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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
Krishna S Vyas, Sibi Rajendran, Shane D Morrison, Afaaf Shakir, Samir Mardini, Valerie Lemaine, Maurice Y Nahabedian, Stephen B Baker, Brian D Rinker, Henry C Vasconez
BACKGROUND: Management of postoperative pain often requires multimodal approaches. Suboptimal dosages of current therapies can leave patients experiencing periods of insufficient analgesia, often requiring rescue therapy. With absence of a validated and standardized approach to pain management, further refinement of treatment protocols and targeted therapeutics is needed. Liposomal bupivacaine (Exparel) is a longer acting form of traditional bupivacaine that delivers the drug by means of a multivesicular liposomal system...
October 2016: Plastic and Reconstructive Surgery
Keisuke Kashiwagi, Yoshiro Abe, Soshi Ishida, Kazuhide Mineda, Yutaro Yamashita, Yutaka Fukunaga, Sho Yoshimoto, Ryosuke Yamato, Tatsuya Tsuda, Ichiro Hashimoto
BACKGROUND: Breast reconstruction generally involves autologous tissue transplantation and placement of a mammary prosthesis. When the patient's breasts are extremely large and ptotic, breast reconstruction often results in significantly asymmetrical appearance. However, a good aesthetic outcome after reconstruction surgery following cancer resection is an important quality-of-life factor. We evaluated the efficacy of touch-up surgery, either reduction mammaplasty or mastopexy, performed on the contralateral breast for symmetrization...
2016: Journal of Medical Investigation: JMI
Seyed Abolhassan Emami, Roohollah Sobhani
AIM OF STUDY: Women with breast hypertrophy often experience a number of physical symptoms and psychological difficulties. The breasts are very important for the psychological well-being of women, which might be affected negatively because of breast size and shape distortions. Self-body dissatisfaction and, in this background, the breasts can lead to low levels of self-confidence and self-esteem, which might affect sexuality. MATERIALS AND METHODS: Thirty-five women with macromastia and their partners were evaluated for their sexual function and surgery satisfaction before and 6 months following reduction mammaplasty...
October 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Peter W Henderson, Michelle M Chang, Erin M Taylor, Ross Weinreb, Christine H Rohde
BACKGROUND: The superomedial pedicle parenchymal excision pattern for reduction mammaplasty has the benefits of a reproducible breast shape and improved superomedial fullness, but is limited by a susceptibility to nipple retraction. The senior author of this paper has formalized the "superior ledge" modification of the superomedial pedicle technique (SL-SMP) to address these limitations. OBJECTIVE: To describe the technical details of the SL-SMP breast reduction technique and to analyze patient outcomes...
October 2016: Aesthetic Plastic Surgery
Jingjing Sun, Dali Mu, Chunjun Liu, Kai Ji, Lin Chen, Wenyue Liu, Jie Luan
BACKGROUND: The inframammary fold (IMF) incision is widely used in Western countries for breast augmentation surgery, whereas the axillary incision is the dominant approach used in China, because many Chinese surgeons believe that the Asian population has a higher risk of developing hypertrophic scars. However, comparative data of scar assessment through different incisions in Chinese patients are scarce. The aims of the study were as follows: (1) to evaluate the outcomes of scar assessment using the Vancouver scar scale (VSS), combined with patient satisfaction scoring, in the scar assessment after breast augmentation surgery; (2) to compare the long-term cosmetic effects of surgical scars between axillary and IMF incisions...
October 2016: Aesthetic Plastic Surgery
Ruth Graf, André Ricardo Dall Oglio Tolazzi, Priscilla Balbinot, André Pazio, Pedro Miguel Valente, Renato da Silva Freitas
BACKGROUND: The pectoralis muscle sling has proven to be a suitable alternative technique for long-term results in breast parenchyma suspension. Although the pectoralis muscle sling has been subjectively observed to reduce the bottoming-out effect with a bipedicled muscle flap (muscular loop), there has not been a study to objectively or numerically prove it. OBJECTIVES: This study aimed to radiologically evaluate the influence of a pectoralis muscle sling in supporting the chest wall-based flap after a vertical breast-reduction technique...
July 8, 2016: Aesthetic Surgery Journal
Paul A Ghareeb, Albert Losken
BACKGROUND: Reduction mammaplasty is commonly performed for symptomatic macromastia and is useful in achieving symmetry in unilateral breast reconstruction and oncoplastic surgery. Postoperatively, however, recurrent macromastia or asymmetry often develops. In the past, there has been concern about safely resecting additional volume and moving the nipple. We analyze our outcomes with regard to rereduction mammaplasty, (and discuss) these results in comparison to the current literature...
July 6, 2016: Annals of Plastic Surgery
Ozan Bitik, Hakan Uzun
BACKGROUND: Postoperative changes following superior pedicle breast reduction are closely related to the pattern of skin resection. We have observed that the superior pedicle, short horizontal scar breast reduction technique provides a stable breast shape in the long term. We test the validity of our clinical observations through objective analysis of postoperative dimensional changes following superior pedicle, short horizontal scar breast reduction. METHODS: Of 42 patients who underwent superior pedicle, short horizontal scar breast reductions between January 2011 and June 2012, 38 (75 breasts) were available for long-term follow-up...
October 2016: Aesthetic Plastic Surgery
A Carpelan, S Kauhanen
BACKGROUND AND AIMS: Reduction mammaplasties are increasingly performed as outpatient procedures. Cost savings are assumed, but published data on the subject are scarce. The aim of this study was to retrospectively determine the possible cost savings achieved by performing reduction mammaplasties as outpatient procedures. MATERIAL AND METHODS: Reduction mammaplasty was performed for 90 outpatients and 44 inpatients, with comparable health status. Demographic, surgical, and complication data were collected retrospectively...
June 1, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Marco Klinger, Fabio Caviggioli, Silvia Giannasi, Valeria Bandi, Barbara Banzatti, Alessandra Veronesi, Federico Barbera, Luca Maione, Barbara Catania, Valeriano Vinci, Andrea Lisa, Guido Cornegliani, Micol Giaccone, Mattia Siliprandi, Francesco Klinger
BACKGROUND: The exact prevalence of tuberous breast deformity (TBD) has not been properly investigated and still remains undetermined. We report our data about TBD prevalence with the aim of demonstrating its high prevalence. MATERIALS AND METHODS: A retrospective analysis was performed on preoperative photographs of 1600 Caucasian female patients admitted to our department from January 2009 to July 2014 for augmentation or reduction mammaplasty and other breast clinical conditions...
August 2016: Aesthetic Plastic Surgery
Metin Temel, Ömer Berberoğlu, Arif Türkmen
This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors .".
August 2016: Aesthetic Plastic Surgery
Shweta Aggarwal, Sekhar Marla, Donald Nyanhongo, Sita Kotecha, Narendra Nath Basu
INTRODUCTION: Therapeutic mammaplasty (TM) is a useful technique in the armamentarium of the oncoplastic breast surgeon (OBS). There is limited guidance on patient selection, technique, coding, and management of involved margins. The practices of OBS in England remain unknown. METHODS: Questionnaires were sent to all OBS involved with the Training Interface Group. We assessed the number of TM cases performed per surgeon, criteria for patient selection, pedicle preference, contralateral symmetrisation, use of routine preoperative MRI, management of involved margins, and clinical coding...
2016: International Journal of Surgical Oncology
M Kääriäinen, K Salonen, M Helminen, U Karhunen-Enckell
BACKGROUND AND AIMS: Chest-wall contouring surgery is an important part of the gender reassignment process that contributes to strengthening the self-image and facilitating living in the new gender role. Here, we analyze the surgical techniques used in our clinic and report the results. MATERIAL AND METHODS: Female-to-male transgender patients (n = 57) undergoing chest-wall contouring surgery at Tampere University Hospital between January 2003 and April 2015 were enrolled in the study...
April 22, 2016: Scandinavian Journal of Surgery: SJS
Justine Goldberg, Alexander Zuriarrain, Christopher Brooks
This article presents the case of a 35-year-old woman who sustained a shotgun blast injury to the left forearm and chest wall causing significant soft tissue loss of the extensor compartment. The patient suffered a Gustilo IIIB open radial shaft fracture requiring orthopedic stabilization and plastic surgery intervention. As a result, the patient eventually was reconstructed with the use of a pedicled breast flap. Because of the patient's macromastia and her large forearm wound and morbid obesity, an individualized approach was developed such that a breast flap was designed because of its proximity to the upper extremity...
January 2016: Plastic and Reconstructive Surgery. Global Open
Qi Tang, Shaoqiang Zhou, Yunchao Huang
OBJECTIVE: To investigate the correlation between infection and capsular contracture by observing the effect of infection on the formation of the surrounding capsule after breast implants. METHODS: Three healthy adult female Diannan small-ear pigs underwent augmentation mammaplasty using miniature implants, which were randomly divided into group A (12 nipples), group B (10 nipples), and group C (12 nipples). Staphylococcus epidermidis (SE ATCC12228 and SE RP62A, 1...
December 2015: Chinese Journal of Reparative and Reconstructive Surgery
Sarah Fernandez, Loretta Coady, Rachel Cohen-Shohet, Justine Molas-Pierson, Bruce A Mast
INTRODUCTION: Multiple techniques exist for reduction mammoplasty, but no singular consensus exists as to which method is the most effective in providing an aesthetically pleasing breast. We reviewed our institution's reduction mammoplasty experience over a 2-year period to evaluate aesthetic and surgical outcomes comparing superiorly based pedicles with skin excisions resulting in either an inverted T or vertical scar. METHODS: An IRB-approved retrospective review of our institution's surgical database identified patient characteristics and outcomes of all breast reductions performed over a 2-year period (n = 104)...
June 2016: Annals of Plastic Surgery
Karen L Powers, Linda G Phillips
Mammary hypertrophy can occur in the postburn breast. Patients with burned breasts exhibit the same symptoms of symptomatic macromastia as patients with unburned breasts. The extent of the deformity, the location of the deformity, and the status of the surrounding soft tissue are all assessed before embarking on any surgical plan, which then proceeds in a conservative stepwise fashion. Although many plastic surgeons are reluctant to operate on burned breasts for fear of devascularizing the skin graft or nipple areolar complex, reduction mammaplasty in this group of patients is safe and carries minimal risk if key concepts are followed...
April 2016: Clinics in Plastic Surgery
Neal Handel, Sara Yegiyants
The objectives of this article are to explain the mechanisms of injury that result in ischemia of the nipple areolar complex (NAC) after reduction mammaplasty or mastopexy, to offer recommendations about the management of this complication, and to illustrate reconstructive techniques that can be used to correct deformities arising from necrosis of the NAC. With these goals in mind, the article is divided into 3 sections: prevention of ischemia of the NAC, management of the ischemic nipple, and reconstruction after ischemic necrosis of the nipple and areola...
April 2016: Clinics in Plastic Surgery
Dennis C Hammond, Kuylhee Kim
Breast reduction is one of the most common plastic surgery procedures performed on the breast. There are now numerous alternatives to the standard inverted-T inferior pedicle technique. The short scar periareolar inferior pedicle reduction (SPAIR) mammaplasty is one of these techniques. The procedure was designed to reduce the scar burden associated with breast reduction. However, postoperative complications can occur. The purpose of this article is to outline these potential complications that are of particular concern with the SPAIR mammaplasty and describe methods for their treatment and prevention...
April 2016: Clinics in Plastic Surgery
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