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World Journal of Surgical Oncology Apr 2016Mesh use in surgical breast reconstruction is becoming increasingly common; however, there is still no consensus on whether synthetic matrices or biological matrices... (Review)
Review
Mesh use in surgical breast reconstruction is becoming increasingly common; however, there is still no consensus on whether synthetic matrices or biological matrices produce the best outcomes. This review analyses these outcomes, namely the differences in aesthetic outcomes, cost, and the rates of the most commonly reported complications.The results indicate that breast reconstruction with a synthetic matrix produces comparable aesthetic outcomes to a biological matrix, with lower costs and complication rates. The individual results for complication rates show that biological matrixes are associated with lower infection rates and slightly lower capsular contracture, but higher haematoma rates, and slightly higher rates of skin necrosis and explantation--although many had post-op radiotherapy.The majority of the studies evaluated used biological matrices, and there are no randomised controlled trials directly comparing the two types of meshes; definite conclusions cannot be drawn from the available evidence. The authors suggest that a randomised controlled trial comparing these outcomes in synthetic and biological matrix use is needed.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Surgical Mesh
PubMed: 27102580
DOI: 10.1186/s12957-016-0874-9 -
In Vivo (Athens, Greece) 2023Silicone implants or tissue expanders placed under the pectoralis major (PM) muscle are often used for breast reconstruction. However, the disruption of PM insertions,... (Review)
Review
Silicone implants or tissue expanders placed under the pectoralis major (PM) muscle are often used for breast reconstruction. However, the disruption of PM insertions, which is often an inevitable part of the surgical procedure, is known to cause PM morbidity and, subsequently, problems with the use of the ipsilateral arm. In this systematic review, we present current knowledge regarding the effect of submuscular silicone-based breast reconstruction on the function of PM and the ipsilateral arm. A search of the relevant English literature was performed through PubMed and ten eligible studies were identified. Articles reporting breast augmentation were accepted as the techniques of implant insertion are similar to reconstruction. Questionnaires reporting the status of the arm, analysis of the range of motion of the shoulder with 3-D video, isometric or isokinetic dynamometry, ultrasound shear-wave elastography, volumetric MRI, electromyography and light and electron microscopy of the PM fibers were used for the assessment of PM and arm status. The insertion of implants under the PM, especially when combined with dissection of some of its insertions, seems to be associated with measurable abnormal microscopic, imaging, and dynamometric findings. However, the intact part of the muscle and possibly other nearby muscular structures are able to compensate for the lost part of PM. Thus, the insertion of implants fully or partially under the PM seems to have no or little effect on the function of the ipsilateral upper limb in daily life.
Topics: Pectoralis Muscles; Silicones; Mammaplasty; Prostheses and Implants; Magnetic Resonance Imaging; Breast Implants
PubMed: 37652471
DOI: 10.21873/invivo.13289 -
Annals of the Royal College of Surgeons... Feb 2017
Topics: Female; Humans; Mammaplasty; Nipples; Surgical Flaps
PubMed: 27659355
DOI: 10.1308/rcsann.2016.0307 -
Tidsskrift For Den Norske Laegeforening... Mar 2005It is estimated that approximately 50,000 Norwegian women have silicone breast implants following breast augmentation or breast reconstruction. Their numbers are growing... (Review)
Review
BACKGROUND
It is estimated that approximately 50,000 Norwegian women have silicone breast implants following breast augmentation or breast reconstruction. Their numbers are growing and doctors will more often be confronted with the health problems related to these implants.
MATERIAL AND METHODS
This review is based on information retrieved from Medline and our clinical experience.
RESULTS AND INTERPRETATION
The modern silicone breast implant is the product of four decades of development. The ongoing debate on health problems associated with the implants has been a vibrant stimulator for research, but a causal relationship between implants and the development of breast cancer and autoimmune defects has not been found. The implants are not, however, without complications; more research is required in order to improve the implants and for quality assurance of treatment and follow up.
Topics: Breast Implantation; Breast Implants; Female; History, 20th Century; History, 21st Century; Humans; Mammaplasty; Prosthesis Failure; Silicone Elastomers
PubMed: 15776068
DOI: No ID Found -
Editorial Comment on: One-Year Experience of Same-Day Mastectomy and Breast Reconstruction Protocol.Annals of Surgical Oncology Sep 2022
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Postoperative Complications; Retrospective Studies
PubMed: 35834143
DOI: 10.1245/s10434-022-12021-1 -
Advances in Clinical and Experimental... 2015Breast cancer remains the most common tumor in women, and new techniques for post- surgical breast reconstruction have been recently introduced. These new procedures... (Review)
Review
Breast cancer remains the most common tumor in women, and new techniques for post- surgical breast reconstruction have been recently introduced. These new procedures include autologous fat grafting with or without the enrichment with autologous stromal vascular fraction (SVF), platelet-derived growth factors and insulin. The reported improvement of fat graft viability with these techniques likely depends on the presence in the SVF of multipotent resident adipose derived-stem cells (ASCs). The clinical advantage derives from the plasticity of ASCs and their ability to generate new functional adipose tissue and vessels. However, there is an ongoing debate regarding the possible interplay between breast tumor cells and resident or transplanted ASCs for their capacity to locally secrete growth factors. Most of the data in the literature concerning ASCs is derived from in vitro models, whereas the knowledge of ASC behavior in vivo remains scarce. Recent reports concerning SVF/ASC enrichment of fat graft did not describe any significant worsening of prognosis for patients undergoing those procedures. However, further studies and longer follow-ups are needed to specifically define technical procedures and to confirm the safety of procedures of SVF/ASC enrichment during post-surgical breast reconstruction.
Topics: Adipose Tissue; Animals; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Regenerative Medicine; Risk Factors; Stem Cell Transplantation; Treatment Outcome
PubMed: 26467147
DOI: 10.17219/acem/31673 -
Medicine Mar 2023Currently, autologous fat grafting is the common surgery employed in the department of plastic and cosmetic surgery. Complications after fat grafting (such as fat... (Review)
Review
Currently, autologous fat grafting is the common surgery employed in the department of plastic and cosmetic surgery. Complications after fat grafting (such as fat necrosis, calcification, and fat embolism) are the difficulties and hotspots of the current research. Fat necrosis is one of the most common complications after fat grafting, which directly affects the survival rate and surgical effect. In recent years, researchers in various countries have achieved great results on the mechanism of fat necrosis through further clinical and basic studies. We summarize recent research progress on fat necrosis in order to provide theoretical basis for diminishing it.
Topics: Humans; Fat Necrosis; Adipose Tissue; Mammaplasty; Autografts; Transplantation, Autologous
PubMed: 36897702
DOI: 10.1097/MD.0000000000033220 -
Aesthetic Plastic Surgery Jun 2024Breast hypertrophy, a common pathological condition, often requires surgical intervention to alleviate musculoskeletal pain and improve patients' quality of life....
INTRODUCTION
Breast hypertrophy, a common pathological condition, often requires surgical intervention to alleviate musculoskeletal pain and improve patients' quality of life. Various techniques have been developed for breast reduction, each with its own advantages and complications. The primary aim of this study is to evaluate the efficacy, safety, and patient-reported outcomes of the authors technique: the Superomedial-Posterior Pedicle-Based Reduction Mammaplasty.
MATERIAL AND METHODS
A prospective study was conducted on 912 patients who underwent breast reduction surgery between November 2012 and July 2020. The surgical technique involved preserving all glandular tissue from the areola to the pectoralis major muscle using the superomedial-posterior pedicle. The patients' demographic data, operative details, complications, breast-related quality of life (measured using the Breast-Q questionnaire), and nipple-areola complex sensitivity were analyzed.
RESULTS
The average operative time was 62.12 ± 10.3 minutes. Complications included minor wound dehiscence (4.05%) and hematoma (1.2%), with no cases of nipple-areola complex necrosis. Nipple-areola sensitivity was fully restored in all patients at the 2-year follow-up. Patient satisfaction with the procedure was high with a statistically significant difference observed between pre- and postoperative scores (p < 0.001) of the Breast-Q questionnaire.
CONCLUSION
Authors technique offers reliable vascularization and innervation of the nipple-areola complex and achieves satisfactory aesthetic outcomes. It is associated with shorter operative times compared to other techniques reported in the literature. The Superomedial-Posterior Pedicle-Based Reduction Mammaplasty represents a safe and effective method for breast reduction surgery, providing significant benefits to patients with breast hypertrophy.
LEVEL OF EVIDENCE I
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; Mammaplasty; Female; Adult; Prospective Studies; Hypertrophy; Treatment Outcome; Breast; Middle Aged; Patient Satisfaction; Patient Reported Outcome Measures; Quality of Life; Esthetics; Young Adult; Operative Time; Cohort Studies; Surgical Flaps
PubMed: 37783863
DOI: 10.1007/s00266-023-03676-6 -
Journal of Plastic, Reconstructive &... Mar 2012
Topics: Breast; Breast Diseases; Breast Implants; Female; Humans; Mammaplasty; Patient Satisfaction; Silicone Gels
PubMed: 21996441
DOI: 10.1016/j.bjps.2011.09.021 -
Journal of Plastic, Reconstructive &... Aug 2011
Topics: Breast Implants; Female; Humans; Mammaplasty; Surgical Flaps; Tissue Expansion
PubMed: 21440521
DOI: 10.1016/j.bjps.2011.02.004