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Image by Apostolos Vamvouras

BREAST TECHNIQUE

Correction and lifting of small or medium breast with mild to moderate ptosis.
Patient does not wish for breast augmentation, though the procedure will push-up breast volume lightly.

GENERAL RECOMMENDATIONS​

  • The thread must end 1 cm beyond the area you want to lift

  • Adapt the depth of the thread to the tissues

  • Always make a slight over-correction

  • Smooth the skin folds as much as possible that may appear when stretching the threads

  • No massage or any friction for a week

  • In case of over-tension, you can unhook some cogs during the first week, before fibrosis 4 to 6 threads per side depending on the ptosis and the patient profile

NON SURGICAL LAYING SCHEME

  • Technique 1: circular laying with threads BL 8-300 by entry points in V (6 threads)

  • Technique 2: for smaller-sized breasts, passage of 2 long threads BL 50-350 in U shape under the gland, eventually crossed.

  • Technique 3: passage of 4 threads BL 8-300 in L and J shape on each side of the breast.

  • Technique 4: passage of 2 shorter threads (BL 8-300) on the front of the breast.

STEPS TO FOLLOW

STEP 1: DRAWING

With the patient standing, modelize with Micropore the lifting effect desired on the breast.
Draw the path of the thread and its points of entry and exit.
Precision: The entry points are situated in the upper part of the breast.

STEP 2: PREPARATION

With the patient reclining, disinfect the skin with Povidone iodine (Betadine), Chlorhexidine or equivalent.
Local anesthesia along the thread’s path in its input and output.
Redraw the path if necessary.
Place a sterile drape on the work surface and surrounding the treatment area.
Always follow the Protocol for Infection Prophylaxis

STEP 3: ENTRY POINTS

Perform small punctures with a Nokor needle for each thread’s entry points. Perform 1 incision per thread.

STEP 4: THREAD IMPLANTATION

  • Introduce the needle perfectly perpendicular to the skin, penetrate 2 to 3 mm and then turn to be in the subcutaneous fat layer

  • If you are in the right layer, the needle will move freely within it

  • If you feel resistance, you are pushing too superficial or deeply

  • If you can see the needle, you are too superficial

  • Bring out the needle after about 10 cm, pushing and without the need for incision and then slowly pull the wire (it is possible to arch the needle if necessary)

  • Perform a hydro-dissection if you have difficulty inserting the needle

  • Pass the second strand of the thread in the desired direction. Arch the needle if necessary

Note: Bending the needle slightly can help to navigate the needle more closely to the contours of the body
which means the needle exits slightly further on than it would do so otherwise.

STEP 5: SETTINGS

  1. Upper part: Stretch each upper side strand until you see the traction appear at the entry point.

  2. Lower part: To adjust the lower part, due to the elasticity, it is necessary to pull each strand with one hand and push the tissue with the other hand. This adjustment is made on the patient when reclined then checked when seated.

  3. Finally, slightly pull the end of each strand (by around 2 or 3 cogs) and cut the excess end. The strand then settles naturally under the skin due its elasticity.

  4. Due to the flexibility of the silicone you can easily unhook an over lifted part.

POST OPERATIVE CARE

Anti-inflammatories (Ibuprofen) if necessary.
Prescribe oral AB 500 mg Ciprofloxacin BD for 5-10 days. Give the first dose 1 hour before procedure.
Place large micropore (50mm) to support the tissues during the first days.

Note: Review the Patient within one week. As oedema has diminished, if necessary, in cases of over correction, you can
unhook some cogs before fibrosis is established.

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