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Techniques Endopeel Pectoroplasty for Females

It s recommended to begin with techniques for males to understand each step of the procedure.

position of the patient

Step 1a . Position of the Patient

Before Marking
  • In Orthostatic Position
  • Arms behind the back
  • Strapless Bra 
  • The Head should not look down abd should be positioned straight.
superior limit of female pectoral working area

Step 1b: Marking the Lower Limit of the Work Area

The back of the operator's hand should lift the patient's breast to determine the upper limit of the forbidden zone ( mammary gland ) which is too the lower limit of the working area

female-marking the extremities of the clavicle

Step 2 : Marking the sternal and acromial end of the clavicle

Marking the 2 ends of the clavicula

Draw a line with a wooden tongue depressor .

measure the clavicular line

Step 3 : Draw a line between the 2 ends of the clavicle and mesure it

Use a centimeter to measure the ,, clavicular line,,

step 4 : vertical line

Step 4: Draw a vertical line from the middle of the clavicle

female step 5

Step 5 : The ,, red horizontal line,,

  • DRAW AN HORIZONTAL LINE GOING FROM THE BASE OF THE AXILLARIS HOLLOW ON THE WORK AREA ( WITH THE ARM AT 90 GRADES THE DELTOID FINISHES ON ITS INTERNAL PART.)

step 6 female horizontal line

Step 6: Marking the new maximum projection point

FASHION STYLE CHANGES MOSTLY TWICE A YEAR .

SINCE 2019. DUED TO FASHION NEW TRENDS, THE MAXIMUM POINT OF PROJECTION IS NOW 4 CM ABOVE THE OLDER ONE , ON THE SAME VERTICAL LINE.

female step 7

Step 7 :Marking the limits of the working area

Anatomic Lines
  • The lower limit ( Step 1b) corresponds to the upper limit of the mammary gland .

  • the work area is presented as a lunar crescent with

    -the infraclavicular fossa above,

    -the anterior axillary line outside,

    -the sternal line inside

The Anterior Axillary Line

External Limit of the Work Area
anterior axillary line

It's the imaginary line that runs down from the point midway between the middle of the clavicle and the lateral end of the clavicle.

The Sternal Line

Internal Limit of the Work Area
sternal line

Sternal line is an important reference line on the anterior chest wall, which extends along the lateral border of the sternum, on both right and left sides.

step 8a : 8a: Division of the pectoral working area into quadrants with verticales

Step 8: Vertical Division of the pectoral working area

Vertical Division

with 2 tongue depressors, draw the verticals going from the vertical red line inwards and also outwards

3 vertical lines

3 vertical lines

  • the red vertical line
  • 2 white vertical lines on either side of the vertical red line
female step 9

Step 9 : Horizontal Division of the pectoral working area

Horizontal Lines
  • with 2 tongue depressors, draw the horizontals going from the horizontal red line upwards and also downwards

  • the quadrants are thus delimited by 2 vertical and 2 horizontal.

step 10

Step 10: Vectors

  • YOU NEED TO APPLY VECTORS NORMAL TO THE CENTER OF EACH SQUARE  WITH A MINIMUM OF 0.1 ML .
  • FOR BIGGER SQUARES, THE QUANTITY OF PRODUCT SHOULD BE > 0.1 ML.

VECTOR NORMAL TO THE CENTER OF AN UNIT-AREA

female step 11

Step 11 :Marking the tensors

  • THE TENSORS ( HERE ARROWS) LOOK TOWARDS THE NEW PROJECTION POINT WITH A DIRECTION AND A SENSE OF LIFTING+TIGHTENING UNDER THE NEW RED HORIZONTAL LINE AND ONLY TIGHTENING WITHOUT LIFTING ABOVE THE NEW RED HORIZONTAL LINE. FOR EACH TENSOR, YOU NEED TO APPLY 0.1 ML MINIMUM.

  • BIGGER QUANTITY OF PRODUCT IS APPLIED IF THE SQUARE IS BIGGER

step 12

Step 12 : Tensor of new maximum projection point

See black arrow

  • POSITION THE SYRINGE ON THE RED VERTICAL BETWEEN THE 2 MAXIMUM PROJECTION POINTS

  • PUSH AND INJECT 0.5 ML FROM THE BOTTOM UPWARDS, BEGINNING FROM THE ,,OLD,, POINT OF MAXIMUM PROJECTION TO THE ,,NEW,, POINT OF MAXIMUM PROJECTION

female step 13

Step 13 : Lateral Tensors of M.Tiziani

simulation of mastopexy

  • THIS PROCEDURE HAS TO BE DONE WITH PATIENT IN ORTHOSTATIC POSITION

  • BEFORE INJECTING, ALWAYS POSITION THE SYRINGE AND SIMULATE THE INJECTION TO CHECK IF THE MAMMARY GLAND IS LIFTED

  • 2 TENSORS WITH 0.5 ML/TENSOR ARE APPLIED

  • THOSE 2 TENSORS ARE MOSTLY VERTICAL GOING FROM DOWNWARDS TO UPWARDS. THEY ARE MOSTLY APPLIED OVER THE LATISSIMUS DORSI AVOIDING THE AXILLARY HOLLOW.

Step 14 : First Immediate Results

Right Pectoroplasty- Toboggan of A.Tenenbaum
step 14 The toboggan

For A.TENENBAUM, if you look on a 3/4 or a profile, the line going from the clavicle to the areaola doesnt look any more straight but like ,,a toboggan allowing the boyfriends of husbands hand to surf on this line to reach the tit ,,

Step 15: Quantities to inject

per side

  • 0.1 ML TO MAX 0.3 ML PER SQUARE PER VECTOR

  • 0.1 ML TO MAX 0.3 ML PER SQUARE PER TENSOR

  • 0.5 ML  TO MAX 1 ML  FROM THE ,,OLD,, POINT OF MAXIMUM PROJECTION TO THE ,,NEW,, POINT OF MAXIMUM PROJECTION ( black arrow)

  • 2X 0.5 ML PER EACH LATERAL TENSOR OF M.TIZIANI

 

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