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Zhongguo Xiu Fu Chong Jian Wai Ke Za... Aug 2023To review the advances in methods for reconstructing nipple projection based on tissue graft support. (Review)
Review
OBJECTIVE
To review the advances in methods for reconstructing nipple projection based on tissue graft support.
METHODS
The literature related to nipple projection reconstruction based on tissue graft support was reviewed and summarized in terms of the advantages and disadvantages of various tissue grafts and the improved nipple projection results.
RESULTS
Loss of nipple projection is a common cause of decreased patient's satisfaction. Reconstructing nipple projection based on tissue graft support is a more common clinical method and can be done with autologous and allogeneic tissues. Autologous tissue grafts include dermis, adipose tissue with dermis, adipose tissue, ear cartilage, rib cartilage, and contralateral nipple tissue. Autologous tissue grafts are easy to obtain and have no immune rejection, but may lead to donor area damage and prolong the surgical time for tissue collection. Allogeneic tissue grafts include acellular dermal matrix, lyophilized rib cartilage, and extracellular matrix collagen, and decellularized nipple tissue. Allogeneic tissue grafts do not cause additional donor area damage, are highly malleable, and can be designed to be utilized according to the recipient area, but the high cost often limits the development of this technique.
CONCLUSION
There is no gold standard regarding tissue graft-assisted nipple projection reconstruction techniques, and there are advantages and disadvantages to both autologous and allogeneic tissue grafts. Surgeons should choose the appropriate graft based on the actual condition of the patient.
Topics: Humans; Adipose Tissue; Autografts; Costal Cartilage; Nipples; Transplants
PubMed: 37586806
DOI: 10.7507/1002-1892.202304096 -
Journal of Surgical Oncology Jul 2016Sensation and quality of life (QOL) before and after nipple sparing mastectomy (NSM) are poorly understood. (Observational Study)
Observational Study
BACKGROUND
Sensation and quality of life (QOL) before and after nipple sparing mastectomy (NSM) are poorly understood.
METHODS
Women electing mastectomy with immediate reconstruction and eligible for NSM were prospectively enrolled in a sensation and satisfaction/QOL study. Women self-selected skin-sparing mastectomy (SSM) or NSM. Skin sensation testing using Semmes Weinstein monofilaments and patient satisfaction/QOL surveys were administered preoperatively and at 1 year postoperatively.
RESULTS
53 patients were enrolled (n = 38, 72% NSM and n = 15, 28% SSM). Both groups had significant reduction in postoperative skin sensation. For NSM, measurable NAC sensation was preserved in both NAC for 26% of patients and in one NAC for 68%. QOL and satisfaction was similar between groups. Neither group was satisfied with sexual arousal with breast or nipple stimulation after surgery.
CONCLUSION
Patients undergoing SSM and NSM have considerable loss in skin and NAC sensation following surgery. Satisfaction and QOL did not differ between groups. J. Surg. Oncol. 2016;114:11-16. © 2016 Wiley Periodicals, Inc.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Body Image; Breast Neoplasms; Female; Humans; Mastectomy, Subcutaneous; Middle Aged; Nipples; Outcome Assessment, Health Care; Patient Satisfaction; Prospective Studies; Quality of Life; Skin Physiological Phenomena; Touch; Young Adult
PubMed: 27087574
DOI: 10.1002/jso.24264 -
Aesthetic Plastic Surgery Dec 2023Most of the time, female-to-male (FtoM) chest surgery involves mastectomy techniques and free transplantation of the nipple-areola complex. With the increasing...
INTRODUCTION
Most of the time, female-to-male (FtoM) chest surgery involves mastectomy techniques and free transplantation of the nipple-areola complex. With the increasing prevalence of gender dysphoria and the demand for female-to-male gender reassignment surgery, the need for FtM top surgery is also rising. To meet this demand, we present a new approach: the PIPe technique, based on a fasciocutaneous flap with a posteroinferior pedicle.
MATERIALS AND METHODS
All patients with FtoM gender dysphoria undergoing surgery using the posteroinferior pedicle flap technique in the Plastic Surgery Department at Rennes University Hospital Center were included. The procedure involved extensive liposuction of the lower internal and external mammary quadrants, followed by liposuction of deep tissues in the upper quadrants, except in the pedicle area. After removing skin from the lower quadrants down to the dermis and de-epithelializing the posteroinferior pedicle flap, the thoracic flap was lowered and the areola transposed.
RESULTS
From July 2022 to March 2023, fifteen patients underwent surgery, and their results were collected prospectively. The average age was 25 years, the mean weight was 76.6 kg, and the average BMI was 28.1 kg/m. The average operating time was 102 min, and the mean weight excised was 459.5 g. The average length of hospital stay was 3.3 days, and the drainage duration was 2.4 days. No major complications were reported, and there were no cases of reintervention or recurrence.
CONCLUSIONS
Our study presents a novel surgical approach utilizing the posteroinferior pedicle technique. Its key benefit lies in the preservation of neurovascular function, which makes it an attractive option for patients seeking to retain nipple sensitivity. This procedure is reliable, reproducible, and recommended as a first-line treatment for grade II and III gynecomastia due to its low rate of major complications and favorable functional and aesthetic outcomes.
LEVEL OF EVIDENCE IV
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; Male; Female; Adult; Sex Reassignment Surgery; Breast Neoplasms; Mammaplasty; Mastectomy; Retrospective Studies; Nipples; Esthetics; Treatment Outcome
PubMed: 37684416
DOI: 10.1007/s00266-023-03552-3 -
Indian Journal of Dermatology,... 2019Hyperkeratosis of the nipple and areola is a rare condition first described by Tauber in 1923. Less than 100 cases have been reported in the literature. Hyperkeratosis...
Hyperkeratosis of the nipple and areola is a rare condition first described by Tauber in 1923. Less than 100 cases have been reported in the literature. Hyperkeratosis of the nipple and areola presents as hyperkeratotic, hyperpigmented plaques on the nipple and areola. It is more common in females. An 18-year-old female patient presented with hyperkeratotic, plaque-like, hard crusts on both nipples and areolas. The examining physician could successfully remove this crust using his finger. The crust had accumulated as a result of the patient's reluctance to touch or clean the breast area due to psychological issues. A crusted nipple and areola may occur as a secondary condition due to a patient's reluctance to touch or clean their breasts.
Topics: Adolescent; Female; Humans; Hygiene; Hyperpigmentation; Keratosis; Nipples; Saudi Arabia; Skin Care
PubMed: 29491192
DOI: 10.4103/ijdvl.IJDVL_399_17 -
Computational and Mathematical Methods... 2022Axillary lymph node (ALN) staging is the most effective method to evaluate the condition of patients with breast cancer, their choice of treatment options, and...
BACKGROUND
Axillary lymph node (ALN) staging is the most effective method to evaluate the condition of patients with breast cancer, their choice of treatment options, and prognosis. The sentinel lymph node (SLN) status assessment is the key to sentinel lymph node biopsy (SLNB) in patients with breast cancer. The choice of tracer and tracer injection sites affects SLNB.
OBJECTIVE
This study mainly analyzes the best tracer for SLNB and the best choice of tracer injection site.
METHODS
A total of 165 breast cancer patients who underwent SLNB were selected and injected with methylene blue or 99mTc-labeled sodium phytate or nanocarbon 20 min before biopsy. The number of SLNs detected by different tracers in different injection sites such as peritumoral tissue (PT) and subareolar area (SA) was counted, and the sensitivity, specificity, and positive/negative prediction rates were recorded and compared.
RESULTS
The detection success rate, average detection number of SLNs, and detection accuracy of the nanocarbon tracer were higher than the other two. The detection sensitivity, specificity, and positive and negative prediction rates of nanocarbon for SLNB were also higher than those of the other two tracers. When comparing the performance of tracers in different injection sites, it was found that the detection of three tracers injected in the SA was better than the injection in the PT.
CONCLUSION
For women with early-stage breast cancer, nanocarbon can be used as the preferred tracer for SLNB to determine the status of the patient's ALNs, and the areola area can be used as the best injection site.
Topics: Axilla; Breast Neoplasms; Female; Humans; Lymph Nodes; Nipples; Sentinel Lymph Node Biopsy
PubMed: 35321201
DOI: 10.1155/2022/4066179 -
Supportive Care in Cancer : Official... Feb 2024The dermopigmentation of the Nipple-Areola Complex (NAC) is a safe non-surgical reconstruction technique that can restore psychophysical integrity, representing the... (Review)
Review
PURPOSE
The dermopigmentation of the Nipple-Areola Complex (NAC) is a safe non-surgical reconstruction technique that can restore psychophysical integrity, representing the final step after oncological surgery. This scoping review aims to identify and synthesize the literature focused on medical tattooing for NAC reconstruction in women who underwent breast reconstruction after cancer surgery. Competence and training, outcomes and organizational aspects were assessed as specific outcomes.
METHODS
The Joanna Briggs Institute (JBI) methodology for scoping reviews was followed. MEDLINE, Embase, Cochrane Library, Clinical Key, Scopus and Cinahl databases were consulted. After title (N = 54) and abstract (N = 39) screening and full-text review (N = 18), articles that met eligibility criteria were analyzed, critically apprised and narratively synthesized.
RESULTS
13 articles were analysed, with full texts (N = 11) and only abstract (N = 2). The overall quality of the literature (N observational studies = 11; N pilot experimental studies = 2) is weak. Nurses were the professionals mostly involved (N = 6), then medical staff (N = 4) and tattoo artists (N = 2). The professional training is poorly described in 6 papers. The most frequently assessed outcome was the satisfaction rate (N = 8). One study explored aspects of quality of life with a validated questionnaire. The management of these services resulted variable. Nurse-led services were implemented in 2 studies.
CONCLUSION
Despite methodological weaknesses, NAC tattooing research is relevant because it helps women redefine their identity after demolitive cancer treatments. Further research on processes and outcomes is needed.
Topics: Female; Humans; Tattooing; Nipples; Quality of Life; Mastectomy; Mammaplasty; Breast Neoplasms; Retrospective Studies
PubMed: 38337084
DOI: 10.1007/s00520-024-08351-3 -
Annals of the Royal College of Surgeons... Feb 2017
Topics: Female; Humans; Mammaplasty; Nipples; Surgical Flaps
PubMed: 27659355
DOI: 10.1308/rcsann.2016.0307 -
Breast (Edinburgh, Scotland) Apr 2021The current review paper was written in collaboration with breast cancer surgeons from the European Breast Cancer Research Association of Surgical Trialists (EUBREAST),... (Review)
Review
The current review paper was written in collaboration with breast cancer surgeons from the European Breast Cancer Research Association of Surgical Trialists (EUBREAST), a breast pathologist from the Danish Breast Cancer Group (DBCG), and representatives from the European SocieTy for Radiotherapy & Oncology (ESTRO) breast cancer course. Herein we summarize the different mastectomies and reconstruction procedures and define high-risk anatomical areas for breast cancer recurrences, to further specify the challenges in the surgical procedure, histopathological evaluation, and target volumes in case of postmastectomy irradiation, as recommended by the ESTRO guidelines according to the surgical procedure. The paper has original figures and illustrations for all disciplines for in-depth understanding of the differences between the procedures.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Neoplasm Recurrence, Local; Nipples
PubMed: 33610903
DOI: 10.1016/j.breast.2021.02.004 -
Women's Health (London, England) Jan 2010Nipple discharge is a common complaint among women. It is classified as normal or abnormal depending on features such as laterality, cycle variation, quantity, color or...
Nipple discharge is a common complaint among women. It is classified as normal or abnormal depending on features such as laterality, cycle variation, quantity, color or presentation (i.e., induced vs spontaneous). It can be related to benign conditions, such as intraductal papilloma, duct ectasia, plasma cell mastitis or galactorrhea; or to malignant conditions such as ductal, lobular or papillary carcinoma. Techniques used in nipple discharge evaluation include mammography, ultrasound, cytology (which could be assisted by a mammary pump), duct endoscopy, ductography, immunochemical methods and at least surgical excision of the pathological ducts for diagnosis and treatment in the same procedure.
Topics: Breast Diseases; Breast Neoplasms; Diagnosis, Differential; Female; Galactorrhea; Humans; Mammography; Nipple Aspirate Fluid; Nipples; Papilloma, Intraductal
PubMed: 20050819
DOI: 10.2217/whe.09.81 -
Indian Pediatrics Dec 2011
Topics: Breast Diseases; Female; Humans; Lactation; Male; Nipples
PubMed: 22253169
DOI: No ID Found