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Nipple reconstruction

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https://www.readbyqxmd.com/read/28894930/oncological-safety-and-technical-feasibility-of-nipple-sparing-mastectomy-for-breast-cancer-the-hong-kong-experience
#1
Yolanda Ho-Yan Chan, Wai-Ming Yau, Polly Suk-Yee Cheung
BACKGROUND: Nipple-sparing mastectomy (NSM) has gained widespread popularity in recent years. Nonetheless, patient selection, technical consideration and oncological safety of its extension to breast cancer treatment remain uncertain. Few publications have reviewed the application of NSM in Asian populations. METHODS: We retrospectively reviewed 91 women with malignant breast tumours, who underwent 97 NSM in Hong Kong Sanatorium and Hospital from 2009 to 2015. Breast cancer patients who required mastectomy and opted for immediate reconstruction were considered for NSM if they showed no obvious nipple involvement clinically...
September 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28894666/optimizing-aesthetic-outcomes-in-delayed-breast-reconstruction
#2
Wojciech Dec
BACKGROUND: The need to restore both the missing breast volume and breast surface area makes achieving excellent aesthetic outcomes in delayed breast reconstruction especially challenging. Autologous breast reconstruction can be used to achieve both goals. The aim of this study was to identify surgical maneuvers that can optimize aesthetic outcomes in delayed breast reconstruction. METHODS: This is a retrospective review of operative and clinical records of all patients who underwent unilateral or bilateral delayed breast reconstruction with autologous tissue between April 2014 and January 2017...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28894660/mastectomy-flap-thickness-and-complications-in-nipple-sparing-mastectomy-objective-evaluation-using-magnetic-resonance-imaging
#3
Jordan D Frey, Ara A Salibian, Mihye Choi, Nolan S Karp
BACKGROUND: Ischemic complications after nipple-sparing mastectomy (NSM) have been associated with numerous variables. However, the impact of NSM flap thickness has been incompletely evaluated. METHODS: NSM flap thickness was determined for all NSMs from 2006 to 2016 with available pre- or postoperative breast magnetic resonance imaging (MRIs). Demographics and outcomes were stratified by those with and without ischemic complications. RESULTS: Of 1,037 NSM reconstructions, 420 NSMs had MRI data available, which included 379 preoperative MRIs and 60 postoperative MRIs...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28892228/immediate-nipple-reconstruction-in-combination-with-implant-reconstruction-using-dermal-sling
#4
George Filobbos, Nathan Hamnett, Joseph Hardwicke, Joanna Skillman
The inferior de-epithelialized dermal flap with implant is increasingly used for immediate breast reconstruction. We have adapted the technique to provide concurrent immediate nipple reconstruction by recruiting the triangle of skin above the excised nipple as a modified C-V flap. The safety and efficacy of this technique has been assessed in 15 patients, of which eight were bilateral and seven were unilateral cases. We suggest that this is a safe, reliable, and original technique for immediate nipple reconstruction in patients undergoing immediate breast reconstruction with an inferior dermal sling and implant...
September 11, 2017: Breast Journal
https://www.readbyqxmd.com/read/28885214/breast-sensitivity-after-mastectomy-and-autologous-reconstruction
#5
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/28871582/pyoderma-gangrenosum-after-breast-mastectomy-and-primary-rectus-abdominis-flap-reconstruction
#6
Yasuhiro Suzuki, Kozue Yokoyama, Mayako Terao, Toru Morioka, Banri Tsuda, Naoki Niikura, Takuho Okamura, Eri Yamada, Kotaro Imagawa, Tadashi Akamatsu, Yutaka Tokuda, Nobue Kumaki
Pyoderma gangrenosum is an intractable disease of unknown cause involving recurrent ulcerative lesions on the skin, and may accompany ulcerative colitis, rheumatoid arthritis, leukemia, systemic lupus erythematosus, and other conditions. Here, we report a rare case of pyoderma gangrenosum in the thoracic abdomen following post-mastectomy reconstructive surgery. A 39-year-old presented at the hospital with a complaint of left papilla erosion. Skin biopsy at the site revealed invasive skin cancer, with Paget-like progression in the cancerous nipple and suspected malignancy of skin appendages...
September 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28870056/-application-of-autologous-fat-grafting-in-breast-reconstruction
#7
L Cai, X F Han, B Q Wang, F C Li
Objective: To observe the outcome of breast reconstruction with autologous fat grafting in the patients following treatment for breast cancer. Methods: The clinical data of 22 patients after breast cancer modified radical mastectomy with fat grafting for breast reconstruction from January 2012 to March 2015 at Department of Body Contouring and Liposuction Center of Plastic Surgery, Hospital of Peking Union Medical College were analyzed retrospectively. The age of 22 patients (all female) was 28 to 54 years...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28862111/how-can-we-improve-education-of-breast-surgeons-across-europe
#8
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/28861381/use-of-acellular-dermal-matrix-adm-in-nipple-reconstruction-the-central-pillar-technique
#9
Russell J Bramhall, Paul T R Thiruchelvam, Mae Concepcion, Gerald P Gui
Nipple reconstructions are prone to a variable and unpredictable degree of flattening, which in some cases lead to secondary reconstruction. The use of an acellular dermal matrix (ADM) augmentation may be appropriate in cases with very thin dermis that are particularly prone to flattening or in revision cases where the first procedure has already failed. The authors present a series of 13 nipple reconstructions in ten cases. Average projection at 12 months was 51% in primary cases and 46% in secondary revision cases...
August 2017: Gland Surgery
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
#10
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/28841598/discussion-prepectoral-breast-reconstruction-a-safe-alternative-to-submuscular-prosthetic-reconstruction-following-nipple-sparing-mastectomy
#11
Allen Gabriel, G Patrick Maxwell
No abstract text is available yet for this article.
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
#12
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
#13
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/28792427/the-psychosexual-impact-of-postmastectomy-breast-reconstruction
#14
Alexandra M Hart, Ximena Pinell-White, Albert Losken
BACKGROUND: The surgical management of breast cancer with mastectomy and breast reconstruction (BR) has been shown to increase the quality of life of cancer survivors. Yet the impact of surgery on sexuality, femininity, and condition of intimate relationships as a measure for sexual health has not been fully evaluated. METHODS: Ninety-six women who underwent mastectomy and immediate BR participated in the series. Surveys assessed patients' level of sexual health in the areas of femininity, sexual confidence during intimate relationships, and the role of breast sensibility in sexual satisfaction as compared with how they felt preoperatively...
November 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28758551/retention-of-a-reconstructed-nipple-using-a-c-v-flap-with-different-layer-thicknesses-in-the-c-flap
#15
Yoshihiro Sowa, Sizu Itsukage, Kouichi Sakaguchi, Tetsuya Taguchi, Toshiaki Numajiri
BACKGROUND: The C-V flap for nipple reconstruction is now one of standard surgical techniques. But decreased projection is still a problem. In recent years, it has been suggested that projection can be more easily maintained when raising of the C-flap is performed with a split thickness dermis. In this study, we examined whether decrease of projection can be prevented by raising of a C-flap with a split dermis rather than with full dermis. METHODS: A total of 49 consecutive patients who underwent reconstruction of a nipple using the C-V flap technique were enrolled...
July 30, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28758229/time-dependent-factors-in-diep-flap-breast-reconstruction
#16
Rosaria Laporta, Benedetto Longo, Michail Sorotos, Alessio Farcomeni, Vittoria Amorosi, Fabio Santanelli di Pompeo
BACKGROUND: The process of harvesting and performing microsurgical anastomosis may lengthen deep inferior epigastric artery perforator (DIEP) flap breast reconstruction affecting results and patient safety. The aim of the study was to investigate the associations between predictors and operative time (OT). METHODS: Between 2004 and 2016, 336 immediate and 68 delayed unilateral reconstructions were performed in 404 patients. Age, weight, height, body mass index (BMI), nulliparity, or pluriparity condition were collected to determine the impact of patient characteristics on OT...
July 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28746266/quality-of-life-outcomes-improve-with-nipple-sparing-mastectomy-and-breast-reconstruction
#17
Christopher R Bailey, Onyebuchi Ogbuagu, Pablo A Baltodano, Usamah F Simjee, Michele A Manahan, Damon S Cooney, Lisa K Jacobs, Theodore N Tsangaris, Carisa M Cooney, Gedge D Rosson
BACKGROUND: Loss of the nipple-areola complex can be psychologically and sexually devastating. Nipple-sparing mastectomy provides robust cosmetic results, but few studies have investigated the quality-of-life outcomes associated with it. METHODS: The authors performed an institutional review board-approved retrospective study of 32 patients who underwent nipple-sparing mastectomy with implant-based or autologous reconstruction and 32 control patients who underwent non-nipple-sparing mastectomy with reconstruction matched by reconstruction type and operative period...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28740796/goldilocks-mastectomy-a-safe-bridge-to-implant-based-breast-reconstruction-in-the-morbidly-obese
#18
Jean-Claude Schwartz
BACKGROUND: Reconstructive surgeons are encountering an increasing number of obese women requiring postmastectomy reconstruction. These patients are poor candidates for autologous and prosthetic-based reconstructions as they have a high rate of reconstructive failure, surgical complications, and poor aesthetic outcomes. We demonstrate here the utility of the previously described Goldilocks mastectomy with free nipple grafts as a safe bridge to second stage implant-based breast reconstruction...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740781/direct-to-implant-reconstruction-in-nipple-sparing-mastectomy-patient-selection-by-preoperative-digital-mammogram
#19
Alberto O Rancati, Claudio H Angrigiani, Dennis C Hammond, Maurizio B Nava, Eduardo G Gonzalez, Julio C Dorr, Gustavo F Gercovich, Nicola Rocco, Roman L Rostagno
BACKGROUND: Digital mammography clearly distinguishes gland tissue density from the overlying nonglandular breast tissue coverage, which corresponds to the existing tissue between the skin and the superficial layer of the fascia superficialis surrounding the gland (i.e., dermis and subcutaneous fat). Preoperative digital imaging can determine the thickness of this breast tissue coverage, thus facilitating planning and reducing the rate of necrotic complications after direct to implant (DTI) reconstruction in nipple sparing mastectomy (NSM)...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28725962/optimal-positioning-of-the-nipple-areola-complex-in-men-using-the-mohrenheim-estimated-tangential-tracking-line-mett-line-an-intuitive-approach
#20
Tobias R Mett, Nicco Krezdorn, Rosalia Luketina, Maria K Boyce, Helga Henseler, Ramin Ipaktchi, Peter M Vogt
INTRODUCTION: The reconstruction of the body shape after post-bariatric surgery or high-grade gynecomastia involves, besides skin tightening, the repositioning of anatomical, apparent landmarks. The surgeon usually defines these during the preoperative planning. In particular, the positions of the nipple-areola complexes (NAC) should contribute to the gender-appropriate appearance. While in the female breast numerous methods have been developed to determine the optimal position of the NACs, there are only a few, metric and often impractical algorithms for positioning the nipples and areoles in the male...
July 19, 2017: Aesthetic Plastic Surgery
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