Introduction: Breast Augmentation is the second most common cosmetic surgical procedure in Italy. This procedure is still gaining in interest and certainly represents a large portion of aesthetic surgery practice with more than 33.000 procedures. However, this operation is associated with significant pain and discomfort in the immediate postoperative period and may cause unwanted side effects. In this study we examine our single accredited outpatient surgery center experience transitioning from the use of classical breast augmentation technique to the use of BAT breast surgery. Methods: We performed a retrospective analysis of all breast augmentations cases performed over a 5-year period from January 2012 to July 2017 by multiple surgeons in the practice. Postoperative follow-up length and side effects as level of pain and discomfort, bruising and swelling were noted. Also complications including hematoma, infection, seroma, hypertrophic scar, need for revision surgery, and pulmonary embolism/deep venous thrombosis (PE/DVT) were observed. Results: Four of the most interesting findings were a significantly decreased pain level and discomfort, bruising, swelling and hematoma in the BAT group (310 patients) where no pain occurred in 17.7%, light pain in 77.4%, moderate pain in 4.8%, intense or serious pain in 0%. Whereas serious pain occurred in the TBA group (95 patients) in 13.6%, intense pain in 73.6%, moderate pain in 6.3%, light or no pain in 0%. Discussion: Pain level and discomfort in the Bloodless Atraumatic Technique Breast Augmentation Group were much lighter than that in the Traditional Breast Augmentation Group, which demonstrated that BAT significantly reduced postoperative pain and discomfort, without complications for the patients who received silicone prostheses implanted into subpectoral space for cosmetic breast augmentation. Conclusions: The use of Bloodless Atraumatic Technique significantly decreased the pain level and discomfort in our practice. Bloodless Atraumatic Technique Breast Augmentation offers objective improvements in recovery, complications, reoperation rates, and the overall patient experience, but do not happen in a predictable manner without substantial commitment of the surgical staff and effort primarily of the surgeon.
