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SOURCE Dr. Rian A. Maercks
Dr. Rian A. Maercks is Committed to Transaxillary Armpit Placement of Sientra and Allergan 410 Form Stable Anatomic Breast Implants in the Cold-Subfascial Plane
MIAMI, Sept. 16, 2013 /PRNewswire/ -- "There is just not a good reason to place scars on the breast in an aesthetic intervention unless absolutely necessary." – Dr. Ran A. Maercks
Dr. Rian A. Maercks, a well renowned innovator and founder of The Maercks Institute of Miami, announced publicly that he has been routinely placing form stable anatomic implants through the axilla, or armpit, as part of his "Cold-Subfascial Breast AugmentationTM." This is exciting news as it has been just over a year since the Sientra product was reapproved and only months for the Allergan Natrelle 410 implants. Dr. Maercks was an early adopter of these implants because of his favorable experience with anatomic shaped implants during his international work. "As soon as they were approved I ordered a full stock in my office. I no longer offer a choice of implant outside of either Sientra highly cohesive implants of Allergan Natrelle style 410 implants, the safety profile is just not worth cutting corners."
Many surgeons are hesitant to use anatomic implants because of lack of experience or resistance to changing technique. Anatomic implants require a carefully designed pocket of exacting precision to avoid rotation, a problem not present with round shapes. Dr. Maercks favors the anatomically shaped implants because they fit perfectly into his unique technique called Cold-Subfascial Breast AugmentationTM. "In the Cold-Subfascial technique, a strong fascial layer is used to create a customized teardrop shape, the shaped implants fit perfectly like a puzzle piece, Its a match made in heaven."
There is widespread agreement that there are strong advantages to highly cohesive form stable implants, perhaps most importantly a drastic reduction in capsular contracture rates. The issue is that many surgeons believe a much larger incision is required for placement and in general it is thought that transaxillary placement is impossible. Thanks to Dr. Maercks' incredible international background and experience with the myriad of implants and placement techniques, transaxillary placement of these devices in his hands is routine. "There are so many misconceptions about the transaxillary approach. In my opinion, an endoscope just gets in the way and can compromise the result. I don't use them. With the correct equipment and technique the entire procedure can be completed safely, precisely and expeditiously with direct visualization. There is also plenty of room for an appropriately sized access incision within the dome of the implant that can be shortened with suture technique at the end of the case. I have never had a patient dissatisfied with the placement scar which usually disappears rapidly. There is just not a good reason to place scars on the breast in an aesthetic intervention unless absolutely necessary."
Other commonly posed concerns about transaxillary placement are implant rotation and migration into the armpit or failure to lower the inframammary fold. Dr. Maercks feels that these concerns result from lacking appropriate equipment and judgement or experience. He reports that these failures result from lack of respect for the transaxillary access limits and failure to appropriately judge and design a pocket. "When the transaxillary incision is started it is very important to stay high and superficial to preserve breast lymphatic drainage for the possible need of future breast cancer node screening. If this is done, there is consequently a geometric separation between the implant cavity and the transaxillary access and a high riding or axillary implant placement is averted."
According to Maercks, the subfascial plane is even more misunderstood. "Most plastic surgeons think it [the pectoral fascia] doesn't exist although there are redundant studies of the structure in result driven clinical studies, in cadaver studies and in strength analysis studies published in mainstream plastic surgery literature. Of those that practice subfascial placement, most actually destroy the fascia by burning and vaporizing it with electrocautery. In reality the destruction of fascia converts the procedure to a subglandular result. I believe this explains several published galleries of very poor results with 'subfascial breast augmentation.' This is one of the many reasons that I developed a completely new technique to create what I consider the perfect breast augmentation, the Cold-Subfascial Breast AugmentationTM. I wanted to perform a breast augmentation that allowed her to be in complete control of all aesthetics, shape, volume distribution and all dimensions of placement, not one dictated by what I consider to be inappropriately shaped implants. Now I create breast implants that are very difficult to discriminate from perfect natural breasts and I leave no stigmata of surgery."
Once Dr. Maercks publicly announced the routine breast augmentation practices at The Maercks Institute, buzz seems to be growing among the large population of women who desire the best possible result for their breast augmentation and who do not want unsightly scars on their breasts. For this population, Dr. Maercks' Cold-Subfascial Breast Augmentation is a dream come true providing a beautiful and enduring result with no evidence of surgery!
Exclusive Private consultations with Dr. Maercks are by appointment only at The Maercks Institute in Miami's Design District. Consultation requests can be directed to (305) 328-8256 or Dr.Rian(at)RianMaerckMD(dot)com.
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