{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:02:48Z","timestamp":1790787768702,"version":"4.1.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preservation breast augmentation (PBA) is an intralamellar technique preserving the pectoralis major muscle, circummammary ligament, and Cooper's suspensory ligaments. Its perioperative pain profile and the value of regional anesthesia adjuncts remain uncharacterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize the perioperative pain profile of PBA under local anesthesia and sedation and to determine whether a preoperative deep SAP block reduces intraoperative analgesic requirements and early postoperative pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, randomized, single-blind trial enrolled 40 women undergoing PBA. Patients were randomized 1:1 to a preoperative deep SAP block (20\u2005mL of 0.25% bupivacaine bilaterally) or standard care; all procedures used tumescent local anesthesia and propofol sedation. Endpoints included 24-hour NRS score, rescue propofol and fentanyl consumption, hemodynamic response, and postoperative analgesic use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline characteristics were comparable. The SAP group required less rescue propofol (45 \u00b1 3 vs. 55 \u00b1 4\u2005mg; P &amp;lt; .001; d = 2.83) and fentanyl (12 \u00b1 5 vs. 22 \u00b1 9\u2005\u00b5g; P &amp;lt; .001; d = 1.37). NRS scores favored the SAP group at 60\u2005minutes (3.4 vs. 4.5; P = .011) and 6\u2005hours (3.8 vs. 4.7; P = .035), converging by 24\u2005hours (3.4 vs. 3.2; P = .377); both groups remained within a low pain range (NRS \u2264 3.5). No major complications occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PBA under local anesthesia and sedation is associated with a consistently low perioperative pain profile. The SAP block provides a clinically meaningful intraoperative analgesic advantage and improves early postoperative comfort, supporting selective rather than routine use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 2 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjag188","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:42:39Z","timestamp":1788522159000},"source":"Crossref","is-referenced-by-count":0,"title":["Preservation Breast Augmentation Under Sedation Is a Low-Pain Procedure: A Randomized Controlled Trial of Serratus Anterior Plane Block Is an Adjunct"],"prefix":"10.1093","author":[{"given":"Burak Erg\u00fcn","family":"Tatar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezgi","family":"Polat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emirhan","family":"Kahraman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferhat","family":"\u015eim\u015fek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Ayd\u0131n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-8369","authenticated-orcid":false,"given":"Burak","family":"\u00d6zkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"2026093012330772700_sjag188-B1","author":"International Society of Aesthetic Plastic Surgery"},{"key":"2026093012330772700_sjag188-B2","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1177\/1090820X12436601","article-title":"Breast augmentation and augmentation-mastopexy with local anesthesia and intravenous sedation","volume":"32","author":"Colque","year":"2012","journal-title":"Aesthet Surg J"},{"key":"2026093012330772700_sjag188-B3","doi-asserted-by":"publisher","DOI":"10.1093\/asjof\/ojae033","article-title":"Endoscopic primary breast augmentation with loco-regional anesthesia: preliminary experience of 200 consecutive patients","volume":"6","author":"Araco","year":"2024","journal-title":"Aesthet Surg J Open Forum"},{"key":"2026093012330772700_sjag188-B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00266-023-03831-z","article-title":"Pain levels following cosmetic breast surgery and an easy-to-use pain treatment algorithm for plastic surgeons","volume":"48","author":"Eryilmaz","year":"2024","journal-title":"Aesthetic Plast Surg"},{"key":"2026093012330772700_sjag188-B5","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1093\/asj\/sjag038","article-title":"Tissue-preserving inframammary fold breast augmentation: a three-year clinical experience","volume":"46","author":"Randquist","year":"2026","journal-title":"Aesthet Surg J"},{"key":"2026093012330772700_sjag188-B6","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1093\/asj\/sjaf196","article-title":"The 3-year results of a 100-patient prospective study of the safety and effectiveness of Mia Femtech","volume":"46","author":"Chacon-Quiros","year":"2026","journal-title":"Aesthet Surg J"},{"key":"2026093012330772700_sjag188-B7","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1097\/PRS.0000000000011612","article-title":"Subfascial transaxillary breast augmentation: critical evaluation of a 25-year review of 1015 consecutive cases","volume":"155","author":"Munhoz","year":"2025","journal-title":"Plast Reconstr Surg"},{"key":"2026093012330772700_sjag188-B8","doi-asserted-by":"publisher","DOI":"10.1093\/asjof\/ojae107","article-title":"Planes in aesthetic breast surgery: is subfascial a misnomer?","volume":"6","author":"Gabriel","year":"2024","journal-title":"Aesthet Surg J Open Forum"},{"key":"2026093012330772700_sjag188-B9","doi-asserted-by":"publisher","first-page":"ojaf003","DOI":"10.1093\/asjof\/ojaf003","article-title":"Capsular contracture after breast augmentation: a systematic review and meta-analysis","volume":"7","author":"Haas","year":"2025","journal-title":"Aesthet Surg J Open Forum"},{"key":"2026093012330772700_sjag188-B10","doi-asserted-by":"publisher","first-page":"NP639","DOI":"10.1093\/asj\/sjae118","article-title":"Outcomes in subfascial versus subglandular planes in breast augmentation: a systematic review and meta-analysis","volume":"44","author":"Yuan","year":"2024","journal-title":"Aesthet Surg J"},{"key":"2026093012330772700_sjag188-B11","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1007\/s00266-019-01465-8","article-title":"Is there a breast augmentation outcome difference between subfascial and subglandular implant placement? 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