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Journal of Immunology Research 2022Breast implants are commonly placed postbreast cancer reconstruction, cosmetic augmentation, and gender-affirming surgery. Breast implant illness (BII) is a systemic... (Review)
Review
BACKGROUND
Breast implants are commonly placed postbreast cancer reconstruction, cosmetic augmentation, and gender-affirming surgery. Breast implant illness (BII) is a systemic complication associated with breast implants. Patients with BII may experience autoimmune symptoms including fatigue, difficulty concentrating, hair loss, weight change, and depression. BII is poorly understood, and the etiology is unknown. The purpose of this literature review is to characterize BII autoimmune disorders and determine possible causes for its etiology.
METHODS
The PubMed, Google Scholar, Embase, Web of Science, and OVID databases were interrogated from 2010 to 2020 using a query strategy including search term combinations of "implants," "breast implant illness," "autoimmune," and "systemic illness."
RESULTS
BII includes a spectrum of autoimmune symptoms such as fatigue, myalgias/arthralgias, dry eyes/mouth, and rash. A review of epidemiological studies in the past ten years exhibited evidence affirming an association between breast implants and autoimmune diseases. The most commonly recognized were Sjogren's syndrome, rheumatoid arthritis, systemic sclerosis, chronic fatigue syndrome, and Raynaud's syndrome. Explantation resulted in alleviation of symptoms in over 50% of patients, strengthening the hypothesis linking breast implants to BII. Studies have shown that silicone is a biologically inert material and unlikely to be the cause of these symptoms. This is supported by the fact that increased risk of autoimmune disease was also reported in patients with other implantable biomaterials such as orthopedic implants. Recent studies shed light on a possible role of bacterial biofilm and subsequent host-pathogen interactions as a confounding factor to this problem.
CONCLUSION
BII could be dependent on biofilm infection and the microenvironment around the implants. The true pathophysiology behind these complaints must be further investigated so that alternative treatment regimens other than explantation can be developed. Translational significance of these studies is not limited to breast implants but extends to other implants as well.
Topics: Arthritis, Rheumatoid; Autoimmune Diseases; Breast Implantation; Breast Implants; Humans; Silicones
PubMed: 35571560
DOI: 10.1155/2022/8536149 -
Indian Journal of Surgical Oncology Jun 2019Advancements in oncoplastic techniques have enhanced commitment to restore shape and, hence, has improved cosmetic outcomes. Donut mastopexy lumpectomy is one such...
Advancements in oncoplastic techniques have enhanced commitment to restore shape and, hence, has improved cosmetic outcomes. Donut mastopexy lumpectomy is one such technique and is best utilized in a setting of a malignancy not extending to the skin or the nipple-areolar complex. As a potential alternative to standard lumpectomy, it has many advantages including restriction of scar to the periareolar region, ease and rapidity of surgery, retention of nipple-areolar sensation, and the possibility of performing augmentation mammoplasty. A mini breast lift is also provided without ugly and visible scars. This report provides an insight into the technical details and utility of donut mastopexy lumpectomy (DML) in breast oncoplasty.
PubMed: 31168264
DOI: 10.1007/s13193-018-0865-0 -
Medicina (Kaunas, Lithuania) Nov 2021Breast implantation (BI) is the most common plastic surgery worldwide performed among women. Generally, BI is performed both in aesthetic and oncoplastic procedures.... (Review)
Review
Breast implantation (BI) is the most common plastic surgery worldwide performed among women. Generally, BI is performed both in aesthetic and oncoplastic procedures. Recently, the prevalence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or breast implant illness (BII) has aroused concerns. As a result, several countries, like Australia, Korea or the United Kingdom, introduced national registries dedicated to the safety and quality of BI surgeries. This narrative review aimed to focus on the clinical challenges, management and the current state of knowledge of BI. Both short and long-term outcomes of BI are determined by various alternatives and differences, which surgeons must consider during the planning and performing breast augmentation along with further complications or risk of reoperation. Proper preoperative decisions and aspects of surgical technique emerged to be equally important. The number of performed breast reconstructions is increasing, providing the finest aesthetic results and improving patient's quality of life. Choice of prosthesis varies according to individual preferences and anatomical variables. A newly diagnosed cases of BIA-ALCL with lacking data on prevention, diagnosis, and treatment are placing it as a compelling medical challenge. Similarly, BII remains one of the most controversial subjects in reconstructive breast surgery due to unspecified diagnostic procedures, and recommendations.
Topics: Breast Implantation; Breast Implants; Breast Neoplasms; Female; Humans; Lymphoma, Large-Cell, Anaplastic; Mammaplasty; Quality of Life
PubMed: 34833432
DOI: 10.3390/medicina57111214 -
Plastic and Reconstructive Surgery.... Aug 2019Dual-plane augmentation mammaplasty has gained wide popularity in treating breast ptosis. However, in our experience, dual-plane augmentation mastopexy fails to treat...
UNLABELLED
Dual-plane augmentation mammaplasty has gained wide popularity in treating breast ptosis. However, in our experience, dual-plane augmentation mastopexy fails to treat severe cases of ptosis (grade 3) and glandular ptosis. Therefore, we conceived a method to manage these cases effectively. The aim was to achieve harmonious, natural fullness, better projection, and appropriate size with limited scarring. We named this technique triple-plane augmentation mastopexy as three planes are used: the first plane is the subfascial plane, the second is the subglandular plane, and the third is the subpectoral plane.
METHODS
A retrospective review was performed of 75 consecutive cases of grade 3 or glandular ptosis treated in a single clinic by three separate surgeons adopting the same technique from January 2010 to January 2017. Triple-plane augmentation mastopexy begins by undermining the breast tissue through a tunnel until the second rib is in the prepectoral plane. Then, the subpectoral pocket for the implant is dissected with release of the lower border of the pectoralis major and avoiding release of the sternal border. Subsequently, the breast tissue is suspended at the lower border of the second rib, followed by subpectoral insertion of the implant and skin envelope excision.
RESULTS
Surgical follow-up varied from a minimum of 6 months to a maximum of 6 years, with an average of 3 years. Among a total of 75 patients, 64 patients (85.3%) complied with follow-up and 49 (76.5%) of these patients were satisfied. Complications varied from early complications (14.6%) to late complications (21.5%).
CONCLUSIONS
Grade 3 and glandular ptosis represent a challenge to plastic surgeons. Traditional techniques may fail to achieve optimized results. Triple-plane augmentation mastopexy is a safe, reliable procedure that ensures long-term desired aesthetic outcomes with limited scarring.
PubMed: 31592039
DOI: 10.1097/GOX.0000000000002344 -
Medicina (Kaunas, Lithuania) Sep 2022: Lipofilling is a commonly performed procedure worldwide for breast augmentation and correction of breast contour deformities. In breast reconstruction, fat grafting... (Review)
Review
: Lipofilling is a commonly performed procedure worldwide for breast augmentation and correction of breast contour deformities. In breast reconstruction, fat grafting has been used as a single reconstructive technique, as well as in combination with other procedures. The aim of the present study is to systematically review available studies in the literature describing the combination of implant-based breast reconstruction and fat grafting, focusing on safety, complications rate, surgical sessions needed to reach a satisfying reconstruction, and patient-reported outcomes. : We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) throughout the whole review protocol. A systematic review of the literature up to April 2022 was performed using Medline, Embase, and Cochrane Library databases. Only studies dealing with implant-based breast reconstruction combined with fat grafting were included. : We screened 292 articles by title and abstract. Only 48 articles were assessed for full-text eligibility, and among those, 12 studies were eventually selected. We included a total of 753 breast reconstructions in 585 patients undergoing mastectomy or demolitive breast surgeries other than mastectomy (quadrantectomy, segmentectomy, or lumpectomy) due to breast cancer or genetic predisposition to breast cancer. Overall, the number of complications was 60 (7.9%). The mean volume of fat grafting per breast per session ranged from 59 to 313 mL. The mean number of lipofilling sessions per breast ranged from 1.3 to 3.2. : Hybrid breast reconstruction shows similar short-term complications to standard implant-based reconstruction but with the potential to significantly decrease the risk of long-term complications. Moreover, patient satisfaction was achieved with a reasonably low number of lipofilling sessions (1.7 on average).
Topics: Adipose Tissue; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Mastectomy, Segmental; Retrospective Studies
PubMed: 36143908
DOI: 10.3390/medicina58091232 -
The Journal of Surgical Research Dec 2022Capsular contracture is a common complication associated with breast implants following reconstructive or aesthetic surgery in which a tight or constricting scar tissue... (Review)
Review
Capsular contracture is a common complication associated with breast implants following reconstructive or aesthetic surgery in which a tight or constricting scar tissue capsule forms around the implant, often distorting the breast shape and resulting in chronic pain. Capsulectomy (involving full removal of the capsule surrounding the implant) and capsulotomy (where the capsule is released and/or partly removed to create more space for the implant) are the most common surgical procedures used to treat capsular contracture. Various structural modifications of the implant device (including use of textured implants, submuscular placement of the implant, and the use of polyurethane-coated implants) and surgical strategies (including pre-operative skin washing and irrigation of the implant pocket with antibiotics) have been and/or are currently used to help reduce the incidence of capsular contracture. In this article, we review the pharmacological approaches-both commonly practiced in the clinic and experimental-reported in the scientific and clinical literature aimed at either preventing or treating capsular contracture, including (i) pre- and post-operative intravenous administration of drug substances, (ii) systemic (usually oral) administration of drugs before and after surgery, (iii) modification of the implant surface with grafted drug substances, (iv) irrigation of the implant or peri-implant tissue with drugs prior to implantation, and (v) incorporation of drugs into the implant shell or filler prior to surgery followed by drug release in situ after implantation.
Topics: Humans; Implant Capsular Contracture; Polyurethanes; Breast Implants; Breast Implantation; Contracture; Anti-Bacterial Agents
PubMed: 35969932
DOI: 10.1016/j.jss.2022.06.073 -
Plastic and Reconstructive Surgery.... Feb 2022The muscle splitting technique is a submuscular pocket used for augmentation mammoplasty. Its use and results following primary and secondary procedures are presented.
BACKGROUND
The muscle splitting technique is a submuscular pocket used for augmentation mammoplasty. Its use and results following primary and secondary procedures are presented.
METHODS
A retrospective study that analyzed complication and revision rates following primary and secondary mastopexy with augmentation in a muscle splitting pocket performed between April 2007 and March 2020 was carried out. Data were divided into two groups: primary and secondary single-stage mastopexies with augmentation.
RESULTS
A total of 169 patients had a primary procedure and 49 had secondary procedures. The mean ages of patients in the primary and secondary were 32.3 ± 9.89 and 38.2 ± 9.63 years, respectively. Five (3.0%) patients had periprosthetic or wound infections in the primary group when compared with 0% in secondary surgery group. Wound breakdown was seen in 13 (7.7%) patients with a primary procedure compared with one patient (2%) with a secondary procedure. One patient had partial nipple loss and another had total nipple loss in the primary group (1.2%) when compared with one patient (2.0%) who had partial nipple loss in the secondary group. Revision surgeries were carried out in 16 (10.1%) of the primary procedures compared with five (10.2%) of the secondary procedures.
CONCLUSION
Even though there was a higher prevalence of complications in the primary procedures group than in the secondary procedures group, the overall complications following muscle splitting mastopexy with augmentation are within an acceptable range.
PubMed: 35242490
DOI: 10.1097/GOX.0000000000004138 -
Plastic and Reconstructive Surgery Jul 2019The evolution of silicone implants has included advances in both gel and shell technology to improve the clinical outcomes of the implants. The newest generation of... (Review)
Review
The evolution of silicone implants has included advances in both gel and shell technology to improve the clinical outcomes of the implants. The newest generation of implants includes implants with thick, strong shells and highly cohesive gel fill. These advancements allow for better maintenance of implant form and shape over time and improved implant safety. The Natrelle Inspira product line offers 3 different levels of gel cohesivity in a range of profiles to provide a wide variety of options for use in both breast augmentation and postmastectomy breast reconstruction. This article will review the use of Inspira implants in primary aesthetic and reconstructive breast surgery.
Topics: Breast; Breast Implantation; Breast Implants; Breast Neoplasms; Decision Making; Elasticity; Esthetics; Female; Humans; Implant Capsular Contracture; Mastectomy; Prosthesis Design; Silicone Gels; Treatment Outcome
PubMed: 31246762
DOI: 10.1097/PRS.0000000000005951 -
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