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Cirugía Plástica Ibero-Latinoamericana

versión On-line ISSN 1989-2055versión impresa ISSN 0376-7892


BALLIVIAN RICO, José Luis; BALLIVIAN RICO, José Luis  y  VERA CUCCHIARO, Javier. Mammary implants in submuscular plane through intraoperatory anesthesic blocking of brachial plexus using open access and cannula. Cir. plást. iberolatinoam. [online]. 2020, vol.46, n.1, pp.37-44.  Epub 25-Mayo-2020. ISSN 1989-2055.

Background and objective

Breast augmentation is one of the most performed surgeries in Plastic Surgery.

Our aim is to show an anesthetic technique for placement of breast implants in a submuscular plane, using intraoperative blocking of the brachial plexus branches, and to present our experience in a clinical series.


Technique consists on a lower peri-areolar skin incision under sedation and local anesthesia, reaching by transglandular dissection and cut to the plane of the pectoral muscle aponeurosis; we open a 5 cm incision on the aponeurosis and divide the muscle fibers following their direction; we identify the plane between the pectoralis major and the pectoralis minor and insert a Klein cannula in that plane to the anatomical point where the lateral and medial branches of the brachial plexus are located (2 cm below the clavicle and in its lateral third), where the anesthetic solution preparation is injected.

A series of 172 patients undergoing surgery from January 2014 to April 2018 with this anesthetic procedure was analyzed.


Anesthetic procedure was successful in all patients, ending surgery without needing general anesthesia.


In our experience, the safety and ease execution of the proposed technique, allowed it to be used routinely in all our submuscular augmentation mamoplasties.

Palabras clave : Augmentation mamoplasty; Breast implants; Breast prosthesis; Block anesthesia; Brachial plexus.

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