To Do and Not to Do: My Evolution in Breast Surgery | Featuring Brazil, Argentina | Global Partner Webinar Series-To Do and Not to Do: My Evolution in Breast Surgery (Featuring Brazil, Argentina)

Video Transcription

Video Summary

The ASPS Global Partners webinar focused on breast surgery best practices, featuring expert insights from Alberto Raconte, Jaime Anger, and Renee Burke. Alberto emphasized preserving nipple sensitivity by avoiding incisions at the inframammary fold’s central (6 o’clock) position, as this area contains the critical fifth intercostal artery perforator (ICAP), a neurovascular pedicle essential for blood supply and sensation. He recommended lateralizing incisions slightly to protect this structure, supported by anatomical cadaver studies and advanced nerve imaging techniques.<br /><br />Jaime Anger presented a mastopexy technique performed without preoperative markings, stressing intraoperative judgment to tailor skin and tissue resection. This approach avoids the risk of excessive tissue removal inherent in fixed markings, allowing adjustments during surgery to optimize breast shape and symmetry. He demonstrated successful outcomes integrating implants and fat grafting, highlighting minimal scarring, use of suction drains, and careful soft tissue management.<br /><br />Renee Burke shared broad lessons from her extensive clinical experience, urging surgeons to prioritize tissue preservation, lift the nipple properly rather than relying solely on large implants, and incorporate soft tissue support like mesh when appropriate. She advised minimizing areola size for aesthetic preference and discussed management strategies for complications such as nipple ischemia, including hyperbaric oxygen, CO2 therapy, and timely surgical intervention. She advocated for flexibility in implant placement, often favoring pre-pectoral over submuscular pockets to reduce animation deformities and improve long-term results.<br /><br />The panelists underscored the importance of evolving beyond traditional training, using intraoperative flexibility, preserving anatomy, and carefully balancing aesthetics with safety to achieve durable, natural breast surgery outcomes.

Keywords

breast surgery

nipple sensitivity preservation

inframammary fold incision

fifth intercostal artery perforator

mastopexy without preoperative markings

intraoperative judgment

implant integration

fat grafting

soft tissue support mesh

complication management nipple ischemia