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Flap over mastectomy

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https://www.readbyqxmd.com/read/28328628/unilateral-versus-bilateral-breast-reconstruction-is-less-really-more
#1
Lauren V Kuykendall, Bugra Tugertimur, Corin Agoris, Sara Bijan, Ambuj Kumar, Deniz Dayicioglu
OBJECTIVE: Over the recent years, there has been an increase in prophylactic mastectomies with an associated increase in bilateral breast reconstruction. We aimed to compare outcomes in terms of patient satisfaction with unilateral versus bilateral breast reconstruction after deep inferior epigastric perforator (DIEP) flap and implant-based reconstruction. METHODS: Patients who underwent breast reconstruction by a single surgeon between July 2011 and July 2015 were surveyed using the independently validated BREAST-Q questionnaire...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28293504/an-appraisal-of-internal-mammary-artery-perforators-as-recipient-vessels-in-microvascular-breast-reconstruction-an-analysis-of-515-consecutive-cases
#2
Felix H Vollbach, Christoph D Heitmann, Hisham Fansa
BACKGROUND: The usage of internal mammary artery perforators (IMAPs) has been described in autologous breast reconstruction although IMAPS are not yet considered standard recipient vessels. It remains unclear if these vessels can be safely used in large flaps after radiation therapy or in delayed breast reconstruction. METHODS: Over a 2-year period, 515 free flaps for autologous breast reconstruction were performed on 419 patients by 2 surgeons (S1 and S2). In a retrospective analysis, time of reconstruction, ischemia time, flap weight, diameter of couplers, and complications were analyzed...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28275427/resection-and-reconstruction-following-recurrent-malignant-phyllodes-case-report-and-review-of-literature
#3
Aashish Rajesh, Mohammed Farooq
INTRODUCTION: Phyllodes tumors are uncommon biphasic fibroepithelial neoplasms of the breast of varying malignant potential occurring in middle aged women. They exhibit diverse biological behavior. Margin free excision is the mainstay of treatment. CASE PRESENTATION: A 27 year-old lady was referred with a painless ulceroproliferative right breast lesion which had rapidly progressed over six months. Three years back, she had been diagnosed with a borderline phyllodes tumor and underwent a wide local excision followed by a right mastectomy for recurrence...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28229288/complications-in-diep-flap-breast-reconstruction-after-mastectomy-for-breast-cancer-a-prospective-cohort-study-comparing-unilateral-versus-bilateral-reconstructions
#4
Ryckie G Wade, Sergio Razzano, Elaine M Sassoon, Richard M Haywood, Rozina S Ali, Andrea Figus
BACKGROUND: The demand for bilateral breast reconstructions is rising worldwide. In the UK, approximately 30% of breast cancer patients undergoing mastectomy choose autologous tissue breast reconstruction. Although the deep inferior epigastric perforator (DIEP) flap is gaining popularity, bilateral DIEP flap breast reconstruction remains a complex procedure and reliable outcome data are lacking. In the absence of clinical trials, evidence from cohort studies is needed to better inform clinicians and patients...
February 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28195894/breast-reconstruction-using-pedicled-latissimus-dorsi-myocutaneous-flaps-in-asian-patients-with-small-breasts
#5
I-Han Chiang, Chih-Hsin Wang, Yuan-Sheng Tzeng, Hao-Yu Chiao, Chang-Yi Chou, Chi-Yu Wang, Tim-Mo Chen, Shyi-Gen Chen
BACKGROUND: The use of implants is still the most common procedure for breast reconstruction because they are easy, less painful than tissue transplants, and do not need a donor site. However, it is challenging to find a suitable implant for patients with small breasts, and some women fear foreign bodies and possible complications or reoperations. Autologous breast reconstruction using the pedicled latissimus dorsi (LD) myocutaneous flap without an implant provides a good option for Asian women with small breasts...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195672/predictors-of-satisfaction-and-quality-of-life-following-post-mastectomy-breast-reconstruction
#6
Hannah Matthews, Natalie Carroll, Derek Renshaw, Andrew Turner, Alan Park, Jo Skillman, Kate McCarthy, Elizabeth A Grunfeld
OBJECTIVE: Breast reconstruction is associated with multiple psychological benefits. However, few studies have identified clinical and psychological factors associated with improved satisfaction and quality of life. This study examined factors which predict satisfaction with breast appearance, outcome satisfaction and quality of life following post-mastectomy breast reconstruction. METHODS: Women who underwent post-mastectomy breast reconstruction between 2010 and 2016 received a postal questionnaire consisting of: The BREAST-Q Patient Reported Outcomes Instrument, The European Organisation for Research and Treatment of Cancer QLQ-30 Questionnaire, The Patient and Observer Scar Assessment Scale and a series of Visual-Analogue Scales...
February 13, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28152706/optimizing-surgical-instrument-sets-for-cases-involving-breast-and-plastic-surgeons
#7
Jason B Fleming, Brian M Garcia, Marina Lozano, Darryl Rigby, Rita Manuel-Byrd, Lisa McMillian, Chris Avalos, Rachel Hodge, Charles E Butler, Kelly Hunt, Don Baumann
33 Background: Processing operative instrumemt sets is a major cost for surgical cancer care. Optimizing standard sets requires availability of instruments reflecting varied surgeon preferences while minimizing unnecessary instruments. Additionally, increasing utilization of oncoplastic reconstruction after mastectomy and lumpectomy requiring breast and plastic surgery sets further expands the number of instruments required. The goal of our study was to optimize standard sets used for cases combining breast and plastic surgeons and to determine cost savings Methods: Baseline data was recorded over a 2 week period (13 cases) including number of instruments available and number unused for non- flap breast-plastics combo (BPC) cases...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28130560/the-reconstruction-choice-for-giant-phyllodes-tumor-of-breast-bi-pedicled-deep-inferior-epigastric-perforator-flap
#8
Chien-Liang Fang, Chin-Hao Hsu, Chin-Wen Tu
BACKGROUND: Phyllodes tumors of the breast are the rarest of all breast neoplasms. Giant phyllodes tumors (>10 cm) of the breast have been less discussed in the literature. Reconstruction of the large defect created after wide excision (safety margin >1 cm) is a challenge in these patients. We present one technique using a bi-pedicled deep inferior epigastric perforator flap for post-mastectomy breast reconstruction for giant phyllodes tumors. METHODS AND RESULTS: We treated three patients with giant phyllodes tumors between 2013 and 2016...
January 27, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28121852/outcome-evaluation-after-2023-nipple-sparing-mastectomies-our-experience
#9
Roy De Vita, Giovanni Zoccali, Ernesto Maria Buccheri, Maurizio Costantini, Claudio Botti, Marcello Pozzi
BACKGROUND: Although quadrantectomy and lumpectomy help diminish the psychological and physical devastation inflicted, mastectomy is still elected in 20 to 30 percent of breast cancers. Although initially inciting controversy over heightened risk of local recurrences, recent studies maintain that nipple-sparing mastectomy can be used in any patient qualifying for total mastectomy and also improves aesthetic and psychologic outcomes. The manner in which mastectomy influences reconstructive implant outcomes has been documented by several groups...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28106627/outcomes-after-elevation-of-serratus-anterior-fascia-during-prosthetic-breast-reconstruction
#10
Akhil K Seth, Elliot M Hirsch, John Y S Kim, Neil A Fine
BACKGROUND: Achieving optimal inferolateral coverage is critical to successful prosthetic breast reconstruction. Serratus anterior fascia (SF) elevation, a promising alternative to muscle flaps and acellular dermis (ADM), has not been rigorously studied. This study evaluates complication rates after mastectomy and immediate tissue expander (TE) coverage using SF, relative to other existing methods of reconstruction. METHODS: Retrospective review of consecutive patients undergoing mastectomy with immediate TE reconstruction over 10 years at 1 institution was performed...
January 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28079533/national-and-regional-differences-in-32-248-postmastectomy-autologous-breast-reconstruction-using-the-updated-national-inpatient-survey
#11
Parisa Kamali, Marek A Paul, Ahmed M S Ibrahim, Pieter G L Koolen, Winona Wu, Marc L Schermerhorn, Bernard T Lee, Samuel J Lin
BACKGROUND: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. The aim of this study was to assess national and regional trends in different types of autologous BR. METHODS: Using the Nationwide Inpatient Sample database (2008 to 2012), data on BC and mastectomy rates, type of autologous BR, and sociodemographics were obtained and analyzed...
January 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27777885/male-papillary-breast-cancer-treated-by-wide-resection-and-latissimus-dorsi-flap-reconstruction-a-case-report-and-review-of-the-literature
#12
Malgorzata Banys-Paluchowski, Eike Burandt, Joanna Banys, Stefan Geist, Guido Sauter, Natalia Krawczyk, Peter Paluchowski
Breast cancer (BC) in men represents between 0.5% and 1% of all BC diagnosed each year. We report a case of advanced BC in a 62-year-old male treated at our interdisciplinary Breast Cancer Center. The patient presented with a newly diagnosed large, symptomatic mass in his left breast. Clinical examination showed a not movable mass of 16 cm diameter, deforming the whole breast; the overlying skin was livid and hypervascularized. Enlarged lymph nodes were palpable in the axillary pit. He had no concomitant diseases at time of presentation...
October 10, 2016: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27776942/national-trends-in-immediate-and-delayed-post-mastectomy-reconstruction-procedures-in-england-a-seven-year-population-based-cohort-study
#13
J C Mennie, P-N Mohanna, J M O'Donoghue, R Rainsbury, D A Cromwell
INTRODUCTION: Little is known about post-mastectomy reconstruction procedural trends in women diagnosed with breast cancer in England. Our aim was to examine patterns of immediate and delayed reconstruction procedures over time and within regions. METHODS: Women with breast cancer who underwent unilateral index immediate or delayed post-mastectomy reconstruction between 2007 and 2014 were identified using the National Hospital Episode Statistics database. Women were grouped into categories based on the type of reconstruction procedure...
January 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27689057/a-novel-nipple-reconstruction-technique-for-maintaining-nipple-projection-the-boomerang-flap
#14
Young-Eun Kim, Ki Yong Hong, Kyung Won Minn, Ung Sik Jin
Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up...
September 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27682158/reduction-mammoplasty-using-oxidized-regenerated-cellulose-as-a-filler-in-breast-conservation-surgery
#15
Gianluca Franceschini, Alejandro Martin Sanchez, Giuseppe Visconti, Alba Di Leone, Sabatino D'Archi, Antonino Mulè, Angela Santoro, Marzia Salgarello, Riccardo Masetti
Oncoplastic surgery of the breast has generated great excitement over the past years and has become an integrated component of the surgical treatment of breast cancer. Oncoplastic procedures (OPP) associate the best surgical oncologic principles to achieve wide tumor-free margins with the best principles of plastic surgery to optimize cosmetic outcomes. So, a number of conventional mammoplasty techniques have been adapted to allow reconstruction of resection defects with parenchymal flaps using a variety of different approaches...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27600636/current-trends-and-outcomes-of-breast-reconstruction-following-nipple-sparing-mastectomy-results-from-a-national-multicentric-registry-with-1006-cases-over-a-6-year-period
#16
Donato Casella, Claudio Calabrese, Lorenzo Orzalesi, Ilaria Gaggelli, Lorenzo Cecconi, Caterina Santi, Roberto Murgo, Stefano Rinaldi, Lea Regolo, Claudio Amanti, Manuela Roncella, Margherita Serra, Graziano Meneghini, Massimiliano Bortolini, Vittorio Altomare, Carlo Cabula, Francesca Catalano, Alfredo Cirilli, Francesco Caruso, Maria Grazia Lazzaretti, Icro Meattini, Lorenzo Livi, Luigi Cataliotti, Marco Bernini
BACKGROUND: Reconstruction options following nipple-sparing mastectomy (NSM) are diverse and not yet investigated with level IA evidence. The analysis of surgical and oncological outcomes of NSM from the Italian National Registry shows its safety and wide acceptance both for prophylactic and therapeutic cases. A further in-depth analysis of the reconstructive approaches with their trend over time and their failures is the aim of this study. METHODS: Data extraction from the National Database was performed restricting cases to the 2009-2014 period...
September 6, 2016: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/27536498/initial-experience-using-closed-incision-negative-pressure-therapy-after-immediate-postmastectomy-breast-reconstruction
#17
Allen Gabriel, Steven R Sigalove, G Patrick Maxwell
Although immediate postmastectomy breast reconstruction is favored over delayed reconstruction, it remains associated with high complication rates. Potential complications include seroma formation, dehiscence, infection, and tissue necrosis along incision edges. Closed incision negative pressure therapy (ciNPT; Prevena Incision Management System, KCI, an Acelity company, San Antonio, Tex.) has been reported to help hold incision edges together, protect incisions from external contamination, and remove fluid and infectious material...
July 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27536479/a-complication-analysis-of-2-acellular-dermal-matrices-in-prosthetic-based-breast-reconstruction
#18
Orion P Keifer, Eugenia K Page, Alexandra Hart, Randall Rudderman, Grant W Carlson, Albert Losken
BACKGROUND: Acellular dermal matrices (ADM) are now routine in postmastectomy prosthetic-based breast reconstruction. The goal of the current study was to compare the complications of 2 ADM products-AlloDerm and Cortiva. METHODS: A retrospective analysis of prosthetic-based breast reconstruction in Atlanta, Ga., over 5 years. Inclusion criteria were the use of the ADM types (AlloDerm or Cortiva) and use of a tissue expander or implant. Statistical analysis compared group demographics, risk factors, and early complications...
July 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27348679/spy-imaging-use-in-postmastectomy-breast-reconstruction-patients-preventative-or-overly-conservative
#19
Gennaya L Mattison, Priya G Lewis, Subhas C Gupta, Hahns Y Kim
BACKGROUND: SPY Elite imaging uses an injectable fluorescing agent to intraoperatively assess the perfusion and viability of tissue, including skin flaps, during postmastectomy reconstruction for breast cancer patients. In this study, the authors sought to compare the surgeon's assessment of flap viability with that of SPY imaging perfusion, analyzing the clinical outcomes postoperatively. METHODS: In this study, the intraoperative difference between the plastic surgeon's assessment of skin viability and the SPY imaging assessment was analyzed by the skin flap area preserved in patients undergoing skin-sparing mastectomy...
July 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27127834/allergan-style-410-implants-for-breast-reconstruction-a-prospective-study-in-efficacy-safety-and-symmetry
#20
Jacob G Unger, Jennel M Carreras, Purushottam Nagarkar, Haneol S Jeong, William Carpenter
BACKGROUND: Implant-based breast reconstruction is performed with both saline and silicone. In 2001, a study was conducted in which a novel implant made of highly cohesive silicone gel in anatomical shape was used. It differs from others because it holds its anatomical shape and forces tissue to conform to the implant. METHODS: Two hundred twelve consecutive patients who underwent reconstruction with Allergan 410 cohesive gel anatomical implants were enrolled prospectively over a 12-year period...
September 2016: Plastic and Reconstructive Surgery
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