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Flap over mastectomy

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https://www.readbyqxmd.com/read/28195894/breast-reconstruction-using-pedicled-latissimus-dorsi-myocutaneous-flaps-in-asian-patients-with-small-breasts
#1
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...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195672/predictors-of-satisfaction-and-quality-of-life-following-post-mastectomy-breast-reconstruction
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27121604/risk-factors-of-mastectomy-skin-flap-necrosis-in-immediate-breast-reconstruction-using-low-abdominal-flaps
#17
Taik Jong Lee, Tae Suk Oh, Eun Key Kim, Hyunsuk Suh, Sei Hyun Ahn, Byung Ho Son, Jong Won Lee, Jonghan Cho, Jin Sup Eom
BACKGROUND: The purpose of this study was to determine the risk factors associated with mastectomy skin flap necrosis during immediate reconstruction with TRAM or DIEP flaps. METHODS: This study reviewed 1116 cases of immediate breast reconstruction over 10 years. Patients ranged in age from 29-76 years (average = 45.1 years), and had an average follow-up period of 65.6 months. Thirteen factors (age, BMI (body mass index), smoking habits, diabetes ptosis grade, midclavicle-to-nipple distance, neoadjuvant chemotherapy, free or pedicled flap, mastectomy method, surgeon, stage, axillary dissection, mastectomy weight) known to be associated with mastectomy flap necrosis were retrospectively analysed...
October 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27119911/dual-pedicle-flap-for-unilateral-autologous-breast-reconstruction-revisited-evolution-and-optimization-of-flap-design-over-15-years
#18
Edward I Chang, Steven J Kronowitz
BACKGROUND: In thin patients or when a significant amount of skin is needed, use of the entire abdomen to reconstruct a single breast may be necessary. In this article, the authors present their 15-year experience in dual-pedicle flap evolution and optimization of flap design. METHODS: A retrospective review was conducted of all bipedicle flaps performed from 2000 to 2015. RESULTS: Overall, 57 patients (mean age, 49.2 years; mean body mass index, 26...
May 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/26914349/nipple-pathology-in-total-skin-sparing-mastectomy-implications-for-immediate-reconstruction
#19
Lesley Wong, Ryan M Wilson, W Kelsey Snapp, Raevti Bole, Krishna S Vyas
PURPOSE: The management of occult tumor involvement of the nipple during total skin-sparing mastectomy (TSSM) and immediate reconstruction is not well addressed in the literature. We reviewed our experience with positive nipple core biopsies, comparing outcomes of different management options. METHODS: Mastectomy and implant/expander reconstructions over a 5-year period were reviewed. Patient characteristics, type of mastectomy, and complications were analyzed. Patients were grouped by type of mastectomy/immediate reconstruction and delayed reconstruction to compare outcomes...
June 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/26855905/conservative-mastectomies-and-immediate-delayed-autologous-ideal-breast-reconstruction-the-diep-flap
#20
Maximilian Otte, Carolin Nestle-Krämling, Sonia Fertsch, Mazen Hagouan, Beatrix Munder, Philip Richrath, Peter Stambera, Alina Abu-Ghazaleh, Christoph Andree
BACKGROUND: With the development of conservative mastectomies, there are an increasing number of women seeking immediate implant based and autologous breast reconstruction. Despite the oncologic safety of the procedures, the focus will be on the timing of reconstruction. METHODS: Our plastic surgery unit is focused primarily on autologous breast reconstruction and is part of an interdisciplinary breast center. We offer immediate breast reconstruction (IBR) with autologous tissue for patients with positive BRCA 1 and 2, ductal carcinoma in situ (DCIS), invasive cancer without margin problems to the skin, as well as to correct poor oncologic and aesthetic breast conserving therapy (BCT) outcomes...
February 2016: Gland Surgery
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