It s recommended to begin with techniques for males to understand each step of the procedure.
Step 1a . Position of the Patient
In Orthostatic Position
Arms behind the back
The Head should not look down abd should be positioned straight.
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
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 .
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: Draw a vertical line from the middle of the clavicle
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: 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.
Step 7 :Marking the limits of the working area
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
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 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 8: Vertical Division of the pectoral working area
with 2 tongue depressors, draw the verticals going from the vertical red line inwards and also outwards
3 vertical lines
the red vertical line
2 white vertical lines on either side of the vertical red line
Step 9 : Horizontal Division of the pectoral working area
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: 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
Step 11 :Marking the tensors
THE TENSORS ( HERE ARROWS) LOOK TOWARDS THENEW PROJECTION POINTWITH A DIRECTION AND A SENSE OFLIFTING+TIGHTENINGUNDER THE NEW RED HORIZONTAL LINEAND ONLYTIGHTENING WITHOUT LIFTINGABOVE 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 : 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
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
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
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)