* Bioplasty of the Breastplate Masculine - I Increase of the Breastplate Masculine *

The increase of the Breastplate muscles can be accomplished with the application intramuscular of P.M.M.A as it is already done in the glúteos increase, increase of the biceps, increase of the calf (gastrocnêmicos) among others.

Suitable, also, in hipotrofia of the breastplate muscle, poland (agenesia of the breastplate muscle) syndrome - muscular asymmetry, and people with disproportion that you/they don't get with physical training and muscular activity an appropriate development of the breastplate muscle.

Procedure:

pertrofia of the muscle;
modelling of the larger breastplate muscle where we can model in a harmonicer way with his/her thorax;

Biomodulation of the Breastplate Masculine with Polimetilmetacrilato (PMMA) - I TELL OF CASE

The liquid implants Infiltrativos comes been used thoroughly in the aesthetic medicine, plastic surgery and reparative. Now it exists a big a lot of range of these products, several concentrations and deferential indications.

The ideal liquid implant needs to have some characteristics as already described by Robert Ersek. In Brazil he/she was discovered in Polimetilmetacrilato (PMMA) the following characteristics, being them, biocompatível, inert, stable in his/her application place, moldável inside of a certain time and permanent, where now it comes been used for the most several ends, as increase glúteo, calves, penises, deltóide, biceps, triceps, thighs, abdomen, in the modelamento of the nose, definition of the line of the jaw and it bears of the face.

The present case report has for objective to describe the used technique and the result obtained in an increase of the breastplate masculine with PMMA to 30%.

LAG, 31 years, 80 Kg attended at the clinic with a disproportion in the size of his/her breastplate one in relation to the remaining of the body, mainly biceps and deltóide, referring several years of academy and a lot of difficulty for the development of the same with exercise and muscular activity, it possessed a great bone and muscular structure however a corporal discord for the inadequate volume of the musculature of the breastplate.

Used material:

PMMA 30%, with ...................;
Microcânula of 20 cm for the anesthetic's infiltration and of Filler (polimetilmetacrilato);
Needle 40X 12;
Pokar cable;
Xilocaína 2% without vasoconstritor;
Pen for demarcation, flexible ruler;
Sterile Campos;

Solution of modified Klein, for local anesthesia (500ml of serum physiologic 0,9% cold, 20 ml. of xilocaína without vase 2%, 2 ml. of adrenaline 1 ml., bicarbonate of sodium 10 ml.).

Antiseptic solution.

Procedure

First we accomplished a previous antisepsis with iodofor, and we accomplished the demarcation. The implant liquid infiltrativo with PMMA to 30% is infiltrated in deep plans, in the musculature of the breastplate larger, for so much he/she needs to accomplish a good revision of the anatomy to avoid possible complications.

The breastplate adult possesses two parts, the portion esternocostal and the portion clavicular, we still have a small portion more inferior abdominal call. As the infiltration is accomplished with a microcânula atraumática, with a tip romba, that doesn't allow lesion of the vasculo-nervous bunch, vascular complications are rare, however some exist cares that should be taken in the demarcation of the procedure.

First we marked a point in the line medium clavicular, we will have in this area the beginning of the delto-breastplate furrow where it will pass the cephalic vein and branches of the artery toracoabdominal, we drew the outline close to portion expresses with 2 lateral cm to the bone breastbone, passing 2 cm below the nipple.

For the demarcation of the infiltration pertuíto as much of the anesthetic as of the filler (polimetilmetacrilato), we should be careful with the bunch vasculo-nervous branch of the subclávia, like v. cephalic, for so much we marked 3 cm below the border of the clavicle in the line hemiclavicular.

Accomplished the demarcation with the seating patient was done a new antisepsis, we lied down the patient and we put the transparent sterile field so that we can together with the patient to accompany the evolution of the procedure.

We accomplished an anesthetic button in the infiltration place demarcated already previously, a pertuito with needle 40X12 is accomplished so that we can enter with the microcânula and to infiltrate the anesthetic (solution of Klein modified) that consists in 500 ml. of SF 0,9% cold, 1 ml. of adrenaline, and 10 ml. of bicarbonate.

40 ml was infiltrated. of anesthetic solution distributed in the plan intramuscular with the same microcânula that we will infiltrate PMMA in each breastplate one respecting the limits preset already, after anesthetic infiltration we left for the implantation of PMMA to 30%, to remind that we cannot leave accumulated amounts of the product in a single place for the possibility of granulomas formation, not to apply in the subcutaneous for the contraindication of PMMA in concentration to 30%, besides the favorecimento of migration of the product.

We accomplished a massage soon after procedure to spread homogeneamente the product.

Illustration 1. patient 15 days after infiltration of 40 ml. of PMMA to 30% in each breastplate one, to notice that the whole edema was already reabsorbed, as well as the vehicle of the filler used in our procedure, being this the definitive result of our procedure.

After having accomplished the procedure a micropore curative it was put, accomplished 1 diprospam flask IM and initiate profilaticamente cefalexina 1 gm grandma 12 / 12 hours for 5 days.

To notice that the vehicle of the used filler is reabsorbed in 4 days, inside of this period the implant is still in his/her phase gel, being moldável, we accomplished the revision in 3 days, we advised not to expose in the sun nor hot objects, not to manipulate the area treated by 1 week, I return the physical activity in 14 days.

After the absorption of the vehicle the spheres of PMMA to 30% of 50 micras of healthy diameter firstly invaded by neutrófilos and later for macrófagos that will stimulate the production of collagen and local fibrose, turning this an impermeable and definitive implant.

DISCUSSION

The Result is permanent, simple, without powders operative, fast, being accomplished ambulatoriamente, with local anesthesia, where the patient can participate actively and to accompany all the accomplishment of the procedure.

Contraindication doesn't exist in the use of PMMA, to not to be local infections and sangramento history. The Procedure is definitive, stable in the application place, moldável in the first days, and inert.

My personal experience demonstrates a high satisfaction degree, not just in the procedure with PMMA in breastplate muscles but in glúteos, nose, biceps, facial among others.

Studies demonstrate complications of 0.05% being the considered edema the main complication, as described by Dra Rosana. ....

After years of training and malhação without result the mentioned patient lost his/her high esteem and you/he/she discredited in the exercise as a form of health and well to be. Today the patient meets very satisfied, and you/he/she returned their physical activities, you/he/she elevated his/her high-esteem, what demonstrates an improvement in the social inclusion.

The technique of implants liquid infiltrativos has been diffused strongly in the medical middle, mainly in the aesthetic area, and if correctly applied, for serious professionals with experience, complications are rare and the patients' satisfaction is very gratifying.