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Technique nipple sparing

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https://www.readbyqxmd.com/read/29213346/safe-plastic-surgery-of-the-breast-ii-saving-nipple-sensation
#1
Steven Schulz, Matthew R Zeiderman, J Stephen Gunn, Charles A Riccio, Saeed Chowdhry, Ronald Brooks, Joshua H Choo, Bradon J Wilhelmi
Background: Since its inception, reduction mammoplasty has matured considerably. Primary evolution in clinical research and practice initially focused on developing techniques to preserve tissue viability; breast parenchyma, skin, and nipple tissue that has expanded to include sensation and erectile function play a large role in the physical intimacy of women. Studies regarding primary innervation to the nipple are few and often contradictory. Our past anatomical study demonstrated that primary innervation to the nipple to come from the lateral branch of the fourth intercostal nerve...
2017: Eplasty
https://www.readbyqxmd.com/read/29139613/nipple-sparing-mastectomy-as-treatment-for-patients-with-ductal-carcinoma-in%C3%A2-situ-a-10-year-follow-up-study
#2
Víctor Lago, Vincenzo Maisto, Julia Gimenez-Climent, Jose Vila, Carlos Vazquez, Rafael Estevan
The objective was to determine the 10-year oncological safety of nipple-sparing mastectomy (NSM) in patients diagnosed with ductal carcinoma in situ (DCIS). The use of NSM preserves the nipple-areola complex (NAC). As residual fibroglandular breast tissue can remain behind the spared NAC, its use for patient with breast cancer is controversial. The oncologic outcomes and complication rates after performing NSM compared to other techniques are still under debate and a concern when treating patients with breast cancer...
November 15, 2017: Breast Journal
https://www.readbyqxmd.com/read/29089810/training-oncoplastic-breast-surgeons-the-canadian-fellowship-experience
#3
J Maxwell, A Arnaout, R Hanrahan, M Brackstone
BACKGROUND: Oncoplastic breast surgery combines traditional oncologic breast conservation with plastic surgery techniques to achieve improved aesthetic and quality-of-life outcomes without sacrificing oncologic safety. Clinical uptake and training remain limited in the Canadian surgical system. In the present article, we detail the current state of oncoplastic surgery (ops) training in Canada, the United States, and worldwide, as well as the experience of a Canadian clinical fellow in ops...
October 2017: Current Oncology
https://www.readbyqxmd.com/read/29080660/indications-and-controversies-for-implant-based-breast-reconstruction-utilizing-biological-meshes
#4
REVIEW
Michael R Zenn
The advent of acellular dermal matrices (ADMs) has changed the way implant reconstruction is performed and has opened the door to muscle-sparing techniques that can be performed as an NSM (nipple-sparing mastectomy) with DTI (direct to implant) with excellent cosmesis and less patient morbidity. The article discusses differences in types of ADMs and outlines some current strategies and controversies with ADM use.
January 2018: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/29075821/mastopexy-on-reconstructed-breast-following-massive-weight-loss-an-innovative-technique-using-dermo-capsular-flaps
#5
A Cogliandro, M Barone, G Cassotta, R Salzillo, P Persichetti
BACKGROUND: We have developed a dermo-capsular flap mastopexy technique for patients who have experienced massive weight loss after breast reconstruction. The aim of this technique is to lift the inframammary fold, adequately cover the implant, and remove excess skin, elevating the breast and obtaining symmetry with the contralateral breast. METHODS: Between January 2014 and February 2017, we performed this technique on 20 women who were candidates for second-stage breast reconstruction following nipple-sparing mastectomy...
October 26, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29064921/nipple-sparing-mastectomy-and-direct-to-implant-breast-reconstruction
#6
REVIEW
Amy S Colwell, Joani M Christensen
Breast reconstruction following mastectomy has evolved to preserve the native skin and nipple of the breast and create a natural-appearing reconstruction in 1 or 2 surgeries. Nipple-sparing procedures appear to be oncologically safe with low risks of cancer recurrence. In our series of 2,182 nipple-sparing mastectomies, there was no development or recurrence of cancer in the nipple. Direct-to-implant single-stage surgery offers the patient a complete reconstruction at the time of mastectomy. Patient selection centers on preoperative breast anatomy combined with postoperative goals for size and uplift of the breast...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29064920/what-s-new-in-acellular-dermal-matrix-and-soft-tissue-support-for-prosthetic-breast-reconstruction
#7
REVIEW
John Y S Kim, Alexei S Mlodinow
Of the nearly 90,000 implant-based breast reconstructions performed in the United States, the majority use internal soft-tissue support. Aesthetically, these constructs may allow for better positioning of prosthesis, improve lower pole expansion, and increase projection. They may have particular utility in direct-to-implant, nipple-sparing mastectomies, and prepectoral reconstructions. In recent years, new permutations of acellular dermal matrices have evolved with diverse shapes, sizes, form-factor innovations, and processing characteristics...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29062631/immediate-nipple-areolar-complex-reconstruction-for-patients-undergoing-implant-based-reconstruction-or-therapeutic-mammoplasty
#8
Lyndsey R Highton, John A Murphy
BACKGROUND: We report a technique of immediate nipple-areolar complex (NAC) reconstruction for patients undergoing skin-sparing mastectomy and implant-based breast reconstruction or therapeutic mammoplasty with central excision. METHODS: Immediate nipple reconstruction is performed using a modified C-V flap planned along the edge of the incision. The areola is reconstructed using a full-thickness skin graft taken from skin usually discarded during the procedure...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29037204/thoracodorsal-artery-perforator-flap-as-an-autologous-alternative-to-acellular-dermal-matrix
#9
Tarek Hashem, Ahmed Farahat
BACKGROUND: Thoracodorsal artery perforator (TDAP) flap is one of the relatively new techniques in breast reconstruction. This pedicled flap retains the benefits of perforator flaps as regards minimal donor site morbidity without the need for microvascular anastomosis. Its role in partial breast reconstruction has been well documented. However, there are few reports about the role of this flap in total breast reconstruction. METHODS: This study included 47 cases who presented to the breast unit of the National Cancer Institute of Cairo University from 2013 to 2015...
October 16, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29030030/oncological-safety-of-nipple-sparing-prophylactic-mastectomy-a-review-of-the-literature-on-3716-cases
#10
T Muller, A Baratte, C Bruant-Rodier, F Bodin, C Mathelin
INTRODUCTION: The objective of our study was to evaluate the risk of cancer after prophylactic nipple-sparing mastectomy (PNSM). MATERIAL AND METHODS: The PubMed database was consulted using the following key-words: "nipple-sparing mastectomy", "prophylactic", "locoregional recurrence", "oncological risk". Articles published between January 1995 and December 2016 were searched. RESULTS: Out of the 270 articles found, 19 were included. Overall, 15 studies were retrospective, 2 prospective, 2 prospective and retrospective and 3 were multicentric...
October 10, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28973707/expanding-eligibility-criteria-for-nipple-sparing-mastectomy
#11
Sonia T Orcutt, Cristina O'Donoghue, Paul Smith, Christine Laronga
The use of mastectomy has increased in patients who are high-risk genetic carriers who need or desire mastectomy for prophylactic reasons, as well as for patients who have breast cancer and need or desire mastectomy for treatment of their cancer. Retaining the nipple and skin with a nipple-sparing mastectomy results in improved patient satisfaction as compared with traditional mastectomy, without compromise of oncologic principles. This technique has been performed in patients with small, peripherally located tumors and nonptotic breasts; in recent years, however, consideration has been given to patients with more centrally located, larger tumors, and patients undergoing radiation or with ptotic breasts with the potential for poor cosmetic outcome...
October 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28885214/breast-sensitivity-after-mastectomy-and-autologous-reconstruction
#12
Norbert Heine, Christoph Koch, Vanessa Brebant, Andreas Kehrer, Alexandra Anker, Lukas Prantl
BACKGROUND: Breast Carcinoma is the most common malign tumor disease in women. 20-30% of these tumors have to be treated by removing all of the breast tissue. After that kind of therapeutic procedure, most of the women are severely traumatized and ask for reconstruction. The goldstandard of breast reconstruction is the free perforator flap from the lower abdomen (DIEAP-flap), which can provide body-own tissue and natural shape for the reconstructed breast.Many studies evaluate the shape of the reconstructed breast but neglect the skin sensitivity...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28876554/surgical-anatomy-of-reduction-mammaplasty-a-historical-perspective-and-current-concepts
#13
A O Wamalwa, T Stasch, F W Nangole, S O Khainga
Reduction mammaplasty is the volumetric reduction in the bulk of the breast. Techniques have evolved from primarily reducing the breast bulk to reducing with emphasis on functional and aesthetic outcome. The deeper understanding of the surgical anatomy of the breast has guided this development. While Paulus Aegina (sixth century AD), Dieffenbach (1848) and Gaillard-Thomas (1882) set the pace in glandular reduction; Pousson (1897) and Dehner (1908) focused on breast ptosis. It took quite some time before the enigma of the vascularization to the nipple areolar complex could be solved...
March 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28862111/how-can-we-improve-education-of-breast-surgeons-across-europe
#14
Agnieszka Kolacinska
The proposed global curriculum developed by the American Society of Surgical Oncology (SSO) and the European Society of Surgical Oncology (ESSO) and the textbook: provides a state-of- the- art of breast cancer surgery, complements the syllabus and curriculum of the Union Europeenne des Medecins Specialistes (UEMS) examination in breast surgery/ European Board of Surgery Qualification in Breast Surgery (EBSQinBS) administered by ESSO (1) Knowledge and understanding of the principles of breast cancer incidence, aetiology, risk factors, genetics, premalignant and high-risk lesions, pathology, prognostic and predictive factors, risk prediction models, screening, diagnosis and imaging, breast cancer, oncoplastic, reconstructive breast surgery, axillary surgery and future perspective for this, radiation therapy, neoadjuvant and adjuvant systemic treatment- endocrine-, immuno- and chemotherapy, side effects and toxicities of treatment, locoregional recurrence, follow-up, locally advanced breast cancer, metastatic breast cancer, breast cancer in young and elderly patients, survivor issues, lymphedema, palliative care, chroni pain, body image and sexuality, fertility issues, cognitive functions, etc...
July 2017: Chirurgia
https://www.readbyqxmd.com/read/28841601/prophylactic-nipple-sparing-mastectomy-and-direct-to-implant-reconstruction-of-the-large-and-ptotic-breast-is-preshaping-of-the-challenging-breast-a-key-to-success
#15
Gudjon L Gunnarsson, Camilla Bille, Laurens C Reitsma, Peter Wamberg, Jørn Bo Thomsen
BACKGROUND: Nipple-sparing mastectomy with simultaneous hammock technique direct-to-implant reconstruction is increasingly offered to patients opting for risk-reducing mastectomy. Despite this promising method, patients with macromastia and ptotic breasts remain a challenging group to treat satisfactorily and more often end up undergoing a difficult corrective procedure and experience an unacceptably high rate of failed reconstruction. The authors examined whether targeted preshaping mastopexy/reduction could prepare these patients for a successful nipple-sparing mastectomy/direct-to-implant reconstruction...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28831365/comparative-study-of-prepectoral-and-subpectoral-expander-based-breast-reconstruction-and-clavien-iiib-score-outcomes
#16
Lynne N Bettinger, Linda M Waters, Stephen W Reese, Susan E Kutner, Daniel I Jacobs
Prepectoral breast reconstruction is increasingly popular. This study compares complications between 2 subpectoral and 1 prepectoral breast reconstruction technique. METHODS: Between 2008 and 2015, 294 two-staged expander breast reconstructions in 213 patients were performed with 1 of 3 surgical techniques: (1) Prepectoral, (2) subpectoral with acellular dermal matrix (ADM) sling ("Classic"), or (3) subpectoral/subserratus expander placement without ADM ("No ADM"). Demographics, comorbidities, radiation therapy, and chemotherapy were assessed for correlation with Clavien IIIb score outcomes...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28831361/reelevating-the-mastectomy-flap-a-safe-technique-for-improving-nipple-areolar-complex-malposition-after-nipple-sparing-mastectomy
#17
Shuhao Zhang, Nadia P Blanchet
Nipple-areolar complex (NAC) malposition is one of the most common complications following nipple-sparing mastectomy with implant-based reconstruction. To maximize perfusion to the NAC, traditional methods of correcting NAC malposition limit undermining below the NAC. We demonstrate a series of cases in which improvement of NAC malposition was safely performed by reelevating the NAC and mastectomy flap to allow redraping of the soft tissue envelope over the implant and the overlying capsule. Thirty-four patients were identified in a span over 4 years where 44 NACs were repositioned using this method...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28692558/robotic-nipple-sparing-mastectomy-and-immediate-breast-reconstruction-with-implant-first-report-of-surgical-technique
#18
Antonio Toesca, Nickolas Peradze, Viviana Galimberti, Andrea Manconi, Mattia Intra, Oreste Gentilini, Daniele Sances, Debora Negri, Giulia Veronesi, Mario Rietjens, Stefano Zurrida, Alberto Luini, Umberto Veronesi, Paolo Veronesi
No abstract text is available yet for this article.
August 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28684896/a-technique-of-endoscopic-nipple-sparing-mastectomy-for-breast-cancer
#19
Yu Wang, Ji-Xiang Wu, Shan Guan
BACKGROUND AND OBJECTIVES: Nipple-sparing mastectomy (NSM) is a widely accepted surgical technique for patients with early breast cancer. The technique improves cosmetic outcomes, but a decrease in nipple sensitivity has been observed with NSM because of the incision into the nipple-areola complex (NAC). Endoscopic nipple-sparing mastectomy with skin lifting system (ENSMSLS) removes all breast tissue through the axillary incision used for the sentinel lymph node biopsy, to avoid incision around the NAC area...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28607860/spy-elite-s-ability-to-predict-nipple-necrosis-in-nipple-sparing-mastectomy-and-immediate-tissue-expander-reconstruction
#20
Mark L Venturi, Ali N Mesbahi, Libby R Copeland-Halperin, Victoria Y Suh, Louisa Yemc
BACKGROUND: Nipple-sparing techniques have improved the aesthetics of reconstruction following mastectomy, but nipple necrosis complicates up to 37% of procedures, distressing patients, delaying adjuvant therapy, and compromising outcomes. No method reliably detects nipple necrosis better than clinical assessment of tissue perfusion. We prospectively assessed the accuracy of intraoperative indocyanine green laser angiography to predict nipple necrosis. METHODS: Twenty consecutive women undergoing immediate tissue expander breast reconstruction following 32 nipple-sparing mastectomies underwent indocyanine green fluorescence imaging to assess nipple perfusion immediately before and after intraoperative tissue expansion...
May 2017: Plastic and Reconstructive Surgery. Global Open
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