Combined Autologous and Prosthetic Breast Reconstruction: Defining the Upper Limits of Safe Expansion in Obesity

Background Combined latissimus dorsi and prosthetic reconstruction is a useful reconstructive option in patients with a history of breast radiation who are not good candidates for abdominally based autologous reconstruction. One difficulty, particularly in obese patients, is that the thickness of the flap can impair port localization, increasing the risk of inadvertent puncture during expansion. The authors sought to investigate the upper limits of tissue thickness at which tissue expansion can be reliably performed. Methods A cadaveric study was designed in which 2 blinded observers attempted to localize the port of a Mentor CPX-4 expander under tissue 1, 2, 3, 4, 5, and 6 cm thick. Thirty attempts were made per tissue thickness. Results For tissue thicknesses of 1 to 4 cm, the success rate was 100% (k = 1). At 5 cm, the success rate decreased to 86.6% (k = 1); at 6 cm, 43.3% (k = 0.85). Point biserial correlation revealed a negative correlation between tissue thickness and accuracy at a thicknesses of greater than 4 cm (r = −0.55, P
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Breast Surgery Source Type: research

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This study aims to directly compare prosthetic and autologous reconstruction in the obese population by evaluating surgical outcomes and patient satisfaction. Methods: In an institutional review board–approved study, a retrospective chart review was conducted on patients with a body mass index of 30.0 kg/m2 or greater who underwent breast cancer reconstruction after mastectomy with either free tissue transfer from the abdomen or prosthetic reconstruction over a 3-year period. The authors identified 96 patients with 141 reconstructions. Demographic, intraoperative, and postoperative variables were collected. All pa...
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Breast: Original Articles Source Type: research
Conclusions Breast reduction reduces or removes disease-associated pain. It improves or normalizes perceived health and psychosocial self-esteem in slightly obese women or women of normal weight with preoperative breast volumes around 1000 mL. Women with higher preoperative breast volumes and longer sternal notch-to-nipple distances appear to be more satisfied with the cosmetic result postoperatively.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Breast Surgery Source Type: research
Conclusions Gender affirmation chest surgery can be safely offered using a drain-free or “masculoplasty” technique. Compared with historical data, the use of progressive tension sutures decreases the incidence of hematoma, the need for acute reoperation, and other complications.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Breast Surgery Source Type: research
In conclusion, our WGCNA analysis identified candidate prognostic biomarkers for further basic and clinical researches. Introduction Breast cancer is a frequently diagnosed malignancy and the leading cause of cancer death among females around the world, accounting for 24% of cancer diagnoses and 15% of cancer deaths in females. According to Global Cancer Statistics 2018, there will be nearly 2.1 million new cases diagnosed globally, with ~62 thousand deaths. The incident rates of breast cancer increased in most developing countries during last decades, resulting from a combination of social and economic factors, incl...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractBackgroundThe evolving conceptualization of the management of surgical pain was a major contributor to the supply of narcotics that led to the opioid crisis. We designed and implemented a breast surgery-specific Enhanced Recovery After Surgery (ERAS) protocol using opioid-sparing techniques to eliminate narcotic prescription at discharge without sacrificing perioperative pain control.MethodsA pilot observational study included patients with and without cancer undergoing lumpectomy. The convenience sample consisted of an ERAS group and a control usual care (UC) group who underwent surgery during the same time period...
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Conclusions For pseudogynecomastia, the treatment algorithm of the Gusenoff classification should be modified and adapted according to our recommendations to achieve more optimal masculine results.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Breast Surgery Source Type: research
Conclusions Liposomal bupivacaine decreases postoperative pain, opioid, and antiemetic use in select patients. Liposomal bupivacaine might not be equally efficacious in pain reduction in obese or postmenopausal women given the theoretical increased absorption by adipose tissue. In addition, liposomal bupivacaine may have a dose-dependent effect, and weight-based dosing should be investigated.
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Breast Surgery Source Type: research
AbstractPurposeAccording to the World Health Organization (WHO), 34.7% of females in the United States are obese (BMI  ≥ 30) in 2014, compared to 32.5% in 2010. The previous research has demonstrated high BMI as an independent risk factor for surgical complications after breast surgery. As more patients become obese, we sought to examine whether increasing obesity had an effect on outcomes of women who underwen t a unilateral mastectomy without breast reconstruction.MethodsThe study reviewed the 2007 –2012 ACS-NSQIP database and identified all patients who underwent a unilateral mastectomy without recons...
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Daniella Day, 23, from Nottingham has a breast deformity that saw her develop one much larger than the other and after being told she was too obese for surgery she dropped five stone in as many months.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
Daniella Day, 23, from Nottingham has a breast deformity that saw her develop one much larger than the other and after being told she was too obese for surgery she dropped five stone in as many months.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
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