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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 -
Plastic and Reconstructive Surgery.... Oct 2015Most breast reduction patients are highly satisfied after surgery. However, there is a subset of women who seek breast augmentation years later to restore lost volume...
UNLABELLED
Most breast reduction patients are highly satisfied after surgery. However, there is a subset of women who seek breast augmentation years later to restore lost volume chiefly associated with weight loss and postpartum changes. Breast shape and overall aesthetics are often revised at the same time.
METHODS
A retrospective review was performed of 2 surgeons' experiences with post-reduction breast augmentation. Twenty patients were identified between 2002 and 2014. An in-depth chart review was conducted to determine patient motivation and to examine the operative techniques employed. Implant variables, a reduction specimen weight to implant volume comparison (where available), and complications are reported.
RESULTS
The average age was 37.1 years and average body mass index was 21.8 kg/m(2). Most patients waited over a decade to have their breasts revised. Weight loss was the motivating factor in 8 patients and pregnancy changes in 11. Nineteen patients wished to stay with the same bra size or 1 cup size larger. Although all patients elected to have an implant placed, 19 patients wished to have an improved breast shape, not specifically a larger volume. The average breast implant was 203.5 cm(3) (range, 120-340 cm(3)). Complications from implant placement included a seroma treated by aspiration and a Baker class III capsular contracture that required surgical correction.
CONCLUSIONS
A small subset of reduction mammaplasty patients seek breast augmentation many years later primarily to improve breast contour, not to restore their prereduction breast volumes. Conservative augmentation combined with revision of breast shape and areolar aesthetics yields good results with minimal complications.
PubMed: 26579333
DOI: 10.1097/GOX.0000000000000479 -
Eplasty 2020To evaluate the effects of preoperative oral diazepam on the postoperative course of patients undergoing primary augmentation mammoplasty in an outpatient surgical...
To evaluate the effects of preoperative oral diazepam on the postoperative course of patients undergoing primary augmentation mammoplasty in an outpatient surgical center. A retrospective review was conducted of 189 patients undergoing primary breast augmentation at an outpatient surgical center from 2012 to 2015. Patients receiving same-day premedication with oral diazepam were compared with a control group without premedication. Patients with combined surgical procedures were excluded with the exception of minor, superficial procedures. Patient demographics, perioperative medication use, operative details, and postoperative numeric pain scale (0-10) scores were collected. Ninety-three patients (49%) were included in the premedication group and 96 (51%) in the control group. Difference in age, body mass index, implant size, and intraoperative opioid use were not statistically significantly different between the treatment and control groups ( > .05). No difference was noted in postoperative nausea, emesis, or antiemetic use between the 2 groups. The operative time was slightly longer in the control group (64.5 minutes vs 58.5 minutes, = .006). Immediate postoperative pain (3.6 vs 4.4) and time to discharge (101 minutes vs 110 minutes) were slightly decreased in the premedication group; however, these values did not reach statistical significance. Intraoperative narcotic use was the same between groups, but postoperative narcotic pain medication use was higher in the premedication group (9.68 mg vs 8.26 mg, = .036). Predischarge pain scores (2.87 vs 2.29, = .006) were also noted to be slightly higher in the premedication group. Preoperative diazepam administration does not significantly decrease time to discharge in primary breast augmentation mammoplasty. Furthermore, its use may result in increased postoperative narcotic use and higher pain scores at the time of discharge.
PubMed: 32362988
DOI: No ID Found -
Journal of Cutaneous and Aesthetic... 2022Augmentation mammoplasty refers to "top surgery" for transfemale patients. Before this surgery, due to the hormonal treatment being taken, it may be encountered that...
Augmentation mammoplasty refers to "top surgery" for transfemale patients. Before this surgery, due to the hormonal treatment being taken, it may be encountered that there would be a glandular tissue of breast that seems to be similar to the simple tuberous breast disease, which is one of the diseases in female breast development. The presence of areolar protuberance in transfemale would of course undermine the cosmetic gain after augmentation mammoplasty operation. This situation, which can be difficult to diagnose before surgery especially in transfemale patients, will manifest itself clearly after the end of augmentation mammoplasty. As a precaution, resection of a part of glandular tissue equal to the protruding height of the areola from the posterior wall of the gland is an effective method both in terms of its simple applicability and not to use of an extra skin incision while performing augmentation mammoplasty.
PubMed: 37035598
DOI: 10.4103/JCAS.JCAS_51_21 -
Cleveland Clinic Journal of Medicine Feb 2019Women receive breast implants for both aesthetic and reconstructive reasons. This brief review discusses the evolution of and complications related to breast implants,... (Review)
Review
Women receive breast implants for both aesthetic and reconstructive reasons. This brief review discusses the evolution of and complications related to breast implants, as well as key considerations with regard to aesthetic and reconstructive surgery of the breast.
Topics: Breast Implants; Clinical Decision-Making; Esthetics; Female; Humans; Implant Capsular Contracture; Lymphoma, Large-Cell, Anaplastic; Mammaplasty; Patient Selection; Postoperative Complications; Risk Factors; Silicone Gels
PubMed: 30742581
DOI: 10.3949/ccjm.86a.18017 -
Gland Surgery Aug 2019We review the current literature for validated patient related outcome measures (PROM) in breast augmentation mammoplasty (BAM). Using Medline search between 1966 to... (Review)
Review
We review the current literature for validated patient related outcome measures (PROM) in breast augmentation mammoplasty (BAM). Using Medline search between 1966 to 2018, using the search strategy ("patient reported outcome measure" OR "surveys or questionnaires") AND "breast" AND ("augment" OR "implant") was performed. A manual search with Google Scholar using the search term "Patient Reported Outcome Measures in Bilateral Augmentation Mammaplasty" was also performed. Once the search yielded its results, a further search of bibliographic references within the articles was also performed. The Medline computer search produced 72 results, with a Google Scholar search yielding two results and a bibliographic search of all articles revealing a further single result. Ten studies were included as they used validated PROM. Three articles used the same PROM (Breast-Q) and seven used different PROM, therefore 8 validated PROM were discovered. Bilateral augmentation mammoplasty has been demonstrated to confer an increase in patient reported outcomes in domains of satisfaction with breasts and psychological well-being. There is some decrease in physical well-being following this procedure. Validated PROMs provide objective data relating to different aspects of BAM. Combined with traditional surgeon-based outcome measures and implant registry data, they may provide a more comprehensive insight into the patient journey.
PubMed: 31538068
DOI: 10.21037/gs.2019.03.10 -
Annals of Translational Medicine Apr 2021Gender-affirming surgery (GAS) is often a crucial step during the journey to identity actualization for transgender patients. Surgical breast augmentation, or "top... (Review)
Review
Gender-affirming surgery (GAS) is often a crucial step during the journey to identity actualization for transgender patients. Surgical breast augmentation, or "top surgery", is frequently cited as the most important and sometimes only gender-affirming procedure sought by transfeminine patients. The breast augmentation process is remarkably similar in transgender and cisgender patients. However, there are unique guidelines, anatomic considerations, and contextual issues for the transgender patient population that must be taken into account by providers to achieve optimal outcomes. The aim of this review is to outline the current state of breast augmentation for transfeminine patients. We walk through our suggested pre-surgical evaluation, breast augmentation options, and post-surgical care. In the preoperative period, providers must establish a positive provider-patient relationship that allows for thorough history taking, physical examination, and goal setting. Providers must be able to select an appropriate implant, incision location, and operative plane to balance patient desires and pre-existing anatomic characteristics in transfeminine patients. Postoperatively, the provider must address acute and chronic needs to allow for continued satisfaction and safety. After reading this review, we aim for providers to be well-equipped to provide the highest quality breast augmentation care for their transfeminine patients. As research into best practices for breast augmentation in transfeminine patients continues to develop, we expect that surgical practice will continue to evolve.
PubMed: 33987309
DOI: 10.21037/atm-20-5087 -
Seminars in Plastic Surgery May 2022Rare reports linking textured breast implants to anaplastic large-cell lymphoma have generated controversies regarding their relative advantage over smooth implants. To... (Review)
Review
Rare reports linking textured breast implants to anaplastic large-cell lymphoma have generated controversies regarding their relative advantage over smooth implants. To evaluate trends in implant use in Israel, we sent a seven-item questionnaire to all active board-certified breast plastic surgeons in the country. About half responded. Approximately 60% of responders reported a moderate-to-considerable decrease in both the relative number of augmentation mammoplasty procedures and the use of implants during mastopexies in the last year. Nearly 40% had switched from textured to smooth implants to some extent. More than 40% still used textured implants for aesthetic procedures, and reconstructive procedures. Surgeons with more experience demonstrated a greater preference for smooth implants. The uncertainty regarding the safety of textured breast implants has led to a partial transition to the use of smoother implants and, importantly, to a general reduction in all breast-implant-based procedures.
PubMed: 35937433
DOI: 10.1055/s-0042-1747965 -
Gland Surgery Feb 2014Early diagnosis of breast cancer is the most importance factor that improve patient prognosis. Mammography has been proven in various randomized control trial as an... (Review)
Review
Early diagnosis of breast cancer is the most importance factor that improve patient prognosis. Mammography has been proven in various randomized control trial as an effective screening tool for breast cancer. However, with the increasing of various breast surgical procedures such as breast augmentation, reduction mammoplasty and reconstruction, it may result in more challenging in surveillance and screening of the breast cancer. Imaging appearances of breast augmentation and other surgical altered breast are diverse. Understanding and familiar with the spectrum of imaging findings in the surgical altered breast may require to prevent image misinterpretation and which can result in delay diagnosis of malignancy and detection of locoregional recurrence.
PubMed: 25083494
DOI: 10.3978/j.issn.2227-684X.2014.02.08