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Nipple reconstruction

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https://www.readbyqxmd.com/read/29781241/timing-of-radiation-therapy-in-nipple-sparing-mastectomy-influences-outcomes-and-patient-reported-quality-of-life
#1
Michael Sosin, Aiste Gulla, Lindsay Potdevin, Solange E Cox, Alex J Bartholomew, Sulakshana Seevaratnam, Manisha Sigdel, Troy A Pittman, Shawna C Willey, Eleni A Tousimis
The aim of this study is to assess the complication profile and impact on patient-reported quality of life in those undergoing nipple-sparing mastectomy (NSM) with immediate breast reconstruction and subsequent prosthetic reconstruction in patients with prior breast radiation therapy (pRT) vs those receiving adjuvant post-mastectomy radiation therapy (PMRT). An IRB-approved, retrospective analysis was performed from 2002 to 2014 to identify NSM patients that underwent pRT or PMRT. A 22-item Likert scale questionnaire was administered by a third party to register patient-reported quality of life...
May 20, 2018: Breast Journal
https://www.readbyqxmd.com/read/29746276/deepithelialized-skin-reduction-preserves-skin-and-nipple-perfusion-in-immediate-reconstruction-of-large-and-ptotic-breasts
#2
Danielle H Rochlin, Dung H Nguyen
BACKGROUND: Women with large and/or ptotic breasts are often not considered candidates for nipple-sparing mastectomy (NSM) and/or immediate breast reconstruction given difficulties avoiding ischemic complications and achieving a favorable aesthetic result. We report a novel technique involving deepithelialized skin reduction to simultaneously reduce the skin envelope and preserve perfusion to the skin and nipple in immediate breast reconstruction for women that fit this high-risk anatomic profile...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29736675/influence-of-flap-thickness-on-nipple-projection-after-nipple-reconstruction-using-a-modified-star-flap
#3
Naohiro Ishii, Jiro Ando, Michiko Harao, Masaru Takemae, Kazuo Kishi
BACKGROUND: In nipple reconstruction, the width, length, and thickness of modified star flaps are concerns for long-term reconstructed nipple projection. However, the flap's projection has not been analyzed, based on its thickness. The aim of the present study was to investigate how flap thickness in a modified star flap influences the resulting reconstructed nipple and achieves an appropriate flap width in design. METHODS: Sixty-three patients who underwent nipple reconstruction using a modified star flap following implant-based breast reconstruction between August 2014 and July 2016 were included in this case-controlled study...
May 7, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29725545/single-stage-nipple-sparing-mastectomy-and-reduction-mastopexy-in-the-ptotic-breast
#4
M E Pontell, N Saad, A Brown, M Rose, R Ashinoff, A Saad
Purpose: Given the proposed increased risk of nipple-areolar complex (NAC) necrosis, nipple-sparing mastectomy (NSM) is generally not recommended for patients with large or significantly ptotic breasts. NAC preserving strategies in this subgroup include staged or simultaneous NSM and reduction mastopexy. We present a novel approach towards simultaneous NSM and reduction mastopexy in patients with large, ptotic breasts. Methods: Literature pertaining to NSM for women with large, ptotic breasts was reviewed and a surgical approach was designed to allow for simultaneous NSM and reduction mastopexy in such patients...
2018: Plastic Surgery International
https://www.readbyqxmd.com/read/29718895/long-term-outcomes-of-patients-with-breast-cancer-after-nipple-sparing-mastectomy-skin-sparing-mastectomy-followed-by-immediate-transverse-rectus-abdominis-musculocutaneous-flap-reconstruction-comparison-with-conventional-mastectomy-in-a-single-center-study
#5
Sae Byul Lee, Jong Won Lee, Hee Jeong Kim, Beom Seok Ko, Byung Ho Son, Jin Sup Eom, Taik Jong Lee, Sei-Hyun Ahn
To evaluate the oncological outcomes of patients with breast cancer after nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM), followed by immediate reconstruction, as compared to conventional mastectomy (CM).SSM/NSM has been increasingly used to treat women with breast cancer who wish to preserve the overlying breast skin, but concern exist regarding its oncological safety due to the potential for residual breast tissue. We report our experience performing SSM/NSM for breast cancer treatment compared to CM with a long follow-up period...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29689765/characterization-of-ct-hounsfield-units-for-3d-acquisition-trajectories-on-a-dedicated-breast-ct-system
#6
Jainil P Shah, Steve D Mann, Randolph L McKinley, Martin P Tornai
Hounsfield Units (HU) are used clinically in differentiating tissue types in a reconstructed CT image, and therefore the HU accuracy of a system is important, especially when using multiple sources, novel detector and non-traditional trajectories. Dedicated clinical breast CT (BCT) systems therefore should be similarly evaluated. In this study, uniform cylindrical phantoms filled with various uniform density fluids were used to characterize differences in HU values between simple circular and complex 3D (saddle) orbits...
April 18, 2018: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/29684956/-clinical-utility-of-upper-urinary-tract-reconstruction-by-ileal-ureter-substitution
#7
Yoshinaga Okumura, Shusuke Akamatsu, Yoshiyuki Okada, Hiromitsu Negoro, Takashi Kobayashi, Naoki Terada, Toshinari Yamasaki, Yoshiyuki Matsui, Takahiro Inoue, Tomomi Kamba, Osamu Ogawa
We retrospectively reviewed the indications and outcomes of ileal-ureter substitution cases for complex ureteral reconstruction. We analyzed the patient clinical characteristics, outcomes, and complications of eight patients who had ileal ureter substitution surgery at Kyoto University Hospital between 2009 and 2016. The median patient age was 55.5 years (36-79), and the median follow up period was 25.5 months (7-85). Seven patients had unilateral ureteral obstruction (right:left=4:3), and one had bilateral ureteral obstruction...
March 2018: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/29671730/what-should-be-the-role-of-plastic-surgeons-in-nonanatomic-breast-reconstruction-including-tattooing
#8
Jeffrey H Kozlow
The goal of plastic surgeons performing postmastectomy anatomic reconstruction is to create a breast structure that closely matches the shape and appearance of a patient's native breast. Tattoo artists have helped improve outcomes with nipple-areolar tattooing. Some patients now prefer to have more extensive, nonanatomic designs to help camouflage their scars. Two questions are considered here: What role should plastic surgeons have in supporting or performing nonanatomic reconstruction? And should insurance programs cover nonanatomic breast reconstruction options?...
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29665804/immediate-implant-replacement-with-diep-flap-a-single-stage-salvage-option-in-failed-implant-based-breast-reconstruction
#9
Miguel De La Parra Marquez, Ricardo Fernandez-Riera, Hector Vela Cardona, Jesus María Rangel Flores
BACKGROUND: Implant-based immediate breast reconstruction after skin-sparing mastectomy has shown a significant improvement in patients' quality of life, making the procedure steadily more popular year after year. However, this technique has a high morbidity rate, including skin necrosis and implant exposure. METHODS: A retrospective review of a prospectively held database for autologous breast reconstruction in our institution of the last 5 years found eight cases with exposed implants after nipple-sparing mastectomy and immediate reconstruction...
April 17, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29664829/nipple-sparing-mastectomy-and-immediate-breast-reconstruction-with-a-deep-inferior-epigastric-perforator-flap-a-study-of-patient-satisfaction
#10
Jerry Levy, Romain Bosc, Noel Warren, Sabban Rebecca, Thu Ha Dao, Barbara Hersant, Jean-Paul Meningaud
INTRODUCTION: The morphological result of nipple-areola complex (NAC) reconstruction may be disappointing for patients who undergo skin-sparing mastectomies and immediate breast reconstruction, followed by secondary reconstruction of the nipple-areola complex.The aim of this study was to analyze patient satisfaction after nipple-sparing mastectomy and immediate breast reconstruction with a deep inferior epigastric perforator flap. MATERIALS AND METHODS: Our retrospective study involved all patients who underwent an immediate breast reconstruction after unilateral mastectomy with conservation of the NAC...
April 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29659449/evolution-in-monitoring-of-free-flap-autologous-breast-reconstruction-after-nipple-sparing-mastectomy-is-there-a-best-way
#11
Jordan D Frey, John T Stranix, Michael V Chiodo, Michael Alperovich, Christina Y Ahn, Robert J Allen, Mihye Choi, Nolan S Karp, Jamie P Levine
BACKGROUND: Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy remains controversial. The authors therefore examined outcomes in nipple-sparing mastectomy with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. METHODS: Autologous free flap reconstructions with nipple-sparing mastectomy performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29623151/nipple-areolar-complex-reconstruction-a-review-of-the-literature-and-introduction-of-the-rectangle-to-cube-nipple-flap
#12
Joshua T Henderson, Thomas J Lee, Andrew M Swiergosz, Andrea R Hiller, Joshua Choo, Bradon J Wilhelmi
Objective : There are many approaches to nipple-areola complex reconstruction. Tissue quality and thickness, desired nipple location and size, scar position, and surgeon preference all play a role in selecting a technique. We present the rectangle-to-cube nipple flap, a new technique for challenging nipple reconstruction. A review of published techniques is compared and contrasted with this flap design. Methods : Following bilateral total skin-sparing mastectomies, a patient with breast cancer underwent breast reconstruction with tissue expanders and subsequent nipple reconstruction with the rectangle-to-cube nipple flap...
2018: Eplasty
https://www.readbyqxmd.com/read/29619356/delivering-breast-reconstruction-information-to-patients-women-report-on-preferred-information-delivery-styles-and-options
#13
Carmen Webb, Vishal Sharma, Claire Temple-Oberle
Purpose: To discover missed opportunities for providing information to women undergoing breast reconstruction in an effort to decrease regret and improve patient education, teaching modalities, and satisfaction. Method: Thirty- to 45-minute semi-structured interviews were conducted exploring patient experiences with information provision on breast reconstruction. Purposeful sampling was used to include women with a variety of reconstruction types at different time points along their recovery...
February 2018: Plastic Surgery
https://www.readbyqxmd.com/read/29619355/comparison-of-outcomes-in-immediate-implant-based-breast-reconstruction-versus-mastectomy-alone
#14
Janelle Sousa, Ravi Sood, Daniel Liu, Kristine Calhoun, Otway Louie, Peter Neligan, Hakim Said, David Mathes
Objectives: Immediate implant-based techniques are common practice in post-mastectomy breast reconstruction. Previous studies have shown an increased complication rate in the setting of immediate versus delayed, MD reconstruction. We aimed to quantify any additional risk in complications when implant-based immediate breast reconstruction (IBR) is performed versus mastectomy alone. Materials and Methods: We retrospectively reviewed all IBR cases and all mastectomies without reconstruction from 2007 to 2011...
February 2018: Plastic Surgery
https://www.readbyqxmd.com/read/29616178/scarless-breast-reconstruction-indications-and-techniques-for-optimizing-aesthetic-outcomes-in-autologous-breast-reconstruction
#15
Wojciech Dec
Breast reconstruction that leaves no visible scars on the breast is possible for a subset of patients. This article reviews a cohort of 10 patients who underwent 14 autologous breast reconstructions. To achieve a reconstruction without visible breast scars, the mastectomy and autologous reconstruction are carried out through a periareolar incision. At the completion of the reconstruction, a small skin paddle is externalized through the mastectomy incision and in a subsequent stage entirely incorporated into a nipple areola reconstruction...
February 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29608972/alternative-methodological-approach-to-randomized-trial-for-surgical-procedures-routinely-used
#16
T Filleron, A Lusque, F Dalenc, G Ferron, H Roche, A Martinez, E Jouve
BACKGROUND: In medical oncology, changes in practices are almost always based on randomized trials but medical history shows that it is different in surgical oncology. In the past, many surgical procedures were routinely performed without a rigorous evaluation of the risk-benefit. To highlight the complexity of developing randomized surgical trials, disquisitions on methodology presented in the medical literature. This is particularly true when we consider breast reconstruction after surgical treatment for breast cancer...
March 30, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29596196/reply-how-to-preshape-the-breast-for-a-successful-nipple-sparing-mastectomy-and-direct-to-implant-breast-reconstruction-in-the-challenging-breast
#17
Gudjon L Gunnarsson, Jorn Bo Thomsen
No abstract text is available yet for this article.
April 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29596195/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
#18
Shangshan Li, Jie Luan
No abstract text is available yet for this article.
April 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29579033/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-reply-to-dr-bonomi
#19
Gudjon L Gunnarsson, Jorn Bo Thomsen
No abstract text is available yet for this article.
March 20, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29579029/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
#20
Stefano Bonomi, Laura Sala, Umberto Cortinovis
No abstract text is available yet for this article.
March 20, 2018: Plastic and Reconstructive Surgery
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