scholarly journals Principles of surgical treatment of congenital, developmental and acquired female breast asymmetries

2010 ◽  
Vol 67 (4) ◽  
pp. 313-320 ◽  
Author(s):  
Marijan Novakovic ◽  
Marija Lukac ◽  
Jefta Kozarski ◽  
Nenad Stepic ◽  
Boban Djordjevic ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Surgical Procedures ◽  
Normal Female ◽  
Augmentation Mammoplasty ◽  
Breast Asymmetry ◽  
Military Medical Academy ◽  
Female Breast ◽  
Areola Complex ◽  
Breast Asymmetries ◽  
The Difference

Background/Aim. There is a natural asymmetry in normal female brests. When the difference in the shape, size or position of the breast and nipple-areola complex is visible, surgical correction is the only treatment option and presents one of the greatest challenges for a plastic surgeon. Based on the Nahai classification presented in details, the aim of the study was to present the possibilities of plastic surgery to correct primary (congenital), secondary (developmental) and tertiary (acquired) brest asymmetries. Methods. We conducted a retrospective analysis of female breast asymmetry surgeries performed in the Clinic for Plastic Surgery and Burns, Military Medical Academy (MMA), Belgrade over the last seven years (January 2002 - January 2009). Results. During the above mentioned period, 82 female patients, 18 - 65 years of age, underwent surgery for breast asymmetry. The most frequent asymmetries were developmental, 'pubertal' (n = 43); acquired asymmetries as a consequence of tumor surgery were found in the other 22 patients, while 7 patients were diagnosed with primary asymmetries such as congenital chest-wall asymmetry (Sy. Poland), accessory and tuberous breasts. All patients underwent preoperative ultrasound examination, while hormone status was determined in those with developmental, 'pubertal' asymmetries. The selection of surgical procedure for correction of breast asymmetry depended upon clinical examination findings and patient's wish relating to the shape and size of the breasts. The most of breast asymmetries were corrected by a combination of surgical procedures including primary and secondary reconstruction, reduction, suspension or augmentation mammoplasty. Having combined different surgical procedures, we managed to achieve satisfactory results. The hypertrophic scar formation after reduction mamoplasty was seen in some cases, however, they caused no significant patient's discomfort. Conclusion. Application of plastic, reconstructive and aesthetic surgical principles can considerably contribute to achieving excellent results in corrective surgery for breast asymmetries. In addition to most suitable breast asymmetry surgical procedures choice, motivation of a patient is also very important for achieving satisfactory results.

Methods and importance of volume measurement in reconstructive and aesthetic breast surgery

2014 ◽  
Vol 155 (11) ◽  
pp. 407-413 ◽  
Author(s):  
Csaba Kunos ◽  
Gusztáv Gulyás ◽  
Pál Pesthy ◽  
Eszter Kovács ◽  
Zoltán Mátrai
Keyword(s):  
Magnetic Resonance ◽  
Surgical Planning ◽  
Volume Measurement ◽  
Tumor Removal ◽  
Breast Asymmetry ◽  
Breast Parenchyma ◽  
Implant Selection ◽  
The Difference ◽  
Aesthetic Breast ◽  
Measured Volume

Volume measurment of the breast allows for better surgical planning and implant selection in breast reconstructive and symmetrization procedures. The safety and accuracy of tumor removal, in accordance with oncoplastic principles, may be imporved by knowing the true breast- and breast tumor volume. The authors discuss the methods of volume measurement of the breast and describe the method based on magnetic resonance imaging digital volume measurment in details. The volume of the breast parenchyma and the tumor was determined by processing the diagnostic magnetic resonance scans, and the difference in the volume of the two breasts was measured. Surgery was planned and implant selection was made based on the measured volume details. The authors conclude that digital volume measurement proved to be a valuable tool in preoperative planning of volume reducing mammaplasty, replacement of unknown size implants and in cases when breast asymmetry is treated. Orv. Hetil., 2014, 155(11), 407–413.

scholarly journals Simultaneous Mastopexy Explantation With a Vertical Bipedicle and Novel Open Pattern Marking Technique

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Elliot M Hirsch
Keyword(s):  
Plastic Surgery ◽  
Breast Implant ◽  
Implant Removal ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Depth Analysis ◽  
Safe Technique ◽  
Marking Technique ◽  
Technical Considerations

Abstract There are limited studies in the plastic surgery literature that detail technical considerations in simultaneous breast implant removal and mastopexy procedures. These procedures are difficult, with significant potential for complications and poor cosmesis. The current plastic surgery literature describes a limited number of techniques that address these concerns, virtually all of which are variants of superior or superior medial pedicle vertical pattern mastopexy. This paper details a safe technique for simultaneous explantation and mastopexy with a novel open marking pattern and vertical bipedicle, which can restore breast cosmesis following implant removal. The study will briefly retrospectively review the results of a consecutive series of 86 patients who underwent this procedure from November 2018 to November 2019, with no incidence of partial or total nipple-areola complex necrosis. Thus, the technique is safe and allows the flexibility for intraoperative adjustments that are necessary for these procedures. A future study will conduct a more in-depth analysis of the results. Level of Evidence: 4

Evaluation of the Vertical Movement of Ribeiro’s Dermolipoglandular Mammary Flap One Year After Mammaplasties in Post-Bariatric Patients

2019 ◽  
Vol 40 (1) ◽  
pp. NP21-NP31 ◽  
Author(s):  
Rodrigo P Sizenando ◽  
Marco Túlio C Diniz ◽  
Paulo Roberto da Costa ◽  
Luiz Gustavo S Manhães
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Plastic Surgery ◽  
Breast Tissue ◽  
Vertical Movement ◽  
Level Of Evidence ◽  
Significance Level ◽  
Areola Complex ◽  
Ptotic Breast ◽  
One Year

Abstract Background In 1971, Ribeiro isolated a segment in the inferior pole of the ptotic breast, nourished by muscular perforating vessels, and moved it cranially to the posterior region of the remaining detached breast tissue, where it was fixed to the pectoral fascia. This maneuver created a flap with autologous implant function, independent from the rest of the breast’s support, that maintained long-term mammary projection. Objectives The objectives of this study were to measure the vertical movement of this flap 1 year after mammaplasty and to evaluate the factors involved. Methods The sample included 13 patients who had previously undergone bariatric surgery. The position of a titanium marker attached to the Ribeiro flap was compared on chest radiographs taken 1 day and 1 year after the mammaplasty. The significance level was set at 5%. Results All of the titanium markers moved 0.6 cm to 4.1 cm caudally during the study period (average, 2.4 cm ± 1.02 cm). The greater the weight loss after the plastic surgery, the further the marker’s descent. Weight loss between bariatric surgery and plastic surgery, the vertical dimension of the ptotic breast tissue immediately before plastic surgery, the vertical extent of the nipple-areola complex elevation during mammaplasty, the Ribeiro flap thickness and volume, and the breast volume after mammaplasty were not associated with the vertical movement of the flap. Conclusions The Ribeiro flap employed in mammaplasty of patients who previously underwent bariatric surgery undergoes ptosis that is exacerbated by weight loss after mammaplasty. Level of Evidence: 4

scholarly journals Plastic surgery in the treatment of primary melanoma of the skin

2003 ◽  
Vol 60 (4) ◽  
pp. 427-433 ◽  
Author(s):  
Ljubomir Panajotovic ◽  
Jefta Kozarski ◽  
Snezana Krtinic ◽  
Bojan Stanojevic
Keyword(s):  
Plastic Surgery ◽  
Primary Tumor ◽  
Size Structure ◽  
Primary Melanoma ◽  
Radical Excision ◽  
Reconstructive Procedures ◽  
Military Medical Academy ◽  
Margins Of Excision ◽  
Surgical Methods ◽  
Melanoma Classification

Surgery is still the most effective treatment modality of skin melanoma. The margins of excision are determined by the thickness of primary tumor. From January 1999 to December 2001, 99 patients (57 male and 42 female, of the average age 55), were surgically treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy. The most usual localization of the primary tumor was the back (23.23%), followed by the forearm, and the lower leg. Regarding the clinical type of the melanoma, nodular melanoma dominated (62.62%). Microscopic staging of the melanoma (classification according to Clark and Breslow), showed that the majority of patients already suffered from the advanced primary disease, which called for radical excision and the choice of reconstructive methods in the closure of post-excision defects. The reconstructive plastic surgical methods enabled the closure of post-excision tissue defects, regardless of their size, structure, and localization. During the closure of post-excision defects, direct wound closure or split skin draft was performed in 76.76% of patients. Flaps were applied in 19.19% of patients with the primary melanoma of the head, face foot, and hand. The sufficiency of the available reconstructive procedures makes plastic surgery irreplaceable in the surgical treatment of the primary melanoma of the skin.

scholarly journals Surgical Procedures for Neuroendocrine Neoplasms of the Appendix: A Consensus Guideline Review

2017 ◽  
Vol 10 (2) ◽  
pp. 87-89
Author(s):  
Paulina Tr. Vladova ◽  
Sergey D. Iliev ◽  
Savelina L. Popovska
Keyword(s):  
Surgical Procedures ◽  
Surgical Approach ◽  
Survival Rates ◽  
Right Hemicolectomy ◽  
Neuroendocrine Neoplasms ◽  
Consensus Guideline ◽  
Surgical Interventions ◽  
Proliferation Activity ◽  
The Difference ◽  
Well Differentiated

Summary According to the consensus and the recommendations of the European Neuroendocrine Tumor Society (ENETS), the frequency of appendicular neuroendocrine tumors (NETs) is 0.15-0.6/100 000 a year. They are found a little more often in women aged between 40 and 50. Neuroendocrine neoplasms of the appendix are about 30 to 80% of all appendicular tumors. Their evolution is usually asymptomatic. They are diagnosed accidentally during a conventional or laparoscopic appendectomy. In the past, the surgical approach used to depend on the localization of the tumor. Currently, its localization is not a significant factor in the choice of a surgical approach. Our purpose wass to present the consensus guideline and the recommendations of ENETS 2017 for surgical procedures in neuroendocrine neoplasms of the appendix and analyze the difference in the survival rate in different surgical interventions. The literature overview includes studies on surgical treatment of neuroendocrine neoplasms of the appendix and takes into consideration the last consensus guideline of ENETS 2017 on the topic. ENETS recommends a simple appendectomy in well- differentiated appendix tumors smaller than 2 cm, regardless of their localization. Right hemicolectomy is performed for in tumors sized between 1 cm and 2 cm with positive resection lines, with deep mesoappendiceal invasion, high proliferation activity (G2) and vascular invasion. For tumors over larger than 2 cm – right hemicolectomy is recommended. Although current studies have pointed out no significant differences in survival rates between appendectomy for neuroendocrine neoplasms of the appendix and right hemicolectomy, ENETS 2017 suggests that the latest consensus guidelines should be followed.

The cutaneous innervation of the female breast and nipple-areola complex: implications for surgery

1997 ◽  
Vol 50 (4) ◽  
pp. 249-259 ◽  
Author(s):  
J.J.P. Jaspars ◽  
A.N. Posma ◽  
A.A.H. van Immerseel ◽  
A.C. Gittenberger-de Groot
Keyword(s):  
Nipple Areola Complex ◽  
Female Breast ◽  
Areola Complex ◽  
Cutaneous Innervation

The Normal Female Breast

2013 ◽  
pp. 1-7 ◽  
Author(s):  
Catherine N. Chinyama
Keyword(s):  
Normal Female ◽  
Female Breast

Prophylactic Surgical Procedures in Plastic Surgery

2021 ◽  
pp. 325-358
Author(s):  
Ömer Faruk Dilek ◽  
Fuat Uslusoy ◽  
Mustafa Asım Aydın
Keyword(s):  
Plastic Surgery ◽  
Surgical Procedures ◽  
Prophylactic Surgical Procedures

scholarly journals Midazolam for the Intravenous Induction of Anaesthesia in Children

1982 ◽  
Vol 10 (4) ◽  
pp. 340-343 ◽  
Author(s):  
A. M. Holloway ◽  
D. G. Jordaan ◽  
J. G. Brock-Utne
Keyword(s):  
Surgical Procedures ◽  
Induction Time ◽  
Induction Agent ◽  
Anaesthetic Induction ◽  
Reasonable Alternative ◽  
Successful Induction ◽  
Intravenous Anaesthetic ◽  
The Difference ◽  
Minor Operations ◽  
Induction Of Anaesthesia

Midazolam was compared with thiopentone as an intravenous anaesthetic induction agent in children between four and twelve years of age undergoing elective minor surgical procedures. Successful induction of anaesthesia was achieved in both groups of patients. With midazolam induction time was longer than with thiopentone, but the difference was not statistically significant. The incidence of apnoea was greater with thiopentone, but not significantly so. It is concluded that midazolam is effective and safe, and could prove a reasonable alternative to thiopentone as an intravenous induction agent in children undergoing elective minor operations.

Sign in / Sign up

Export Citation Format

Share Document