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Revista Da Escola de Enfermagem Da U S P Jul 2018To describe and interpret the experience of breastfeeding among women who underwent mammoplasty surgery prior to motherhood.
OBJECTIVE
To describe and interpret the experience of breastfeeding among women who underwent mammoplasty surgery prior to motherhood.
METHOD
A descriptive, qualitative study developed with women attended at a Human Milk Bank between 2014 and 2015. Data analysis was based on the content analysis method and supported by the Interactive Theory of Breastfeeding.
RESULTS
13 women participated in the study. Four categories emerged: 1) Success (or lack thereof) in Exclusive Breastfeeding: influence of maternal and child biological conditions; 2) Maternal feelings: perception about breastfeeding; 3) Decision making on the continuity of breastfeeding or the use of formula; 4) The role of health professionals in protecting, promoting and supporting breastfeeding: Information (or lack thereof) on the implications of the surgery.
CONCLUSION
Unfavorable biological conditions of the women who underwent mammoplasty generated unsuccessful experiences in exclusive breastfeeding and limited their decision-making, despite their desire to breastfeed.
Topics: Adult; Breast Feeding; Female; Health Personnel; Humans; Mammaplasty; Mothers; Professional Role; Qualitative Research
PubMed: 30043930
DOI: 10.1590/S1980-220X2017020003350 -
Plastic and Reconstructive Surgery Feb 2022Because of the multiplying number of patients undergoing breast augmentation, nonprimary augmentation mastopexy will be increasingly requested in the future; this...
BACKGROUND
Because of the multiplying number of patients undergoing breast augmentation, nonprimary augmentation mastopexy will be increasingly requested in the future; this operation represents an even more significant challenge than primary augmentation mastopexy. The authors describe a standardized approach for subglandular-to-subpectoral implant pocket conversion in mastopexy that provides a tight neopocket with inferolateral muscular support, which minimizes implant displacement complications and allows operative strategies to reduce the risk of bacterial load on implants.
METHODS
The authors' technique proposes the following: (1) modified subpectoral pocket, with muscular inferolateral support for the implant; (2) independent approaches to the submuscular pocket and subglandular (preexisting) pocket; and (3) preestablished four-step surgical sequence. The authors collected data from their private practices for 46 patients who underwent the technique from March of 2017 to April of 2020. Patient perception about aesthetic outcomes, photographs from multiple postoperative follow-ups, and surgical complications/reoperation rates were analyzed.
RESULTS
Overall results were positive; 89.1 percent of patients reported satisfaction with their aesthetic outcomes. No major complications occurred. The total revision rate was 15.2 percent, but only 2.1 percent in the last year, as the learning curve progressed.
CONCLUSIONS
Secondary augmentation mastopexy is a complicated procedure. The four-step sequence approach is one reliable option for subglandular-to-subpectoral pocket conversion, once it produced high levels of patient satisfaction while producing low complication rates. Other surgeons' experiences with the technique and further studies are necessary to validate these findings.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, IV.
Topics: Adult; Breast Implantation; Female; Humans; Mammaplasty; Mammary Glands, Human; Middle Aged; Pectoralis Muscles; Retrospective Studies; Young Adult
PubMed: 35077413
DOI: 10.1097/PRS.0000000000008775 -
Journal of Plastic Surgery and Hand... 2023Implant-related breast reconstruction can be divided into subpectoral breast reconstruction (SPBR) and prepectoral breast reconstruction (PPBR) according to the... (Meta-Analysis)
Meta-Analysis Review
Implant-related breast reconstruction can be divided into subpectoral breast reconstruction (SPBR) and prepectoral breast reconstruction (PPBR) according to the different anatomical planes. The previous stereotype was that PPBR had a high complication rate and was not suitable for clinical use. However, with the emergence of acellular dermal matrix (ADM), the clinical effect of PPBR has been improved. To compare the outcomes difference between SPBR and PPBR, We conducted this meta-analysis. Articles on SPBR versus PPBR were searched in PubMed, Web of Sciences, Embase, and Cochrane databases, strictly following the PRISMA guidelines. According to the set criteria, we included the literature that met the requirements. Extracted data were the incidence of adverse events and the duration of drainage. Results show that SPBR has a higher incidence rate in capsular contracture, animation deformity, infection, hematoma and delayed healing wound than PPBR. There are no significant differences in skin flap necrosis, seroma, implant loss, reoperation and duration of drainage between the two groups. Hence, PPBR is no longer a high complication surgical method and can be used in the clinical practice. However, there are few large sample studies at present, so it is necessary to carry out further studies on PPBR.
Topics: Humans; Acellular Dermis; Mammaplasty; Postoperative Complications; Tissue Expansion; Reoperation; Breast Implants; Breast Implantation
PubMed: 34581645
DOI: 10.1080/2000656X.2021.1981351 -
Cleveland Clinic Journal of Medicine Mar 2008Timing of breast reconstruction after mastectomy is determined primarily by patient factors and the need for postmastectomy radiation therapy. If the risk of needing... (Review)
Review
Timing of breast reconstruction after mastectomy is determined primarily by patient factors and the need for postmastectomy radiation therapy. If the risk of needing postmastectomy radiation is low, then immediate reconstruction produces the optimal aesthetic result. If the risk of needing postmastectomy radiation is high, then delayed reconstruction is preferable to optimize both radiation delivery and aesthetic outcome. For patients with an increased risk of needing postmastectomy radiation, "delayed-immediate" reconstruction, which involves placing a tissue expander at the time of mastectomy and awaiting pathology results to determine the need for radiation and guide reconstruction scheduling, is a viable approach. Thorough and informed physician counseling about the pros and cons of these options is critical for all women undergoing mastectomy.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Radiotherapy, Adjuvant; Surgical Flaps; Time Factors
PubMed: 18457195
DOI: 10.3949/ccjm.75.suppl_1.s30 -
Breast (Edinburgh, Scotland) Aug 2011Lipotransfer can be considered a technical revolution in plastic surgery and widely performed for esthetic surgery. Recently the lipofilling has been indicated in breast... (Review)
Review
Lipotransfer can be considered a technical revolution in plastic surgery and widely performed for esthetic surgery. Recently the lipofilling has been indicated in breast reconstruction and deformity correction after breast conservative treatment. However, there is lack of understanding concerning the interactions between the potential tumor beds and the lipoaspirates grafts. Current literature underlines the efficacy of the technique as well as its safety. Nevertheless, many experimental studies provide data on the endocrine, paracrine, and autocrine activities of the transplanted fat tissues. Adipocyte, pre-adipocyte and progenitor cell secretions can stimulate angiogenesis and cell growth. The "tumor-stroma interaction" can potentially induce cancer reappearance by "fueling" dormant breast cancer cells in tumor bed. There is lack of translational research that proves this concern in clinical aspect. No study on the effects of lipotransfer on human cancer breast cells in vivo is available. We provide direct and indirect effects of lipotransfer in breast cancer patients, highlighting pro and con related issues. To confirm the safety of lipotransfer in breast cancer patients we need clinical studies with control group based on long term follow up.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Neoplasm Recurrence, Local; Postoperative Complications; Risk Factors; Subcutaneous Fat; Women's Health
PubMed: 21295982
DOI: 10.1016/j.breast.2011.01.003 -
Cancer Oct 2022Oncological safety of different types and timings of PMBR after breast cancer remains controversial. Lack of stratified risk assessment in literature makes current... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Oncological safety of different types and timings of PMBR after breast cancer remains controversial. Lack of stratified risk assessment in literature makes current clinical and shared decision-making complex. This is the first systematic review and meta-analysis to evaluate differences in oncological outcomes after immediate versus delayed postmastectomy breast reconstruction (PMBR) for autologous and implant-based PMBR separately.
METHODS
A systematic literature search was performed in MEDLINE, Cochrane Library, and Embase. The Cochrane Collaboration Handbook and Meta-analysis Of Observational Studies in Epidemiology checklist were followed for data abstraction. Variability in point estimates attributable to heterogeneity was assessed using I -statistic. (Loco)regional breast cancer recurrence rates, distant metastasis rates, and overall breast cancer recurrence rates were pooled in generalized linear mixed models using random effects.
RESULTS
Fifty-five studies, evaluating 14,217 patients, were included. When comparing immediate versus delayed autologous PMBR, weighted average proportions were: 0.03 (95% confidence interval [CI], 0.02-0.03) versus 0.02 (95% CI, 0.01-0.04), respectively, for local recurrences, 0.02 (95% CI, 0.01-0.03) versus 0.02 (95% CI, 0.01-0.03) for regional recurrences, and 0.04 (95% CI, 0.03-0.06) versus 0.01 (95% CI, 0.00-0.03) for locoregional recurrences. No statistically significant differences in weighted average proportions for local, regional and locoregional recurrence rates were observed between immediate and delayed autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrences after autologous PMBR, and of all outcome measures after implant-based PMBR.
CONCLUSIONS
Delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR. This study highlights the paucity of strong evidence on breast cancer recurrence after specific types and timings of PMBR.
LAY SUMMERY
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial. Lack of stratified risk assessment in literature makes clinical and shared decision-making complex. This meta-analysis showed that delayed autologous PMBR leads to similar (loco)regional recurrence rates as immediate autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrence after autologous PMBR, and of all outcome measures after implant-based PMBR. Based on current evidence, oncological concerns do not seem a valid reason to withhold patients from certain reconstructive timings or techniques, and patients should equally be offered all reconstructive options they technically qualify for.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Neoplasm Recurrence, Local; Transplantation, Autologous
PubMed: 35894936
DOI: 10.1002/cncr.34393 -
Aesthetic Plastic Surgery Jun 2023Because of poor knowledge of risks and benefits, prophylactic explantation of high BIA-ALCL risk breast implant (BI) is not indicated. Several surgical risks have been... (Review)
Review
BACKGROUND
Because of poor knowledge of risks and benefits, prophylactic explantation of high BIA-ALCL risk breast implant (BI) is not indicated. Several surgical risks have been associated with BI surgery, with mortality being the most frightening. Primary aim of this study is to assess mortality rate in patients undergoing breast implant surgery for aesthetic or reconstructive indication.
MATERIALS AND METHODS
In this retrospective observational cohort study, Breast Implant Surgery Mortality rate (BISM) was calculated as the perioperative mortality rate among 99,690 patients who underwent BI surgery for oncologic and non-oncologic indications. Mean age at first implant placement (A1P), implant lifespan (IL), and women's life expectancy (WLE) were obtained from a literature review and population database.
RESULTS
BISM rate was 0, and mean A1P was 34 years for breast augmentation, and 50 years for breast reconstruction. Regardless of indication, overall mean A1P can be presumed to be 39 years, while mean BIL was estimated as 9 years and WLE as 85 years.
CONCLUSION
This study first showed that the BISM risk is 0. This information, and the knowledge that BI patients will undergo one or more revisional procedures if not explantation during their lifetime, may help surgeons in the decision-making process of a pre-emptive substitution or explant in patients at high risk of BIA-ALCL. Our recommendation is that patients with existing macrotextured implants do have a relative indication for explantation and total capsulectomy. The final decision should be shared between patient and surgeon following an evaluation of benefits, surgical risks and comorbidities.
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; Female; Breast Implants; Retrospective Studies; Treatment Outcome; Breast Implantation; Mammaplasty; Lymphoma, Large-Cell, Anaplastic; Breast Neoplasms; Observational Studies as Topic
PubMed: 36376583
DOI: 10.1007/s00266-022-03138-5 -
Journal of Plastic, Reconstructive &... Apr 2022Breast cancer is the most common cancer in females worldwide. One option for total breast reconstruction following total breast amputation is autologous fat transfer... (Review)
Review
BACKGROUND
Breast cancer is the most common cancer in females worldwide. One option for total breast reconstruction following total breast amputation is autologous fat transfer (AFT). However, this is still an upcoming reconstruction technique, and little is known about the donor site complications and their influence on the patient's overall satisfaction.
OBJECTIVES
This systematic review aims to review the current literature regarding donor site complications and donor site satisfaction following AFT for total breast reconstruction.
SEARCH METHODS
A literature search was performed in PubMed, Web of Science, Embase, Cochrane, TRIP pro, and Prospero. All published original literature reporting on complications or satisfaction at the donor site in patients who underwent liposuction, followed by high-volume lipofilling was considered.
MAIN RESULTS
This systematic review resulted in the inclusion of 21 cohort studies, consisting of 2241 participants. None of the studies reported donor site satisfaction scores of any kind. The most frequently reported donor site complication was ecchymosis (268 cases), followed by pain (122 cases), haematoma (58 cases), irregularities (12 cases), burns (four cases), and infection (three cases). Reports on follow-up and management of donor site complications were generally lacking.
AUTHOR'S CONCLUSIONS
Results regarding the donor site are inconclusive. Pre-specified complications, a standardized manner of reporting, long-term follow-up, and patient-reported outcome measures are lacking in most of the studies. The impact of the donor site on quality of life after autologous fat grafting in breast reconstruction remains a blind spot. PROSPERO registration number: CRD42020222870.
Topics: Adipose Tissue; Breast Neoplasms; Female; Humans; Mammaplasty; Personal Satisfaction; Quality of Life; Transplantation, Autologous
PubMed: 35165073
DOI: 10.1016/j.bjps.2022.01.029 -
British Journal of Hospital Medicine... Mar 2020In the field of breast reconstruction, products and techniques are continuing to evolve to ensure good clinical and quality outcomes. This article reviews the published... (Review)
Review
In the field of breast reconstruction, products and techniques are continuing to evolve to ensure good clinical and quality outcomes. This article reviews the published literature regarding the use of fetal bovine-derived acellular dermal matrix (SurgiMend, SurgiMend PRS and SurgiMend PRS meshed), focusing on safety, clinical outcomes and surgical techniques.
Topics: Acellular Dermis; Animals; Cattle; Female; Humans; Mammaplasty; Postoperative Complications; Risk Factors
PubMed: 32240008
DOI: 10.12968/hmed.2018.0428c -
Cancer Control : Journal of the Moffitt... 2001The techniques of breast reconstruction have evolved and matured over the past 25 years. Recent studies have proven the benefit of breast reconstruction for breast... (Review)
Review
BACKGROUND
The techniques of breast reconstruction have evolved and matured over the past 25 years. Recent studies have proven the benefit of breast reconstruction for breast cancer patients.
METHODS
The authors reviewed the recent literature on the techniques of breast reconstruction and the effects of reconstruction on patients following surgery for breast cancer. The findings in recent studies are correlated with the experience of the authors.
RESULTS
A better understanding has been gained regarding surgical techniques of breast reconstruction as well as the proper indications for the various methods. The criteria of patient benefit have been defined by recent long-term studies.
CONCLUSIONS
Breast reconstruction following mastectomy has been proven to be a safe and beneficial procedure.
Topics: Breast; Breast Implants; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Time Factors; Transplantation, Autologous
PubMed: 11579338
DOI: 10.1177/107327480100800505