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https://www.readbyqxmd.com/read/28766199/a-patient-specific-3d-printed-form-accurately-transfers-supine-mri-derived-tumor-localization-information-to-guide-breast-conserving-surgery
#1
Richard J Barth, Venkataramanan Krishnaswamy, Keith D Paulsen, Timothy B Rooney, Wendy A Wells, Elizabeth Rizzo, Christina V Angeles, Jonathan D Marotti, Rebecca A Zuurbier, Candice C Black
BACKGROUND: Wire-localized excision of nonpalpable breast cancer is imprecise, resulting in positive margins 25-30% of the time. METHODS: Patients underwent preoperative supine magnetic resonance imaging (MRI). A radiologist outlined the tumor edges on consecutive images, creating a three-dimensional (3D) view of its location. Using 3D printing, a bra-like plastic form (the Breast Cancer Locator [BCL]) was fabricated, with features that allowed a surgeon to (1) mark the edges of the tumor on the breast surface; (2) inject blue dye into the breast 1 cm from the tumor edges; and (3) place a wire in the tumor at the time of surgery...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28760257/a-historical-review-of-gender-affirming-medicine-focus-on-genital-reconstruction-surgery
#2
REVIEW
Jordan D Frey, Grace Poudrier, Jennifer E Thomson, Alexes Hazen
Gender dysphoria (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is characterized by a marked discrepancy between one's birth-assigned sex and one's gender identity and is sometimes addressed by gender-affirming surgery. As public visibility and institutional support for the transgender and gender non-conforming population continue to increase, the demand for competent multidisciplinary teams of medical professionals equipped to care for this population is expected to rise-including plastic surgeons, urologists, gynecologists, endocrinologists, and breast surgeons, among others...
August 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28746274/male-to-female-sex-reassignment-surgery-using-the-combined-technique-leads-to-increased-quality-of-life-in-a-prospective-study
#3
Nikolaos A Papadopulos, Dmitry Zavlin, Jean-Daniel Lellé, Peter Herschbach, Gerhard Henrich, Laszlo Kovacs, Benjamin Ehrenberger, Hans-Günther Machens, Jürgen Schaff
BACKGROUND: The authors' previous research showed that various plastic surgical procedures can increase a patient's quality of life in its different aspects. In a prospective setting, they evaluated whether sex reassignment surgery has similar effects for male-to-female transgender patients compared to baseline data before sex reassignment surgery. METHODS: All 39 patients who underwent their first-stage male-to-female sex reassignment surgery between October of 2012 and January of 2014 received one set of questionnaires preoperatively (time 0) and approximately 6 months after their final operation (time 1)...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28739500/breast-implant-capsule-associated-squamous-cell-carcinoma-a-report-of-two-cases
#4
Daniel L Olsen, Gary L Keeney, Beiyun Chen, Daniel W Visscher, Jodi M Carter
The use of prosthetic implants for breast augmentation has become commonplace. While implants do not increase the risk of conventional mammary carcinoma, they are rarely associated with anaplastic large cell lymphoma. We report two cases of breast implant capsule-associated squamous cell carcinoma with poor clinical outcomes. Both patients (56-year-old female and 81-year-old female) had long-standing implants (>25years) and presented with acute unilateral breast enlargement. In both cases, squamous cell carcinoma arose in (focally dysplastic) squamous epithelium-lined breast implant capsules, and widely invaded surrounding breast parenchyma or chest wall...
July 21, 2017: Human Pathology
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
#5
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
https://www.readbyqxmd.com/read/28713853/factors-associated-with-acute-postoperative-pain-following-breast-reconstruction
#6
Anita R Kulkarni, Andrea L Pusic, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Edwin G Wilkins, Randy S Roth
INTRODUCTION: Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS: Women (N = 2207; one-week 82...
March 2017: JPRAS Open
https://www.readbyqxmd.com/read/28705484/is-it-all-about-the-money-not-all-surgical-subspecialization-leads-to-higher-lifetime-revenue-when-compared-to-general-surgery
#7
Maria Baimas-George, Brian Fleischer, Douglas Slakey, Emad Kandil, James R Korndorffer, Christopher DuCoin
OBJECTIVE: It is believed that spending additional years gaining expertise in surgical subspecialization leads to higher lifetime revenue. Literature shows that more surgeons are pursuing fellowship training and dedicated research years; however, there are no data looking at the aggregate economic impact when training time is accounted for. It is hypothesized that there will be a discrepancy in lifetime income when delay to practice is considered. DESIGN: Data were collected from the Medical Group Management Association's 2015 report of average annual salaries...
July 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28678328/oncoplastic-breast-surgery-comprehensive-review
#8
N Bertozzi, M Pesce, P L Santi, E Raposio
Breast cancer is the most common female cancer in Western populations, affecting 12.5% of women, with 1.38 million patients per year. Breast-conserving surgery followed by postoperative radiotherapy replaced the radical and modified-radical procedures of Halsted and Patey as the standard of care for early-stage breast cancer once the overall and disease-free survival rates of breast-conserving surgery were demonstrated to be equivalent to those of mastectomy. However, excision of >20% of breast tissue, low or centrally located cancer, and large-sized breasts with various grades of breast ptosis, result a in unacceptable cosmetic outcomes...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28654612/evidence-based-medicine-breast-augmentation
#9
Michael R Schwartz
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Understand the key decisions in patient evaluation for cosmetic breast augmentation. 2. Cite key decisions in preoperative planning. 3. Discuss the risks and complications, and key patient education points in breast augmentation. SUMMARY: Breast augmentation remains one of the most popular procedures in plastic surgery. The integral information necessary for proper patient selection, preoperative assessment, and surgical approaches are discussed...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28654611/evidence-based-medicine-alloplastic-breast-reconstruction
#10
Peter A Lennox, Esta S Bovill, Sheina A Macadam
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand the different advances that have resulted in improved outcomes in implant-based reconstruction. 2. Gain knowledge about specific techniques that have evolved rapidly in recent years and how to implement these. 3. Gain an understanding of controversies associated with alloplastic reconstruction. 4. Recognize undesirable outcomes in implant-based breast reconstruction and understand strategies for correction...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28654582/predictors-classification-and-management-of-umbilical-complications-in-diep-flap-breast-reconstruction
#11
Min-Jeong Cho, Sumeet S Teotia, Nicholas T Haddock
BACKGROUND: In recent years, the deep inferior epigastric perforator (DIEP) flap has become the workhorse flap for autologous breast reconstruction. Despite increased reports on DIEP flaps, umbilical complications have not been previously studied. The aesthetics of the umbilicus dictates the beauty of the abdomen, and it is critical for plastic surgeons to minimize the scarring of the umbilicus. In this study, we retrospectively reviewed patients who underwent DIEP flaps to determine the predictors of umbilical complications, and created a classification system of these wounds...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28650403/the-classic-pitanguy-s-technique-and-its-modifications-in-mammaplasty-ten-years-of-experiences
#12
Harris Zavrides
BACKGROUND: Mammaplasty surgery has been modified in the past few years, as plastic surgeons worked to improve and maintain the breast shape and especially the "bottoming out" of the gland. The classic Pitanguy's technique has been shown to be an anatomically safe technique in the management of the breast. However, as first described, cannot be applied in gigantomastia or in severe breast ptosis cases or in cases of dense breast parenchyma or for a long-lasting breast lift result. Using 2 different modifications, the Pitanguy technique can be applied for breasts of all sizes and for all cases of breast ptosis...
June 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28648581/is-long-term-post-operative-monitoring-of-microsurgical-flaps-still-necessary
#13
Giovanni Zoccali, Alexandra Molina, Jian Farhadi
Autologous microsurgical flap reconstruction has become commonplace in most plastic surgery units, and the success rates of this procedure have markedly increased over recent years. However, the possibility of flap failure still needs to be considered. A review of the literature reveals that the critical period for flap-threatening complications is the first 24-48 post-operative hours; however, the window for the onset of these complications remains open for up to 7 days post-operatively. In this study, we focus on the timing of flap complications, aiming to elucidate the time period over which meticulous flap monitoring can positively contribute to flap salvage rates...
June 1, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28607282/laparoendoscopic-single-site-adnexal-surgery-preliminary-indian-experience
#14
Smitha Balusamy, Hrishikesh P Salgaonkar, Ramya Ranjan Behera, Ashwini Bhalerao-Gandhi, Deepraj S Bhandarkar
INTRODUCTION: Laparoendoscopic single-site surgery (LESS) is an emerging technique in gynaecology. The proposed advantages of the LESS include better cosmesis and reduction in pain. We report our preliminary experience with LESS in the treatment of adnexal pathology. MATERIALS AND METHODS: After a preoperative workup, LESS was offered to 37 patients between July 2009 and April 2015. All the procedures were carried out through a 2-2.5 cm transumbilical incision using conventional laparoscopic instruments...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28599156/mechanical-response-of-human-female-breast-skin-under-uniaxial-stretching
#15
N Kumaraswamy, Hamed Khatam, Gregory P Reece, Michelle C Fingeret, Mia K Markey, Krishnaswamy Ravi-Chandar
Skin is a complex material covering the entire surface of the human body. Studying the mechanical properties of skin to calibrate a constitutive model is of great importance to many applications such as plastic or cosmetic surgery and treatment of skin-based diseases like decubitus ulcers. The main objective of the present study was to identify and calibrate an appropriate material constitutive model for skin and establish certain universal properties that are independent of patient-specific variability. We performed uniaxial tests performed on breast skin specimens freshly harvested during mastectomy...
May 19, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28570456/significance-of-objective-structured-clinical-examinations-to-plastic-surgery-residency-training
#16
Brian J Simmons, Yasmina Zoghbi, Morad Askari, David J Birnbach, Ilya Shekhter, Seth R Thaller
INTRODUCTION: Objective structured clinical examinations (OSCEs) have proven to be a powerful tool. They possess more than a 30-year track record in assessing the competency of medical students, residents, and fellows. Objective structured clinical examinations have been used successfully in a variety of medical specialties, including surgery. They have recently found their way into the subspecialty of plastic surgery. METHODS: This article uses a systematic review of the available literature on OSCEs and their recent use in plastic surgery...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28570450/the-impact-of-physician-assistants-on-a-breast-reconstruction-practice-outcomes-and-cost-analysis
#17
Albert H Chao, Alexander Yaney, Roman J Skoracki, Patrick N Kearns
BACKGROUND: Physician assistants (PAs) are commonly employed in plastic surgery. However, limited data exist on their impact, which may guide decisions regarding how best to integrate them into practice. METHODS: A review of the practices of 2 breast reconstructive surgeons was performed. A comparison was made between a 1-year period before to a 1-year period after the addition of a PA into practice. The practice model was a one-to-one pairing of a plastic surgeon and a PA...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28550924/new-perspective-on-the-in%C3%A2-vivo-use-of-cold-stress-dynamic-thermography-in-integumental-reconstruction-with-the-use-of-skin-muscle-flaps
#18
Szymon Kolacz, Mateusz Moderhak, Jerzy Jankau
BACKGROUND: Among the problems encountered by plastic surgeons is the reconstruction of defects following tumors. One of the reconstructive options is trans rectus abdominis (TRAM) flap. Despite that anatomy is well explored, marginal flap necrosis may develop. To minimize the complications, imaging examinations were designed to determine the degree of flap perfusion. One of them is the thermographic examination. MATERIALS AND METHODS: We examined 38 patients who had undergone 10 reconstructive breast surgeries with a pedicled TRAM ipsilateral flap, 10 patients with a TRAM contralateral flap, and 18 patients with a TRAM supercharged flap...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28536929/inferior-pedicle-reduction-mammoplasty-with-or-without-tourniquet-a-comparative-study
#19
Canser Yilmaz Demir, Yılmaz Sultanoglu, Omer Faruk Kocak, Muhammet Eren Ersoz
OBJECTIVE: To compare the perioperative findings of inferior pedicle reduction mammoplasty (IPRM) performed with or without a tourniquet. METHODS: This study was carried out in the plastic and reconstructive surgery department at a tertiary care center on a total of 42 consecutive women scheduled for IPRM. Patients in Group I (n = 21) underwent surgery using a tourniquet, whereas patients in Group II (n = 21) were operated on without a tourniquet. Levels of hemoglobin (Hb), hematocrit (Hct), Hct/Hb ratio, and platelet counts were noted preoperatively and on postoperative 24th and 48th h...
May 23, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28514124/-partial-breast-reconstruction-by-modified-breast-reduction-techniques
#20
REVIEW
Dean D Ad-El, Sagit Meshulam Derazon, Eran Sharon, Asaf Olshinka
Partial resections of the breast are more than 50% of breast oncological surgery. The resulting defect can be substantial and cause meaningful deformity that leads to reduced body image satisfaction of the patients, affecting their ability to cope with the cancer. Parallel to the development of breast oncology techniques, an evolution of breast reconstruction techniques occurred. During the last decade, by using techniques from cosmetic breast surgery (such as breast reductions, augmentations and mastopexies), we can reconstruct extensive partial defects of the breasts at the immediate and delayed setting and achieve symmetrical aesthetic results...
July 2016: Harefuah
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