area of the
mammary gland along the lower semicircle of the
areola, the tissues are perpendicularly dissected layer by layer to the
fascia of the
pectoralis major muscle. Next,
dissection is performed in the Chassignac space to the level of the submammary groove, and the lateral edge of the right
pectoralis major muscle is isolated. The retropectoral pocket for the
implant is formed using blunt and sharp methods. The lower medial bundle of the pectoralis major
muscle is mobilized to the level of 4 o'
clock on a conventional
clock dial for the
right breast and to the level of 8 o'
clock on a conventional clock dial for the
left breast. Partial vertical myotomy of the free
muscle flap is performed. The distal fragments of the pectoralis major
muscle are fixed at three points to the posterior surface of the gland with an atraumatic Vikryl 2-0 thread at the level of the nipple-areolar complex. A
silicone implant is placed into the formed pocket, and the
implant is evenly distributed and centered within it.EFFECT: preventing uncontrolled cranialization of the pectoralis major muscle flaps during vertical myotomy in dual-plane augmentation mammoplasty.1 cl, 2 ex