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Key iconKeypoints:

  • Transaxillary balloon-assisted augmentation mammoplasty (BAAM) uses a specially developed balloon to enable safe and complete pocket dissection and expansion
  • The approach is simple, safe, reproducibly effective, reduces operative time and can result in excellent, durable cosmetic outcomes

Dr. Kluska
GREENSBURG, PA. — Transaxillary balloon-assisted augmentation mammoplasty (BAAM) is a safe and effective technique with multiple advantages that make it the current method of choice for breast enhancement surgery, according to Michael S. Kluska, D.O.

(Left) 28-year-old female 36A cup pre-op and (right) 36 full-D cup 11 months post-op. Submuscular implants are moderate-profile 500 cc smooth round saline filled to 550 cc. (Photo credit: Michael S. Kluska, D.O.)
BAAM is performed using a SpaceMaker balloon (Snowden Pencer) for auto-dissection and auto-tissue expansion. Appropriate to use whether a patient is receiving saline or silicone implants, BAAM provides a simple and easily reproducible method for creating a large and completely dissected submuscular or subfascial implant pocket. It significantly shortens operative time and can result in excellent and durable cosmetic outcomes.

(Left) 34-year-old female 34A cup pre-op and (right) 34D cup six months post-op. Submuscular implants are high-profile 400 cc smooth round saline filled to 420 cc. (Photo credit: Michael S. Kluska, D.O.)
Additionally, BAAM can allow for primary placement of larger implants than might ordinarily be considered based on the patient's anatomy, shortens the duration of anesthesia time for patients, and, anecdotally, appears to be associated with less post-operative pain relative to alternative approaches to breast augmentation, says Dr. Kluska, a board-certified plastic and cosmetic surgeon practicing in Greensburg, Pa. "A transaxillary approach to augmentation mammoplasty has been used for over two decades, but it has been controversial because of its potential for incomplete and blind dissection that can result in implant malposition and a risk for traumatic pneumothorax. As a result, the trend has been toward use of an endoscope for the entire dissection," Dr. Kluska tells Cosmetic Surgery Times .

"The balloon-assisted technique enables adequate pocket dissection with minimal risk of trauma in an efficient and timely manner. In my experience with the balloon, total operative time from skin opening to closure is now under 30 minutes. There have been no added safety concerns associated with its use, and results have been excellent regarding implant position and longevity of the outcomes."

Dr. Kluska notes that the longest duration of patient follow-up to date extends to seven years, but he expects the favorable cosmetic results should be maintained for much longer.

"This technique allows implant placement in a complete submuscular or subfascial plane and overcomes the challenge of sagging and malpositioning due to partial submuscular placement found many times in the transaxillary approach."

BAAM BY THE NUMBERS The BAAM technique is performed in two primary and a third optional step.

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