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Medical & Biological Engineering &... Mar 2016A multi-view three-dimensional stereophotogrammetry system was developed to capture 3D shape of breasts for breast cancer patients. The patients had received immediate...
A multi-view three-dimensional stereophotogrammetry system was developed to capture 3D shape of breasts for breast cancer patients. The patients had received immediate unilateral breast reconstruction after mastectomy by the extended latissimus dorsi flap and without contralateral surgery. In order to capture the whole breast shape including the inframammary fold, the patients were introduced to the imaging room and leaned over the imaging rig to open up the inframammary fold and to expose the entire area of each breast. The imaging system consisted of eight high-resolution ([Formula: see text] pixels) digital cameras and four flash units. The cameras were arranged in four stereo pairs from four different view angles to cover the whole surface of the breasts. The system calibration was carried out ahead of every capture session, and the stereo images were matched to generate four range images to be integrated using an elastic model proposed. A watertight breast mesh model was reconstructed to measure the volume of the breast captured. The accuracy of using the developed multi-view stereophotogrammetry system for breast volume measurement was 11.12cc with SEM 7.74cc, comparing to the measurements of the water displacement method. It was concluded that the 3D stereophotogrammetry image system developed was more reliable than the method of water displacement.
Topics: Artifacts; Calibration; Female; Humans; Imaging, Three-Dimensional; Mammaplasty; Mastectomy; Photogrammetry
PubMed: 26133282
DOI: 10.1007/s11517-015-1334-3 -
Journal of Plastic, Reconstructive &... Feb 2022Lipomodelling has become increasingly popular for reconstructive, aesthetic and therapeutic indications. The guidelines summarise available evidence for indications,... (Review)
Review
Lipomodelling has become increasingly popular for reconstructive, aesthetic and therapeutic indications. The guidelines summarise available evidence for indications, training, technique, audit and outcomes in lipomodelling and also highlight areas for further research.
Topics: Adipose Tissue; Breast Neoplasms; Female; Humans; Mammaplasty; Plastics; Surgery, Plastic; United Kingdom
PubMed: 34895855
DOI: 10.1016/j.bjps.2021.09.033 -
The impact of breast reduction surgery on breastfeeding: Systematic review of observational studies.PloS One 2017Almost half a million breast reduction surgeries are performed internationally each year, yet it is unclear how this type of surgery impacts breastfeeding. This is... (Review)
Review
BACKGROUND
Almost half a million breast reduction surgeries are performed internationally each year, yet it is unclear how this type of surgery impacts breastfeeding. This is particularly important given the benefits of breastfeeding.
OBJECTIVES
To determine if breast reduction surgery impacts breastfeeding success and whether different surgical techniques differentially impact breast feeding success.
METHODS
Databases were searched up to September 5, 2017. Studies were included if they reported the number of women successful at breastfeeding or lactation after breast reduction surgery, and if they reported either the total number of women who had children following breast reduction surgery, or the total number of women who attempted to breastfeed following surgery.
RESULTS
Of 1,212 studies, 51 studies met the inclusion criteria; they were located worldwide and had 31 distinct breast reduction techniques. The percentage of breastfeeding success among studies was highly variable. However, when analyzed by the preservation of the column of parenchyma from the nipple areola complex to the chest wall (subareolar parenchyma), a clear pattern emerged. The median breastfeeding success was 4% (interquartile range (IQR) 0-38%) for techniques with no preservation, compared to 75% (IQR 37-100%) for techniques with partial preservation and 100% (IQR 75-100%) for techniques with full preservation.
CONCLUSIONS
Techniques that preserve the column of subareolar parenchyma appear to have a greater likelihood of successful breastfeeding. The preservation of the column of subareolar parenchyma should be disclosed to women prior to surgery. Guidelines on the best breast reduction techniques to be used in women of child bearing years may be advantageous to ensure women have the greatest potential for successful breastfeeding after breast reduction surgery.
Topics: Breast Feeding; Female; Humans; Mammaplasty
PubMed: 29049351
DOI: 10.1371/journal.pone.0186591 -
Plastic and Reconstructive Surgery Jul 2023Nipple-sparing mastectomy (NSM) has emerged as an alternative procedure for skin-sparing mastectomy (SSM), followed by immediate breast reconstruction. Because oncologic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nipple-sparing mastectomy (NSM) has emerged as an alternative procedure for skin-sparing mastectomy (SSM), followed by immediate breast reconstruction. Because oncologic safety appears similar, patient-reported outcomes (PROs) and complication risks may guide decision-making in individual patients. Therefore, the aim of this systematic review was to compare PROs and complication rates after NSM and SSM.
METHODS
A systematic literature review evaluating NSM versus SSM was performed using the Embase, MEDLINE, and Cochrane databases. Methodologic quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Form for Cohort Studies. Primary outcomes were PROs and complications. Studies that evaluated BREAST-Q scores were used to perform meta-analyses on five BREAST-Q domains.
RESULTS
Thirteen comparative studies including 3895 patients were selected from 1202 articles found. Meta-analyses of the BREAST-Q domains showed a significant mean difference of 7.64 in the Sexual Well-being domain ( P = 0.01) and 4.71 in the Psychosocial Well-being domain ( P = 0.03), both in favor of NSM. Using the specifically designed questionnaires, no differences in overall satisfaction scores were found. There were no differences in overall complication rates between the two groups.
CONCLUSIONS
Patient satisfaction scores were high after both NSM and SSM; however, NSM led to a higher sexual and psychosocial well-being. No differences in complication rates were found. In combination with other factors, such as oncologic treatments, complication risk profile, and fear of cancer recurrence, the decision for NSM or SSM has to be made on an individual basis and only if NSM is considered to be oncologically safe.
Topics: Humans; Female; Mastectomy; Nipples; Quality of Life; Breast Neoplasms; Mammaplasty; Retrospective Studies
PubMed: 36728484
DOI: 10.1097/PRS.0000000000010155 -
JAMA Surgery Oct 2018In breast reconstruction, it is critical for patients and surgeons to have comprehensive information on the relative risks of the available options. However, previous... (Comparative Study)
Comparative Study
IMPORTANCE
In breast reconstruction, it is critical for patients and surgeons to have comprehensive information on the relative risks of the available options. However, previous studies that evaluated complications were limited by single-center designs, inadequate follow-up, and confounding.
OBJECTIVE
To assess 2-year complication rates across common techniques for postmastectomy reconstruction in a multicenter patient population.
DESIGN, SETTING, AND PARTICIPANTS
This longitudinal, multicenter, prospective cohort study conducted from February 1, 2012, through July 31, 2015, took place at the 11 study sites associated with the Mastectomy Reconstruction Outcomes Consortium study. Eligible patients included women 18 years and older presenting for first-time breast reconstruction with at least 2 years of follow-up. Procedures evaluated included direct-to-implant (DTI) technique, expander-implant (EI) technique, latissimus dorsi (LD) flap, pedicled transverse rectus abdominis myocutaneous (pTRAM) flap, free transverse rectus abdominis myocutaneous (fTRAM) flap, deep inferior epigastric perforator (DIEP) flap, and superficial inferior epigastric artery (SIEA) flap.
INTERVENTIONS
Postmastectomy breast reconstruction.
MAIN OUTCOMES AND MEASURES
Development of complications, reoperative complications, and wound infections during 2-year follow-up. Mixed-effects logistic regression analysis controlled for variability among centers and for demographic and clinical variables.
RESULTS
A total of 2343 patients (mean [SD] age, 49.5 [10.1] years; mean [SD] body mass index, 26.6 [5.7]) met the inclusion criteria. A total of 1525 patients (65.1%) underwent EI reconstruction, with 112 (4.8%) receiving DTI reconstruction, 85 (3.6%) pTRAM flaps, 95 (4.1%) fTRAM flaps, 390 (16.6%) DIEP flaps, 71 (3.0%) LD flaps, and 65 (2.8%) SIEA flaps. Overall, complications were noted in 771 (32.9%), with reoperative complications in 453 (19.3%) and wound infections in 230 (9.8%). Two years postoperatively, patients undergoing any autologous reconstruction type had significantly higher odds of developing any complication compared with those undergoing EI reconstruction (pTRAM flap: odds ratio [OR], 1.91; 95% CI, 1.10-3.31; P = .02; fTRAM flap: OR, 2.05; 95% CI, 1.24-3.40; P = .005; DIEP flap: OR, 1.97; 95% CI, 1.41-2.76; P < .001; LD flaps: OR, 1.87; 95% CI, 1.03-3.40; P = .04; SIEA flap: OR, 4.71; 95% CI, 2.32-9.54; P < .001). With the exception of LD flap reconstructions, all flap procedures were associated with higher odds of reoperative complications (pTRAM flap: OR, 2.48; 95% CI, 1.33-4.64; P = .005; fTRAM flap: OR, 3.02; 95% CI, 1.73-5.29; P < .001; DIEP flap: OR, 2.76; 95% CI, 1.87-4.07; P < .001; SIEA flap: OR, 2.62; 95% CI, 1.24-5.53; P = .01) compared with EI techniques. Of the autologous reconstructions, only patients undergoing DIEP flaps had significantly lower odds of infection compared with those undergoing EI procedures (OR, 0.45; 95% CI, 0.25-0.29; P = .006). However, DTI and EI procedures had higher failure rates (EI and DTI techniques, 7.1%; pTRAM flap, 1.2%; fTRAM flap, 2.1%; DIEP flap, 1.3%; LD flap, 2.8%; and SIEA flap, 0%; P < .001).
CONCLUSIONS AND RELEVANCE
Significant differences were noted across reconstructive procedure types for overall and reoperative complications, which is critically important information for women and surgeons making breast reconstruction decisions.
Topics: Adult; Breast Implants; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Postoperative Care; Postoperative Complications; Prospective Studies; Regression Analysis; Surgical Flaps; Transplantation, Autologous
PubMed: 29926077
DOI: 10.1001/jamasurg.2018.1687 -
Journal of UOEH 2023Few studies have examined the effect of immediate breast reconstruction (IBR) on the overall progression of breast cancer therapy. This study examins the effect of IBR...
Few studies have examined the effect of immediate breast reconstruction (IBR) on the overall progression of breast cancer therapy. This study examins the effect of IBR on the breast cancer therapy. 142 patients underwent mastectomy in our department (With IBR group, n = 17; Without IBR group, n = 125). We examined the number of days from diagnosis to surgery, operation time, length of postoperative stay, number of days from surgery to postoperative therapy, and complications in patients with or without breast reconstruction and by type of reconstruction. In the IBR group, the operation time was longer (P < 0.001), postoperative hospital stay was longer when adjusted for multivariate analysis (P = 0.008), and complications were significantly more common (P < 0.001), but there was no significant difference when limited to grade ≥3 complications. There was no difference until the start of postoperative treatment. The results reveal that IBR requires coordination between the surgical and operating room staff, and does not affect the transition to postoperative treatment but does affect an increased incidence of minor complications and length of postoperative stay.
Topics: Humans; Female; Breast Neoplasms; Mastectomy; Mammaplasty; Chemotherapy, Adjuvant; Retrospective Studies; Postoperative Complications
PubMed: 38057108
DOI: 10.7888/juoeh.45.199 -
Aesthetic Plastic Surgery Dec 2023Capsular contracture (CC) is one of the most common complications of implant-based breast reconstruction or augmentation surgery. Common risk factors of CC include... (Review)
Review
Capsular contracture (CC) is one of the most common complications of implant-based breast reconstruction or augmentation surgery. Common risk factors of CC include biofilm, surgical site infections, history of prior CC or fibrosis, history of radiation therapy, and implant characteristics. Though bacterial contamination of breast protheses is associated with adverse sequelae, there are not universally accepted guidelines and limited best practice recommendations for antimicrobial breast pocket irrigation. Despite advanced molecular biology, the exact mechanism of this complication is not fully understood. Interventions that decrease the rate of CC include antibiotic prophylaxis or irrigation, acellular dermal matrix, leukotriene inhibitors, surgical techniques, and others. However, there is inconsistent evidence supporting these risk factors, and the current data was based on broad heterogeneous studies. The objective of this review was to provide a summary of the current data of contributing risk factors as well as preventative and treatment measures for CC.Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
Topics: Humans; Breast Implants; Breast Implantation; Incidence; Mammaplasty; Anti-Infective Agents; Contracture; Implant Capsular Contracture; Retrospective Studies; Treatment Outcome; Follow-Up Studies
PubMed: 37410129
DOI: 10.1007/s00266-023-03453-5 -
Journal of Plastic Surgery and Hand... 2023The challenge in the operative therapy for enlargement of the male breast is to deal with the skin excess. Shape and scars are the major parameters after which patients... (Review)
Review
OBJECTIVES
The challenge in the operative therapy for enlargement of the male breast is to deal with the skin excess. Shape and scars are the major parameters after which patients assess their operative result. Therefore, we assessed the satisfaction rate among patients undergoing subcutaneous mastectomy at our institution with special regard to scar tissue formation and the postoperative appearance of the chest wall in dependence of the surgical approach (periarolar versus inframammary fold).
METHODS
The study includes = 36 male patients who underwent subcutaneous mastectomy at AGAPLESION Markus Hospital Frankfurt/Main. Patient's satisfaction dependent with the appearance of the chest wall and scar formation was evaluated by a modified BREAST Q® questionnaire plus two male-based additional questions.
RESULTS
There is no statistically significant difference in satisfaction with the operative result depending on the pattern of incision (periareolar versus submammary periareolar; 81.9% versus 75.5%) with the operative result. Evaluation of additional questions of the modified BREAST Q® questionnaire showed that 86% of the patients ( = 31) would rather have more scars and a flatter chest wall. A BMI >25 kg/m is accompanied by a higher risk for complications ( = 0.04).
CONCLUSIONS
Periareolar incision is still the method of choice, if promising an aesthetic appealing result. When reaching its limits though, we showed that a flat and male-shaped appearance of the chest wall is priority for the patients and should therefore be for the surgeon as well.
Topics: Humans; Male; Cicatrix; Gynecomastia; Breast Neoplasms; Mastectomy; Retrospective Studies; Patient Reported Outcome Measures; Patient Satisfaction; Mammaplasty
PubMed: 34591727
DOI: 10.1080/2000656X.2021.1981349 -
Archives of Gynecology and Obstetrics Jun 2022To achieve long-term improvement in health care of transgender women, it is necessary to analyze all aspects of gender-confirming surgery, especially the relation of...
BACKGROUND
To achieve long-term improvement in health care of transgender women, it is necessary to analyze all aspects of gender-confirming surgery, especially the relation of risks and benefits occurring in these procedures. While there are many studies presenting data on the urologic part of the surgery, there are just few data about complications and satisfaction with breast augmentation.
METHODS
This is a retrospective study using parts of the BREAST-Q Augmentation Questionnaire and additional questions for symptoms of capsular contracture and re-operations and analyzing archived patient records of all transwomen which were operated at University Hospital Essen from 2007 to 2020.
RESULTS
99 of these 159 patients (62%) completed the questionnaire after a median time of 4 years after surgery. Breast augmentation led to re-operations due to complications in 5%. The rate of capsular contracture (Baker Grad III-IV) in this population was 3%. Most patients (75%) rated high scores of satisfaction with outcome (more than 70 points) and denied to have restrictions due to their implants in their everyday life. All patients reported an improvement in their quality of life owing to breast augmentation.
CONCLUSION
Breast augmentation by inserting silicon implants is a safe surgical procedure which takes an important part in reducing gender dysphoria.
Topics: Breast Implantation; Breast Implants; Contracture; Female; Follow-Up Studies; Humans; Mammaplasty; Patient Satisfaction; Personal Satisfaction; Quality of Life; Retrospective Studies
PubMed: 35597817
DOI: 10.1007/s00404-022-06603-3 -
Effects of Silicone Breast Implants on Human Cell Types In Vitro: A Closer Look on Host and Implant.Aesthetic Plastic Surgery Oct 2022Silicone (gel) breast implants (SBI) are used world-wide for breast augmentation, and reconstruction or to correct breast deformities. They consist of two compounds: an... (Review)
Review
BACKGROUND
Silicone (gel) breast implants (SBI) are used world-wide for breast augmentation, and reconstruction or to correct breast deformities. They consist of two compounds: an elastomer silicone shell (envelope) and a silicone gel filler (core). Breast Implant Illness (BII) is a term used for women with SBI, who suffer from various of symptoms including myalgia, arthralgia, fatigue, fever, dry eyes and/or dry mouth (sicca), as well as cognitive disturbances, which are rated by these woman as response to SBI. The pathogenesis of these adverse effects as well as the histocompatibility and the SBI-cell interaction of silicone and its surrounding tissue (implant-host tissue interface) is a subject of current research. The main purpose of this review is to provide an overview of the current knowledge regarding the effects of silicone (gel and elastomer surfaces) of a SBI on different human cell types from experimental - in vitro - models.
METHODS
A comprehensive research was conducted by two independent reviewers in March and July of 2020 in the PubMed, MEDLINE, and Cochrane databases.
RESULTS
A number of 1328 articles on this topic were initially identified, of which 62 could be finally included an analysed in this review.
CONCLUSION
SBI may lead to a physiologic pro-inflammatory and foreign body host response with fibrous encapsulation accompanied by a disturbed Th17/Treg balance and IL-17 production. No causal relationship is known for systemic symptoms and/or autoimmune outcomes in the context of BII.
LEVEL OF EVIDENCE III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Humans; Female; Breast Implants; Silicone Gels; Interleukin-17; Follow-Up Studies; Breast Implantation; Mammaplasty; Elastomers
PubMed: 35075507
DOI: 10.1007/s00266-021-02762-x