Dr Constantin StanRomanian plastic surgeon Dr Constantin Stan was a keynote speaker at the Australasian College of Cosmetic Surgery (ACCS) Conference in Adelaide in April 2010. He shares his thoughts with us on some of the latest developments in breast augmentation.

Q: How has technology allowed doctors to streamline and improve the breast augmentation procedure?

A: This kind of cosmetic procedure is particularly influenced by technology. I believe the key areas of development are: new implants; new computer-assisted software for patient evaluation and implant selection; and new surgical instruments for pocket dissection and technique – Ellman 4 MHz radiosurgery machine and Mono Stan RF Forceps – for more accurate dissection and reduced recovery time. I believe the most important role of technology in regards to the breast implants themselves is the new anatomic shaped implants. These stable-shape implants contain highly cohesive gel and are available in a large range of dimensions for width, height and projection.

It is also important to mention the role of the surface of the implant envelope. This plays a part in reducing the rate of capsular contracture, specifically with the textured implants and the polyurethane covered implants.

Q: Are there any new techniques, methods or approaches in relation to the breast augmentation procedure?

A: Our continuous research into achieving the most naturallooking results helped us to discover a new procedure for breast augmentation and management of the ptotic (sagging) breast. This is called multi-plane structural breast size and shape reconstruction. It indicates a paradigm shift in pocket dissection for implant placement and very difficult breast shapes, specifically ptotic breasts, constricted lower pole breasts or tuberous breasts.

This procedure was introduced and developed in the past three years and represents a cornerstone for my practice in breast augmentation. I believe this procedure and the techniques involved have changed the concept of breast augmentation from a volumetric to a 3D architectural approach. The breast implants are now used as a core foundation for the bottom of the future breast mound and the rest of the existing breast tissue layers are modified to cover. I think we are close to developing a universal concept and surgical technique for 21st century breast surgery.

Q: How can patients become better educated on their options, and what complications would you warn them of prior to surgery?

A: Patient education is of paramount importance for optimal results and patient satisfaction. To reduce re-operation rates and maximise the percentage of satisfied patients, surgeons need to inform and educate their patients carefully. We need to deliver the information that can help the patient to choose the best procedure for them.

In my practice, we help patients plan and prepare for their surgery with a step-by-step, media-assisted plan that includes a BioDynamic consultation system. It uses 3D simulation software, which has assisted us in achieving a higher patient conversion and satisfaction rate.