Integration of Plastic Surgery in the Course of Breast-Conserving Surgery for Cancer to Improve Cosmetic Results and Radicality of Tumor Excision

1998 ◽  
pp. 202-211 ◽  
Author(s):  
J.-Y. Petit ◽  
M. Rietjens ◽  
C. Garusi ◽  
M. Greuze ◽  
C. Perry
Keyword(s):  
Plastic Surgery ◽  
Breast Conserving Surgery ◽  
Tumor Excision ◽  
Cosmetic Results

scholarly journals Umbilical Reconstruction with Double Opposing Semilunar Flap, an Appealing Results

2021 ◽  
Vol 3 (1) ◽  
pp. 11
Author(s):  
Arif Rahmat Muharram ◽  
Beta Subakti Nata'atmadja ◽  
Agus Santoso Budi ◽  
Lobredia Zarasade
Keyword(s):  
Plastic Surgery ◽  
Psychological Trauma ◽  
Technical Detail ◽  
Abdominal Tumor ◽  
Postoperative Result ◽  
Tumor Excision ◽  
Advantages And Disadvantages ◽  
Aesthetic Appearance ◽  
Umbilical Reconstruction ◽  
Umbilical Endometriosis

Umbilical loss is not a common problem encountered in plastic surgery routine cases. The absence of umbilicus will cause significant effect in total aesthetic appearance of the abdomen, thus making it an essential part of anatomy landmark. Congenital defect, oncologic and abdominoplasty complication are the most often causes, and tremendous psychological trauma will cause patient to seek help. There are many proposed technique for such reconstruction, based on original scar or wound and final expected shape, of course with their advantages and disadvantages. We used a double opposing semilunar flap for our cases. Along with its technical detail, we will present three cases comprises of the defect after omphalocele scar removal, umbilical endometriosis excision and postcentral abdominal tumor excision. Reports will be presented with preoperative dan postoperative result.

scholarly journals Retrospective review of 108 breast reconstructions using the round block technique after breast-conserving surgery: Indications, complications, and outcomes

2020 ◽  
Vol 47 (6) ◽  
pp. 574-582
Author(s):  
Seok Kyung In ◽  
Yoon Soo Kim ◽  
Ho Sung Kim ◽  
Jin Hyung Park ◽  
Hong Il Kim ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Tumor Volume ◽  
Volume Ratio ◽  
Breast Conserving Surgery ◽  
Tumor Location ◽  
Breast Volume ◽  
Cosmetic Results ◽  
Major Complications ◽  
Resected Tumor ◽  
Good Cosmetic

Background Several oncoplastic approaches have been implemented in recent years to enhance cosmetic results and to reduce complications. The round block technique is a volume displacement technique for breast reconstruction after breast-conserving surgery (BCS). However, its indications are currently limited according to tumor location, and its cosmetic results and complications have not been clearly established. We hypothesized that the round block technique could produce favorable cosmetic results without major complications regardless of tumor location or nipple-tumor distance, below a certain resected tumor volume and tumor-breast volume ratio.Methods All breast reconstructions using the round block technique after BCS were included in this analysis. Patients’ data were reviewed retrospectively to investigate complications during follow-up, and clinical photos were used to evaluate cosmetic results. The relationships of tumor location, nipple-tumor distance, tumor volume, and the tumor-breast volume ratio with cosmetic results were investigated.Results In total, 108 breasts were reconstructed. The mean resected tumor volume was 30.2±15.0 mL. The cosmetic score was 4.5±0.6 out of 5. Tumor location, nipple-tumor distance, tumor volume, tumor-breast volume ratio, radiotherapy, and chemotherapy had no significant effects on cosmetic results or complications. There were no major complications requiring reoperation.Conclusions Breast reconstruction using the round block technique after BCS can lead to good cosmetic results without major complications regardless of the tumor location, nipple-tumor distance, radiotherapy, or chemotherapy. Below the maximum tumor volume (79.2 mL) and the maximum tumor-breast volume ratio (14%), favorable results were consistently obtained.

Assessing cosmetic results after breast conserving surgery

2014 ◽  
Vol 110 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Maria João Cardoso ◽  
Helder Oliveira ◽  
Jaime Cardoso
Keyword(s):  
Breast Conserving Surgery ◽  
Cosmetic Results

scholarly journals Influence of Surgical Technique on Mastectomy and Reexcision Rates in Breast-Conserving Therapy for Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Alison Unzeitig ◽  
Anne Kobbermann ◽  
Xian-Jin Xie ◽  
Jingsheng Yan ◽  
David Euhus ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Surgical Technique ◽  
Neoadjuvant Chemotherapy ◽  
Breast Conserving Surgery ◽  
Breast Conserving Therapy ◽  
Partial Mastectomy ◽  
Total Mastectomy ◽  
Tumor Excision ◽  
Ultrasound Localization ◽  
Intraductal Component

Introduction. Breast conserving surgery (BCS) requires tumor excision with negative margins. Reexcision rates of 30–50% are reported. Ultrasound localization, intraoperative margin pathology, and specimen mammography have reduced reexcisions, but require new equipment. Cavity shave margin (CSM) is a technique, utilizing existing equipment, that potentially reduces reexcision. This study evaluates CSM reexcision impact.Methods. 522 cancers treated with BCS were reviewed. Patients underwent standard partial mastectomy (SPM) or CSM. Data collected included demographics, pathology, and treatments.Results. 455 SPMs were compared to 67 CSMs. Analysis revealed no differences in pathology, intraductal component, or neoadjuvant chemotherapy. Overall reexcision rate = 43%. Most reexcisions were performed for DCIS at margin. SPMs underwent 213 reexcisions (46.8%), versus 16/67 (23.9%) CSMs (P= 0.0003). Total mastectomy as definitive procedure was performed after more SPMs (P= 0.009). Multivariate analysis revealed CSM, % DCIS, tumor size, and race to influence reexcisions.Conclusions. CSM is a technique that reduces reexcisions and mastectomy rates.

scholarly journals Lipofilling after breast conserving surgery: a plastic surgery perspective

Gland Surgery ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 617-619
Author(s):  
Melisa D. Granoff ◽  
Lifei Guo ◽  
Dhruv Singhal
Keyword(s):  
Plastic Surgery ◽  
Breast Conserving Surgery

Repair of the Pixie Ear Deformity with Modified V to Y Plasty during Rhytidectomy

2007 ◽  
Vol 24 (3) ◽  
pp. 146-149
Author(s):  
Achih H. Chen ◽  
Ashli K. O'Rourke ◽  
J. Garrett Harper ◽  
Frank M. Kamer
Keyword(s):  
Plastic Surgery ◽  
Advancement Flap ◽  
Facial Plastic Surgery ◽  
Cosmetic Results ◽  
Skin Tension ◽  
Ear Deformity ◽  
Facial Plastic ◽  
Skin Excision ◽  
Excessive Skin

Introduction: The “pixie ear,” an attached, tapering, inferiorly displaced ear lobule may be congenital or iatrogenic. As a postrhytidectomy complication, the pixie ear deformity is the hallmark of excessive skin tension and a telltale sign of surgery. It is often the result of excessive skin excision or anchoring of the skin to the ear lobule causing it to become displaced in an anterio-inferior direction with elongation and obliteration of the free-hanging edge. Methods: Described is a method of correction useful in addressing both congenital and iatrogenic pixie ear deformities during rhytidectomy that uses a modified V to Y advancement flap where the advanced “V” portion is excised with the redundant skin and the vertical portion of the “Y” is hidden along the contour of the newly created lobule. Results: This technique, used in every patient presenting for rhytidectomy from July 1, 2003, to June 30, 2007, with iatrogenic or congenital pixie ear deformity (n > 30 at the Lasky Clinic and the Georgia Center for Facial Plastic Surgery) results in restoration of the natural, rounded, free border of the ear lobule, while avoiding any conspicuous skin incisions beyond that of the standard rhytidectomy. Conclusions: This method for correcting the pixie ear deformity is easily incorporated into the rhytidectomy and yields excellent cosmetic results. It is useful in correcting iatrogenic pixie ear during revision rhytidectomy or in correcting congenital pixie ear during primary rhytidectomy.

scholarly journals Burow’s triangle advancement flap: a reliabletool on oncoplastic breast-conserving surgery

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Jaime Letzkus ◽  
Maria José Del Río ◽  
Carlos Rencoret ◽  
Alejandro Belmar ◽  
Galina Ivanova ◽  
...  
Keyword(s):  
Wound Dehiscence ◽  
Breast Tumors ◽  
Conservative Surgery ◽  
Breast Conserving Surgery ◽  
Advancement Flap ◽  
Complication Rates ◽  
Cosmetic Results ◽  
Areola Complex ◽  
Good Cosmetic ◽  
Breast Weight

Oncoplastic techniques in breast cancer treatment allow increasing indications of breast-conserving surgery and improving cosmetic results. Breast tumors located at the superior edge of the upper quadrant or at the upper inner quadrant represent a challenge for conservative surgery due to insufficient breast thickness and risk of skin involvement. We present a modified Burow's triangle advancement flap for breast-conserving surgery in patients with breast tumors at these locations. This retrospective observational study analyzed 8 out of 213 patients submitted to major oncoplastic breast procedures, who underwent breast-conserving surgery with matrix rotation mammaplasty, using a modified Burow's triangle advancement flap. All patients were treated in public and private health systems in Santiago, Chile. The median age at diagnosis was 47 years. The average initial tumor size was 5.9 cm, and the mean excised breast weight was 117 g. Patients required neither symmetrization nor displacement of the nipple-areola complex. Only one patient had a minor complication (wound dehiscence). During follow-up, no local recurrences were reported. We conclude that the modified Burow's triangle advancement flap is a safe and effective technique to manage tumors at this complex location. It provides adequate oncological margins, good cosmetic results, and contralateral symmetry, with complication rates similar to those of standard conservative surgery.

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