scholarly journals The “Shirt Pocket” Technique—An Alternative for Augmentation-Mastopexy

2021 ◽  
Vol 54 (03) ◽  
pp. 362-366
Author(s):  
Marcus Vinícius Jardini Barbosa ◽  
Paulo Henrique Costa de Souza ◽  
Fábio Xerfan Nahas ◽  
Lydia Masako Ferreira
Keyword(s):  
Postoperative Period ◽  
Breast Implant ◽  
Early Recurrence ◽  
Postoperative Results ◽  
Breast Ptosis ◽  
Inferior Pole ◽  
Dual Plane ◽  
Safe Option ◽  
Augmentation Mastopexy

AbstractAugmentation-mastopexy is a frequent procedure with high rates of early recurrence of breast ptosis, mainly after subglandular approach. The dual-plane techniques, based on the cranial dissection of the pectoralis, is the most used, but this plane does not cover the inferior pole of the breast. Then, the possibility of a downward dissection of the muscle seems to be more reasonable to retain the implant and improve postoperative results. This study aimed to review the anatomy of the pectoralis in cadavers and the use of its downward dissection to create a pocket for breast implant as a “shirt pocket.” This maneuver was associated with a superior-based dermoglandular flap to overprotect the inferior pole. No complications were related in the postoperative period. The anatomic review showed that the “shirt pocket” is a safe option if done carefully. The technique demonstrated to be feasible and seemed to be effective, being another alternative to prevent early recurrence of breast ptosis in these procedures.

Single-Stage Augmentation Mastopexy With Composite Reverse Inferior Muscle Sling Technique for Autologous Reinforcement of the Inferior Pole: Technical Refinements and Outcomes

2019 ◽  
Author(s):  
Alexandre Mendonça Munhoz ◽  
Ary Marques Filho ◽  
Orlando Ferrari
Keyword(s):  
Three Dimensional ◽  
Single Stage ◽  
Complication Rates ◽  
Lower Pole ◽  
Breast Ptosis ◽  
Common Procedure ◽  
Inferior Pole ◽  
Augmentation Mastopexy

Abstract Background Single-stage augmentation mastopexy (SAM) is a common procedure, but revision rates are high. Muscle slings have been used in SAM, but despite satisfactory outcomes, most studies in the literature do not contain objective or accurate measurements of implant/breast position. This article describes a surgical technique for SAM using a composite reverse inferior muscle sling (CRIMS). Objectives To assess outcomes from primary SAM procedures using the CRIMS technique in a cohort of patients operated on by a single surgeon. Methods Thirty-two patients (60 breasts) with a mean age of 43.1 ± 6.8 years underwent primary CRIMS mastopexy to treat severe ptosis (grade III–IV) in 25 patients (78.1%). The average implant volume was 255 cc (range, 215-335 cc). Three-dimensional imaging obtained from the Divina scanner system was used to evaluate lower pole stretch and lower pole arc, and to determine long-term ptosis. Results Four cases of complications were observed in 3 patients (9.3%): minor dehiscence in 2 and capsular contraction in 1, during a mean follow-up of 42 months. The value for lower pole stretch was 5.5% (p <0.0001) between 10 days and 1 year, with the majority occurring early in the first 6 months, indicating that lower pole arc remains steady during the last months of follow-up. Conclusions Advances in techniques have led to improvements in aesthetic outcomes following SAM, and CRIMS can play a useful role. Our results show this procedure to be suitable for patients with breast ptosis, with acceptable complication rates and the added bonus of implant stabilization within the pocket.

Modified Breast Band Improving the Postoperative Breast Augmentation and Reconstructive Experience

2021 ◽  
pp. 074880682110327
Author(s):  
Arian Mowlavi ◽  
Bryce Bash ◽  
Shea Skenderian ◽  
Zachary Sin
Keyword(s):  
Postoperative Period ◽  
Breast Augmentation ◽  
Breast Implant ◽  
Early Postoperative Period ◽  
Common Complication ◽  
Reconstructive Procedures ◽  
Implant Position ◽  
Time Period ◽  
To Receive

Superior displacement of implants is a common complication in the early postoperative period following breast augmentation surgery. Postoperative breast bands are used during the first 4 weeks to optimize breast implant position following breast augmentation and reconstructive procedures. Although currently available breast bands are effective in maintaining implants in an inferior position, they have been observed to irritate the armpit region. We hypothesized that a modified breast band geometry with cut outs to accommodate the armpit region would provide equal maintenance of desired implant position while providing improved postoperative comfort. Forty patients who underwent breast augmentation and/or reconstruction were randomly assigned to receive either the traditional breast band or the modified cut out designed breast band following surgery for 4 weeks. Patients rated their breast bands on a 1 to 10 scale regarding (1) comfort, (2) appearance, and (3) overall satisfaction at their routine postoperative visits at 1, 2, and 4 weeks following surgery. The modified breast band scored higher for all factors at 1, 2, and 4 weeks following surgery. The traditional band demonstrated decreasing scores for comfort and overall satisfaction when compared at 4 weeks versus 1 week. There was no change in the modified breast band scores for comfort, appearance, nor overall satisfaction over the same time period. This study of 40 patients found that the modified band provides equally effective maintenance of implants in a desired position without compromising comfort and appearance. Patients who used the modified band had a better experience with the band comfort, appearance, and overall satisfaction in comparison to the traditional band. The higher ratings for the cut out band for comfort, appearance, and overall satisfaction were consistent from week 1 to 4. In contrast, the traditional band not only scored lower in comfort, appearance, and overall satisfaction compared to the modified band but also demonstrated significant decrease in the patients’ ratings for comfort and overall satisfaction for the traditional band from week 1 to 4. This study supports the conclusion that a modified cut out breast band design provides an equally effective maintenance of implants in a desired position without compromising comfort, appearance, and overall satisfaction when compared to the traditional band.

scholarly journals Attachment distribution of pectoral muscle origins identified in dual-plane breast implant insertion

2020 ◽  
Vol 47 (2) ◽  
pp. 160-164
Author(s):  
Su Bong Nam ◽  
Kyung Ho Song ◽  
Jung Yeol Seo ◽  
June Seok Choi ◽  
Tae Seo Park ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Breast Implant ◽  
Pectoralis Major Muscle ◽  
Pectoral Muscle ◽  
Augmentation Mammoplasty ◽  
Dual Plane ◽  
Reconstruction Surgery ◽  
Additional Information ◽  
Implant Placement ◽  
The Right

Background Implant-based dual-plane augmentation mammoplasty requires accurate separation of the pectoralis major muscle (PMM) at its origins. The authors identified the PMM origins during breast reconstruction surgery with the goal of providing additional information on subpectoral implant insertion for reconstructive or aesthetic purposes.Methods This study was conducted on 67 patients who underwent breast reconstruction surgery at the breast center of our hospital between November 2016 and June 2018. In total, 34 left and 39 right hemithoraces were examined. The left and right hemithoraces were each divided into 15 zones to determine the percentage of PMM attachments in each zone. The distribution of PMM origins in each zone was examined to identify any statistically significant differences.Results There were no statistically significant differences in the origins of the PMM between the right and left hemithoraces. The percentage of attachments increased moving from the fourth to the sixth rib and from the lateral to the medial aspect.Conclusions The anatomical findings of this study could be used as a reference for accurate dissection of the origins of the PMM for the preparation of the subpectoral pocket for subpectoral implant placement.

Single Staged Mastopexy With Autologous Fat Grafting: An Alternative to Augmentation Mastopexy With Implants

2019 ◽  
Author(s):  
Jules Walters ◽  
Lynn Bourn ◽  
Oren Tessler ◽  
Charles Patterson ◽  
Kamran Khoobehi
Keyword(s):  
Surgical Site Infections ◽  
Breast Implants ◽  
Fat Grafting ◽  
Level Of Evidence ◽  
Breast Ptosis ◽  
Autologous Fat ◽  
Ptotic Breast ◽  
The Mean ◽  
To Receive ◽  
Augmentation Mastopexy

Abstract Background Improving the ptotic breast with mastopexy and restoring upper pole fullness with augmentation continues to be a challenging issue for plastic surgeons. Autologous fat grating (AFG) for shaping and contouring of implant augmented breasts has shown positive outcomes with few complications. Objectives The objective of this study was to evaluate our experience with combined mastopexy and fat grafting for women with existing breast ptosis who prefer not to receive prosthetic breast implants but do desire volume enhancement. Methods A retrospective review of patients undergoing a single staged mastopexy with AFG, from 2006 to 2017, was performed. Inclusion criteria were women with breast ptosis or tuberous breasts desiring improved breast shape and volume. Patients were excluded if they were undergoing implant removal before the procedure. Clinical aesthetic outcomes were assessed by fellow plastic surgeons according to the Telemark Breast Scoring system. Results A total of 284 breasts, in 140 women, underwent a single staged mastopexy with AFG. The mean amount of fat grafted per breast was 299.4 mL (range, 50-710 mL). There were no surgical site infections, hematomas, or seromas. There were 3 major and 8 minor (0.06%) postoperative breast complications. A total of 13 plastic surgeons, of the 183 invited (7.1%), completed the breast outcomes survey. Regarding each category, there was significant improvement (P ≤ 0.0001) in upper pole fullness, ptosis, overall aesthetics, and symmetry postoperatively. Conclusion AFG combined with mastopexy is not associated with significant postoperative complications and results in excellent breast aesthetic outcomes. Level of Evidence: 4

MULTISPIRAL COMPUTER TOMOGRAPHY IN DIAGNOSTICS OF PATIENTS WITH THE PATHOLOGY OF ASCENDING DEPARTMENT OF THE AORTA IN BEFORE AND POSTOPERATIVE PERIOD

2018 ◽  
pp. 28-35
Author(s):  
E. P. Yasakova ◽  
V. S. Pykhteev ◽  
S. A. Belash ◽  
E. I. Zyablova ◽  
V. A. Porkhanov
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Postoperative Period ◽  
Diagnostic Value ◽  
Ascending Aorta ◽  
Postoperative Results ◽  
Transcatheter Aortic Valve ◽  
Technical Issues

This review presents current information on the diagnosis of patients with pathology of the ascending aorta in the pre and postoperative period using multispiral computed tomography. The authors paid attention to the importance of valuation of the valvular apparatus elements, the geometry of the root of the aorta (effective coaptation height, Henle triangles, aortic regurgitation area, etc.), the features of which are necessary for the surgeon to solve technical issues of the forthcoming operation. A comparison of the diagnostic value of multispiral computed tomography and transthoracic echocardiography with respect to the visualization of valvular structures is shown. The role of multispiral computed tomography in the planning of transcatheter aortic valve replacement and the determination of results after intervention is described. With the help of multispiral computed tomography, assessing the state of the ascending aorta, the aortic root and aortic valve elements, the surgeon has an opportunity to choose the optimal variant of the valve-preserving operation and to evaluate postoperative results in the preoperative period.

scholarly journals Comparison between different methods of breast implant volume choice and degree of postoperative satisfaction

2018 ◽  
Vol 45 (1) ◽  
Author(s):  
RAFAEL DAIBERT DE SOUZA MOTTA ◽  
ANA CLAUDIA WECK ROXO ◽  
FABIO XERFAN NAHAS ◽  
FERNANDO SERRA-GUIMARÃES
Keyword(s):  
Postoperative Period ◽  
Breast Augmentation ◽  
Rio De Janeiro ◽  
Statistical Significance ◽  
Breast Implant ◽  
Augmentation Mammaplasty ◽  
University Hospital ◽  
Surgical Scar ◽  
Significant Difference ◽  
Degree Of Satisfaction

ABSTRACT Objectives: to assess the degree of patient satisfaction after undergoing breast augmentation and compare three different, easy, inexpensive and universal methods of preoperative choice of breast implant volume. Methods: a prospective study was carried out at University Hospital Pedro Ernesto of State University of Rio de Janeiro, in 94 women from Rio de Janeiro, aged 18 to 49 years, submitted to breast augmentation mammaplasty with breast implant due to hypomastia. All implants were textured, with a round base and high projection and were introduced into the retroglandular space through an inframammary access. The patients were divided into three groups: Control, Silicone and MamaSize®, with 44, 25 and 25 patients, respectively. Satisfaction questionnaires were applied in the pre and postoperative periods by the same evaluator, through the visual analogue scale, in which ‘0’ meant very unsatisfied and ‘100’ very satisfied for the four variables: shape, size, symmetry and consistency. The degree of satisfaction with the surgical scar was also assessed in the postoperative period. Results: when the preoperative and postoperative satisfaction levels were compared, there was a difference in all variables for the three groups, with statistical significance. However, when the postoperative data were compared with each other, there was no significant difference. The degree of satisfaction with the surgical scar was high. Conclusion: the augmentation mammaplasty with breast implant had a high index of satisfaction among patients. However, there was no difference in the degree of satisfaction in the postoperative period between the three methodologies of breast volume measurement.

scholarly journals Periareolar augmentation mastopexy: A new approach dealing with the cases as tuberous breasts

2016 ◽  
Vol 49 (02) ◽  
pp. 172-177 ◽  
Author(s):  
Roberto Moltó-García ◽  
María Eloísa Villaverde-Doménech ◽  
Virina González-Alonso ◽  
Francisco Ripoll-Orts ◽  
Eduardo Simon-Sanz
Keyword(s):  
Surgical Technique ◽  
Surgical Approach ◽  
Surgical Techniques ◽  
Inferior Pole ◽  
Malpractice Claims ◽  
One Year ◽  
Periareolar Mastopexy ◽  
Augmentation Mastopexy ◽  
New Surgical Technique

ABSTRACTBackground: Periareolar augmentation mastopexy is one of the most demanded operations at Plastic Surgery clinics. Nevertheless, it is one of the leads of malpractice claims in United States caused by the high patient expectations and the standard surgical techniques which may result in common complications. The aim of this report is to present a new surgical approach to solve these complications. Methods: After establishing a working hypothesis, we performed a revision study of our patients and we came to the following conclusion: in order to perform a periareolar mastopexy for ptosis correction, breast has to be tuberous at any level and to have abnormally short inferior pole. These findings may explain the main complications from periareolar augmentation mastopexy with the standard surgical techniques. Consequently, we started a prospective observational study including 56 patients following a new surgical technique which deals the cases as tuberous breasts. Results: During three years, fifty-six periareolar mastopexies were performed with this new surgical approach with one year follow-up. No major complications were observed and 40 of the patients (71%) described the results as very positive. Conclusion: “If a periareolar mastopexy can be performed, then it must be a tuberous breast”. According to this, a new surgical technique for periareolar augmentation mastopexy has been developed obtaining an improvement in our surgical results and achieving a totally different view on this pathology, which has not been reported in literature yet.

scholarly journals Morphological aspects of tympanic bulla after ventral osteotomy in cats

2009 ◽  
Vol 24 (3) ◽  
pp. 177-182 ◽  
Author(s):  
Adelina Maria da Silva ◽  
Wilson Machado de Souza ◽  
Roberto Gameiro de Carvalho ◽  
Gisele Fabrino Machado ◽  
Silvia Helena Venturoli Perri
Keyword(s):  
Connective Tissue ◽  
Inner Ear ◽  
Postoperative Period ◽  
Osteotomy Site ◽  
Tympanic Cavity ◽  
Postoperative Results ◽  
Open Mouth ◽  
Morphological Aspects ◽  
Adult Cats ◽  
Complete Regeneration

PURPOSE: To evaluate tympanic bulla healing after experimental ventral osteotomy in cats. METHODS: Twenty adult cats were submitted to unilateral ventral bulla osteotomy and divided into two groups: cats of A1 group (n=10) were euthanized at 8 weeks and cats of A2 group (n=10), at 16 weeks postoperative. RESULTS: Signs of Horner's syndrome or damage to the inner ear were not found. Open-mouth radiographs taken in the immediate postoperative showed interruption in the contour of the larger compartment of the operated bulla. The result of Mcnemar'test was significant in A2 group (*p=0.0156). Macroscopic exams revealed that the operated bullae were similar to the normal ones, with preservation of the tympanic cavity. Connective tissue at the osteotomy site of the larger compartment was significantly found in the operated bullae in both groups (McNemar test: A1 p=0.0020*; A2 p=0.0078*). Histomorphometric analyses showed that the connective tissue length at the osteotomy site was shorter in A2 group than in the A1 group (Mann-Whitney test: p=0.0021*). CONCLUSIONS: Experimental ventral osteotomy did not alter significantly the tympanic bulla conformation and complete regeneration of tympanic bulla frequently did not occur before 16 weeks of postoperative period.

scholarly journals Eosinophilic Angiocentric Fibrosis as a Stenosing Lesion in the Subglottis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Ivan Keogh ◽  
Rohana O’Connell ◽  
Sean Hynes ◽  
John Lang
Keyword(s):  
Rare Disease ◽  
Postoperative Period ◽  
Early Recurrence ◽  
Airway Compromise ◽  
Benign Condition ◽  
Subglottic Region ◽  
Laboratory Investigations ◽  
Eosinophilic Angiocentric Fibrosis ◽  
Disease Free

Subglottic Eosinophilic Angiocentric Fibrosis (EAF) is an extremely rare disease of an elusive aetiology. It is chronically progressive benign condition that causes narrowing of the subglottic region leading to dysphonia and airway compromise. The diagnosis is historical and imaging is nonspecific. We report a case xc of 56-year-old lady referred to our institution with globus sensation, hoarseness, and mild stridor. Incidental subglottic mass was found at time of diagnostic microlaryngoscopy and biopsy confirmed subglottic EAF. All laboratory investigations were unremarkable. Lesion was removed with laryngeal microdebrider and three courses of intravenous dexamethasone were administered. Patient’s postoperative period was uneventful and had remained disease free for 1 year. To date, no consensus has been reached on the optimal treatment of subglottic EAF. We recommend regular follow-up to detect early recurrence.

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