Scar-free on the Chest of Breast Augmentation: A Novel Approach for Implant-Based Mammaplasty.

I. SUMMARY: Conventional breast augmentation is typically performed using one of three incision techniques: inframammary fold, axillary, periareolar and transumbilical. Each of these methods results in scarring or visible marks, which can be particularly problematic for patients with a predisposition to hypertrophic scarring, such as those of East Asian descent. To address this issue, we propose an innovative implant insertion technique. During abdominoplasty, after elevating the abdominal flap to the subxiphoid region, further dissection in the superolateral direction provides access to the medial-inferior aspect of the inframammary fold. With the aid of endoscopic guidance, precise pockets are created, and meticulous hemostasis is achieved. This technique facilitates the formation of implant pockets at any desired plane, minimizes the risk of downward or lateral displacement of the implants, and avoids scarring in the breast area, thereby eliminating the potential for hypertrophic scarring. Observations were conducted on 43 patients who underwent this surgical method, demonstrating its significant advantages for individuals requiring concurrent abdominoplasty and breast augmentation.