scholarly journals Complication after Aquafilling® gel-mediated augmentation mammoplasty—galactocele formation in a lactating woman: a case report and review of literature

2021 ◽  
Author(s):  
Julie Marie Loesch ◽  
Yasemin-Sibel Eniste ◽  
Konstantin J. Dedes ◽  
Heike Frauchiger-Heuer
Keyword(s):  
Breast Augmentation ◽  
Left Breast ◽  
Filler Material ◽  
Silicone Implants ◽  
Augmentation Mammoplasty ◽  
Level Of Evidence ◽  
Adequate Treatment ◽  
Surgical Incision ◽  
Ultrasound Findings ◽  
History Of

AbstractAugmentation mammoplasty using hydrogel fillers such as polyacrylamide gel (PAAG) or Aquafilling® has been performed commonly in some countries as an alternative to breast augmentation with saline or silicone implants. However, the safety of this procedure remains controversial, and many complications associated with the use of large-volume hydrogel injection have been reported in recent years. We present the case of a 33-year-old woman with a history of bilateral Aquafilling® injection augmentation mammoplasty who presented with an enlarged left breast while breastfeeding. Based on the clinical presentation and ultrasound findings, the patient underwent surgical incision as abscess formation caused by infection of the filler material could not be ruled out with certainty. Surgery revealed a galactocele with drainage of large amounts of milky fluid. Remaining filler material was removed as thoroughly as possible, and vacuum assisted wound dressing was performed. Galactocele formation in lactating women is a known complication after injection of hydrogel. Hence, it is important to be familiar with this uncommon but possibly severe complication in order to make an accurate diagnosis and initiate adequate treatment. To that end, it is recommended that patients who underwent Aquafilling® injection for breast augmentation should avoid lactation and that women intending to breastfeed should not undergo augmentation mammoplasty with injection of Aquafilling®.Level of Evidence: Level V, risk / prognostic study

BAMBI: Bilateral Augmentation Mammoplasty by Injection; Breast Augmentation Using Autologous Fat Transplantation: The Controversy and Personal Experience

2009 ◽  
Vol 26 (3) ◽  
pp. 182-188
Author(s):  
Riad Roomi
Keyword(s):  
Breast Augmentation ◽  
Historical Review ◽  
Developed Countries ◽  
Silicone Implants ◽  
Augmentation Mammoplasty ◽  
Autologous Fat ◽  
Autologous Fat Transplantation ◽  
Small Breast ◽  
The Subject ◽  
Indispensable Tool

Introduction: Breast augmentation is one of the most sought after cosmetic surgical procedures in developed countries. It is accepted that augmentation by silicone implants is the gold standard. However, it is also acknowledged that this method is not without problems and complications in the best hands. Historical review shows that many materials were used to augment the breast. Needless to say, the majority of those have failed, and some with catastrophic consequences. Autologous fat, the subject of this article, was introduced in 1987. In most practices, no other alternative to implants is being offered to prospective patients. It is undeniably true that there is a group of patients who are not candidates for augmentation by implants. Among this group are patients who categorically refuse implants for one reason or another. Objective: In our expanding and rapidly advancing specialty, the ability to offer an alternative treatment for any presenting problem is an indispensable tool of our profession. However, when it comes to the small breast problem, the majority of surgeons are unable or unwilling to offer women who seek breast augmentation any alternative to implants. The objective of this article is to prompt an interest for a forum to look at this method more objectively to establish whether it can be approved as an alternative to implants. Materials and Methods: Review of the literature.

Relation Between Post-Augmentation Parenchymal Atrophy and Local Tissue Pressure

2021 ◽  
Author(s):  
João Pontello ◽  
Ana Claudia Roxo ◽  
Maria Lidia Abreu ◽  
Rodrigo Torezani ◽  
Djenane Pamplona
Keyword(s):  
Vascular Tissue ◽  
Breast Implant ◽  
Left Breast ◽  
Volume Reduction ◽  
Silicone Implants ◽  
Augmentation Mammoplasty ◽  
Local Pressure ◽  
Tissue Pressure ◽  
Breast Parenchyma ◽  
Significant Difference

Abstract Background Breast parenchyma interacts dynamically with an inserted implant, which may lead to local atrophy and sensory involvement, changes in vascular tissue and lactation, besides volume reduction over time. The inversely proportional relationship between pressure and volume cannot be stated with certainty, that is, the larger implants having more local pressure would lead to compression, thus leading to atrophy of parenchyma more intensely when compared with smaller implants. The objective of this study was to assess and list breast parenchyma volume changes with different pressure levels due to silicone implants of several sizes. Objectives To list the pressure exerted by silicone implants and the atrophy caused in the breast tissue. Methods Thirty-six women were placed in 3 groups (n=12) and subjected to augmentation mammoplasty in the subglandular plane. The measurement of pressure in millimeters of mercury was done with help of molds with the same base and projection of implants introduced posteriorly. The magnetic resonance imaging was done in all participants in the pre-operative period and at 6 and 12 months after surgery. Results Twelve months after breast implant insertion, the groups had a significant glandular volume reduction (mean 12.97% in the right breast and 12.42% in the left breast). There is a statistically significant difference in the proportions of volume reduction and the pressure levels measured. Conclusions A reduction in breast volume was verified. This reduction is also related to the level of pressure exerted on the implant.

scholarly journals Aspecte morfopatologice si strategii de preventie a contracturii capsulare după augmentarea mamara cu implante

2021 ◽  
Vol 17 (2) ◽  
pp. 91-98
Author(s):  
Nadia Aladari ◽  
Mihaela Perțea ◽  
Camelia Tamas ◽  
Iulia Dabija Olaru ◽  
Madalina Palaghia ◽  
...  
Keyword(s):  
Breast Augmentation ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Silicone Implants ◽  
Textured Surface ◽  
Number Of Factors ◽  
Antibiotic Solution ◽  
History Of ◽  
Inflammatory Drugs ◽  
After Cancer

Breast augmentation with silicone implants is one of the most common procedures performed by plastic surgeons around the world. Capsular contracture is one of the complication in breast augmentation that requires invasive reparation surgery. The inflammatory response to the breast implants appears to be directly associated with capsular contracture. In addition to the type of material (saline vs. silicone) used and it’s texture (smooth vs. textured), a number of factors were detected related to their position and the existence of a history of radiotherapy after cancer treatment for breast cancer. It tries to identify ideal methods to prevent and minimize the risk of developing capsular contracture. Among the methods currently used were described: placement of the implant in the retropectoral plane, dissection of a larger pocket, performing a rigorous hemostasis, use of implants with textured surface, minimizing the exposure time, contact and handling of the implant, irrigation of the pocket with antiseptic solutions (5% betadine) or broad-spectrum antibiotic solution to prevent the infectious process, the use of talc-free gloves, the use of corticosteroids, immuno-modulators and anti-inflammatory drugs.

scholarly journals The Evolution of Breast Implants

2019 ◽  
Vol 33 (04) ◽  
pp. 217-223 ◽  
Author(s):  
Christodoulos Kaoutzanis ◽  
Julian Winocour ◽  
Jacob Unger ◽  
Allen Gabriel ◽  
G. Patrick Maxwell
Keyword(s):  
United States ◽  
Clinical Outcomes ◽  
Breast Augmentation ◽  
Breast Implants ◽  
The United States ◽  
Scientific Data ◽  
Silicone Implants ◽  
Fifth Generation ◽  
History Of ◽  
Aesthetic Procedures

AbstractBreast augmentation remains one of the most commonly performed aesthetic procedures in the United States and worldwide. Throughout the last few decades, the implants used for this procedure have undergone significant advancements, which has allowed surgeons to provide safer and more aesthetically pleasing outcomes. This article discusses the history of breast implants since their invention in 1962. Particular emphasis is given to the evolution of silicone implants with its many challenges, which has resulted in the development of the currently used fourth- and fifth-generation devices. Knowledge of these advances will allow physicians to more critically evaluate their results, and also will encourage them to provide more up-to-date scientific data on these devices to further improve the clinical outcomes of their patients.

scholarly journals Unilateral Orbital Metastasis as the Unique Symptom in the Onset of Breast Cancer in a Postmenopausal Woman: Case Report and Review of the Literature

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 725
Author(s):  
Cristina Marinela Oprean ◽  
Larisa Maria Badau ◽  
Nusa Alina Segarceanu ◽  
Andrei Dorin Ciocoiu ◽  
Ioana Alexandra Rivis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Postmenopausal Woman ◽  
Median Survival ◽  
Stage Iv ◽  
Left Breast ◽  
Pathological Examination ◽  
Adequate Treatment ◽  
Orbital Metastases ◽  
History Of

The orbit represents an unusual metastases site for patients diagnosed with cancer, however, breast cancer is the main cause of metastases at this level. These orbital metastases were discovered in patients with a history of breast cancer as unique or synchronous lesions. We present a rare case of a unique retroocular metastasis as the first initial symptom of a tubulo-lobular mammary carcinoma in a postmenopausal woman. A 57-year-old patient complains of diplopia, diminishing visual acuity, orbital tenderness, slight exophthalmia and ptosis of the left eyelid, with insidious onset. Clinical examination and subsequent investigations revealed a left breast cancer cT2 cN1 pM1 stage IV. Breast conserving surgery was performed on the left breast. Pathological examination with immunohistochemistry staining established the complete diagnostic: pT2pN3aM1 Stage IV breast cancer, luminal B subtype. After two years from the initial breast cancer diagnosis, the patient was diagnosed by the psychiatrist with a depressive disorder and was treated accordingly. Orbital metastases are usually discovered in known breast cancer patients and they are found in the context of a multi-system end-stage disease. Most reports cite that up to 25% of the total orbital metastases cases are discovered before the diagnosis of the primary tumor, as our case did. MRI is the gold standard for evaluating orbital tumors. The ILC histological subtype metastasizes in the orbitals more frequently than invasive ductal carcinoma. The prognosis of patients with orbital metastases is poor. The median survival after diagnosis of orbital metastases from a breast cancer primary is ranging from 22 to 31 months. Overall survival of our patient was 56 months, longer than the median survival reported in literature. Orbital metastases must be taken into account when patients accuse ophthalmologic symptoms even in the absence of a personal history of cancer. Objective examination of every patient that incriminates these types of symptoms is essential, and breast palpation must be made in every clinical setting. Orbital biopsy is necessary for the confirmation of the diagnosis and for an adequate treatment. Although recommendations for management of orbital metastases are controversial, it appears that multidisciplinary treatment of both metastases and primary cancer improves overall survival.

scholarly journals Breast contracture and skin sclerosis following 20 years of polyacrylamide hydrogel migration in a patient with familial vitiligo: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bin Wang ◽  
Jiaming Sun ◽  
Jing Tong
Keyword(s):  
Breast Augmentation ◽  
Rare Case ◽  
Level Of Evidence ◽  
Case Presentation ◽  
Long Term Effect ◽  
Skin Sclerosis ◽  
Patient Reported ◽  
History Of ◽  
The Relationship

Abstract Background Breast augmentation with polyacrylamide gel (PAAG) injection was approved in China in 1998 and later banned in 2006. The ban ensued numerous complaints from patients such as pain, induration, deformation, infection, displacement, and milk deposition associated with PAAG injection. To date, no study has investigated the long-term effect of PAAG migration on autoimmune diseases. Case presentation We report a rare case of a 49-year-old female patient with familial vitiligo who receiving PAAG injection for breast augmentation. The patient reported to have felt persistent movement of PAAG in her thoracoabdominal area for almost 20 years. Furthermore, the PAAG-induced chronic inflammation that aggravated vitiligo, which in turn promoted skin sclerosis. This damaged the breast contracture, increased chest tightness and induced mild breathing problems. Conclusion Here, we present a rare case in which a patient with a family history of vitiligo experienced long-term complications after receiving PAAG injection for breast augmentation. This case highlights the relationship between vitiligo, migration of PAAG and tissue hardening and skin contraction. Level of evidence: Level V

scholarly journals Long Term Rigid Retained Foreign Object After Breast Augmentation: A Case Report and Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Coral Franco ◽  
Anner Moskovitz ◽  
Iuliana Weinstein ◽  
Samuel Kwartin ◽  
Yoram Wolf
Keyword(s):  
Breast Augmentation ◽  
Diagnostic Methods ◽  
Magnetic Resonance Imaging Scan ◽  
Augmentation Mammoplasty ◽  
Foreign Object ◽  
Imaging Studies ◽  
Case Presentation ◽  
History Of ◽  
Surgical Teams

Introduction: Retained foreign object (RFO) is a rare iatrogenic complication. This article presents an unprecedented case of a plastic RFO post-augmentation mammoplasty.Case Presentation: We present the case of a 32-year-old woman, 8 years after breast augmentation surgery, with a 4 year history of a palpable migrating mass in the superior lateral quadrant of her right breast with fluctuating levels of pain. Imaging studies included mammography tests, sonographic examinations, a Magnetic Resonance Imaging scan, and a Computed Tomography scan, all of which did not identify any pathological findings. Exploratory surgery discovered a syringe-tip cover in the implant pocket.Conclusion: Persistent complaints and symptoms accompanied by non-specific imaging studies warrant escalation of diagnostic methods, in line with a high awareness for the possibility of an RFO. As pocket lavage is a common practice in various surgeries, this report can serve as a valuable reminder for surgical teams to account for syringe covers and other disposable items at the end of all operations.

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

scholarly journals Older trauma patients are at high risk of delirium, especially those with underlying dementia or baseline frailty

2021 ◽  
Vol 6 (1) ◽  
pp. e000639
Author(s):  
Danielle Ní Chróinín ◽  
Nevenka Francis ◽  
Pearl Wong ◽  
Yewon David Kim ◽  
Susan Nham ◽  
...  
Keyword(s):  
Older Patients ◽  
Multivariable Analysis ◽  
Primary Outcome Measure ◽  
Hospital Length ◽  
Assessment Tools ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Level Of Evidence ◽  
Increased Risk ◽  
History Of

BackgroundGiven the increasing numbers of older patients presenting with trauma, and the potential influence of delirium on outcomes, we sought to investigate the proportion of such patients who were diagnosed with delirium during their stay—and patient factors associated therewith—and the potential associations between delirium and hospital length of stay (LOS). We hypothesized that delirium would be common, associated with certain patient characteristics, and associated with long hospital LOS (highest quartile).MethodsWe conducted a retrospective observational cohort study of all trauma patients aged ≥65 years presenting in September to October 2019, interrogating medical records and the institutional trauma database. The primary outcome measure was occurrence of delirium.ResultsAmong 99 eligible patients, delirium was common, documented in 23% (23 of 99). On multivariable analysis, adjusting for age, frailty and history of dementia, frailty (OR 4.09, 95% CI 1.08 to 15.53, p=0.04) and dementia (OR 5.23, 95% CI 1.38 to 19.90, p=0.02) were independently associated with likelihood of delirium. Standardized assessment tools were underused, with only 34% (34 of 99) screened within 4 hours of arrival. On univariate logistic regression analysis, having an episode of delirium was associated with long LOS (highest quartile), OR of 5.29 (95% CI 1.92 to 14.56, p<0.001). In the final multivariable model, adjusting for any (non-delirium) in-hospital complication, delirium was independently associated with long LOS (≥16 days; OR 4.81, p=0.005).DiscussionIn this study, delirium was common. History of dementia and baseline frailty were associated with increased risk. Delirium was independently associated with long LOS. However, many patients did not undergo standardized screening at admission. Early identification and targeted management of older patients at risk of delirium may reduce incidence and improve care of this vulnerable cohort. These data are hypothesis generating, but support the need for initiatives which improve delirium care, acknowledging the complex interplay between frailty and other geriatric syndromes in the older trauma patients.Level of evidenceIII.

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

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