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.

Current Scientific Considerations in Regard to Defining a “Silicone Syndrome”/Disease and the Formation of Silica from Silicone

1998 ◽  
Vol 17 (4) ◽  
pp. 449-463 ◽  
Author(s):  
John A. Todhunter ◽  
Michael G. Farrow
Keyword(s):  
Connective Tissue ◽  
Patient Population ◽  
Breast Implant ◽  
Connective Tissue Diseases ◽  
The Body ◽  
Silicone Implants ◽  
Augmentation Mammoplasty ◽  
Patient Case ◽  
Increased Risk ◽  
Epidemiology Studies

Whether the constellation of various symptoms reported in various case-study reports on some patients who have had augmentation mammoplasty with silicone implants reflects a distinct, novel “silicone syndrome”or disease is important to settingproper endpoints for the epidemiological study of this patient population. To date, epidemiology studies on breast implant patients have focused on end-points which are typical of connective tissue disease, rheumatoid disease, and/ or autoimmune disorders. The consensus at this time, as was recently stated in a paper authored by Food and Drug Administration (FDA) personnel, is that the weight of the evidence from existing epidemiology studies is that silicone breast implants do not appreciably, if at all, increase the risk of these types of diseases. Critics of the epidemiology database have countered that had the analysis of association in these studies been done for a “silicone syndrome,” as opposed to the disease types which were analyzed, an association between silicone breast implantation and increased risk of “silicone syndrome” would have been observed. In the present analysis, this question is approached from two directions: First, the available single or multi-patient case reports available in the open literature were evaluated. The objective was to define those symptoms/ complaints that were reported in all studies or in at least 50% of the patients reported and to assign frequency distributions to individual symptoms or complaints reported in breast implant patients presenting for various complaints. By definition, if a “silicone syndrome” exists, then it can only be characterized by those symptoms or complaints which appear with regular frequency in patients so afflicted. Second, the symptoms or complaints which were used as criteria in the existing epidemiology studies were correlated with their frequency of occurrence among single or multi-patient case-reported breast implant patients. The working hypothesis in this present study is that if the number of “silicone syndrome” symptoms or complaints that also are symptoms of the existing epidemiology endpoints is large, then a distinct “silicone syndrome” is not likely to exist, and it can be concluded that existing epidemiology studies have adequately addressed the relevant issues. Also, to the extent that the frequency of symptom occurrence in “silicone syndrome” is similar to the distribution seen for known connective tissue, rheumatoid, and/ or autoimmune diseases, this will then add to the weight of evidence that no distinct “silicone syndrome” needs be postulated. Conversely, if a different set of symptoms or complaints occurs in silicone breast-implanted patients than is seen in patients with connective tissue diseases, this will argue that a distinct syndrome may exist. In the present study, the more recent suggestion that silicone may be broken down to silica in the body, and evidence for and against this suggestion are also discussed. The present analysis does not support the contention that a distinct “silicone syndrome” exists, but does support the contention that the disease endpoints used in existing epidemiology studies are adequate for examining the patient population. Also, consideration of the chemistry of silicone and its potential hydrolysis or oxidative cleavage indicates that if such reactions occur in the body at any significant rate, the product will be silicic acid, a normal and necessary constituent of the body, and not silica (i.e., silicon dioxide).

Prevention of Capsular Contracture with Montelukast After Insertion of Silicone Implants in Rabbits

2016 ◽  
Vol 13 (10) ◽  
pp. 7623-7627
Author(s):  
Zhenyu Jin ◽  
Ki Yong Hong ◽  
Kyung Won Minn ◽  
Hak Chang ◽  
Ung Sik Jin
Keyword(s):  
Breast Implant ◽  
Capsular Contracture ◽  
White Female ◽  
Silicone Implants ◽  
Control Group ◽  
Tissue Samples ◽  
Significant Difference ◽  
Group A ◽  
The Right ◽  
Experimental Group

Capsular contracture is the most common complication after insertion of silicone implants during breast implant surgery. The discovery that myofibroblasts play an important role in the formation of hypertrophic scars led to the development of pharmacological drugs such as zafirlukast, which prevents capsular contracture by resisting the above mechanism. As a result, the author sought to investigate the effect of the anti-leukotriene montelukast on capsular contracture. Ten white female New Zealand rabbits, each weighing approximately 3 kg, were used as subjects. Through bilateral incision of the midback area, the prostheses were inserted on the subpanniculus carnosus plane. Once the silicone prostheses had been inserted, the right implant was injected with 10 mL of montelukast (10 µg/mL), and the left implant was injected with 10 mL of normal saline. Eight weeks after the procedure, the capsular pressure was measured via tonometry using a circular glass piece weighing 42.7 g. The tissue samples were then extracted, and their thicknesses were measured using hematoxylin-eosin stain and Masson trichrome stain. The average pressure was 4.23±0.99 mmHg in the control group and 3.71±0.51 mmHg in the experimental group, a statistically significant difference (p = 0.02). The average capsular thickness was 947.938±300 µm in the control group and 709.672±274 µm in the experimental group, a statistically significant difference (p = 0.028). The author confirmed that montelukast injections during silicone prosthesis insertion decreased the formation of capsular contracture.

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

scholarly journals Application of silicone implants in mammoplasty (literature survey)

2018 ◽  
Vol 26 (1) ◽  
pp. 133-149 ◽  
Author(s):  
Dj. A. Khodjamurodova ◽  
M. S. Saidov ◽  
G. М. Khodjamuradov
Keyword(s):  
Mammary Gland ◽  
Surgical Approach ◽  
Breast Implant ◽  
Breast Implants ◽  
Long Term Results ◽  
Silicone Implants ◽  
Augmentation Mammoplasty ◽  
Advantages And Disadvantages

In the article literature data concerning indications to placement of silicone breast implants in plastic surgery are presented. Peculiarities of preoperative preparation of patients aimed at prevention of postoperative complications are considered. The technique of surgical intervention, advantages and disadvantages of different methods are described. Difference in choice of surgical approach and positioning of implant relative to mammary gland are considered. Recommendations are given on selection of the type of implant, on determination of the volume of supposed silicone breast-implant prostheses, and also on the choice of optimal access for their insertion. The early and long-term complications and measures proposed by the authors for their elimination are studied. According to different studies, the commonest complication of the augmentation mammoplasty is contracture of the fibrous capsule surrounding the implant that requires surgical correction. One of main complications of all kinds of augmentation mammoplasty is secondary ptosis of mammary gland. A common complication of the augmentation mammoplasty is incorrect position of implants such as their asymmetry and location on different levels. In case of tubular breast a double inframammary fold may result unless tubularity of areola is corrected. Authors think that a significant number of unsolved problems concerning augmentation mammoplasty, optimal surgical approach, existence of the immediate and long-term complications are reasons for further study of augmentation mammoplasty. Increased dissatisfaction of patients with long-term results of augmentation mammoplasty, necessity to prevent such complication as fibrous contracture, create an urgent need for search of new methods. Thus, application of silicone implants in augmentation mammoplasty requires further study with the aim of optimization of the final aesthetic and clinical result.

scholarly journals Application of silicone implants in mammoplasty (literature survey)

2018 ◽  
Vol 26 (1) ◽  
pp. 113-149
Author(s):  
Dj. A. Khodjamurodova ◽  
M. S. Saidov ◽  
G. М. Khodjamuradov
Keyword(s):  
Mammary Gland ◽  
Surgical Approach ◽  
Breast Implant ◽  
Breast Implants ◽  
Long Term Results ◽  
Silicone Implants ◽  
Augmentation Mammoplasty ◽  
Advantages And Disadvantages

In the article literature data concerning indications to placement of silicone breast implants in plastic surgery are presented. Peculiarities of preoperative preparation of patients aimed at prevention of postoperative complications are considered. The technique of surgical intervention, advantages and disadvantages of different methods are described. Difference in choice of surgical approach and positioning of implant relative to mammary gland are considered. Recommendations are given on selection of the type of implant, on determination of the volume of supposed silicone breast-implant prostheses, and also on the choice of optimal access for their insertion. The early and long-term complications and measures proposed by the authors for their elimination are studied. According to different studies, the commonest complication of the augmentation mammoplasty is contracture of the fibrous capsule surrounding the implant that requires surgical correction. One of main complications of all kinds of augmentation mammoplasty is secondary ptosis of mammary gland. A common complication of the augmentation mammoplasty is incorrect position of implants such as their asymmetry and location on different levels. In case of tubular breast a double inframammary fold may result unless tubularity of areola is corrected. Authors think that a significant number of unsolved problems concerning augmentation mammoplasty, optimal surgical approach, existence of the immediate and long-term complications are reasons for further study of augmentation mammoplasty. Increased dissatisfaction of patients with long-term results of augmentation mammoplasty, necessity to prevent such complication as fibrous contracture, create an urgent need for search of new methods. Thus, application of silicone implants in augmentation mammoplasty requires further study with the aim of optimization of the final aesthetic and clinical result.

Using Histological and Chemical Methods for Detection of Unauthorized Tissues Addition in Emulsion Type Meat Product

2020 ◽  
Keyword(s):  
Vascular Tissue ◽  
Meat Product ◽  
Calcium Content ◽  
Processed Meat ◽  
Low Protein ◽  
Significant Difference ◽  
Different Types ◽  
Plant Stem ◽  
High Level ◽  
Reliable Methods

Total twenty different processed meat plant producing emulsion type sausage were histologically and chemically examined for detection of adulteration with unauthorized tissues. Results revealed that samples were adulterated with different types of animal tissues included; hyaline cartilage, tendon, spongy bone, peripheral nerve trunk, basophilic matrix, lymphatic tissue, fascia, fibrocartilage and vascular tissue. Moreover, these samples were adulterated Also, adulterated with plant tissue included; plant stem, leaves and root. Chemical analysis showed a significant difference in their chemical composition (moisture, fat, protein, ash and calcium) content. Moisture and fat content varied around the permissible limit of E.S.S. while low protein, high ash and calcium content was detected in the examined samples. Therefore, Histological and chemical examinations can be used as reliable methods to detect adultration using unauthorized addition of both animal and plant tissues in processed meat product samples which revealed a high level of falsification.

MORPHOLOGICAL EVALUATION OF EFFECTIVENESS OF NECROFASCIOTOMY AND INFILTRATION WITH OZONATED SALINE AREA OF DEEP CIRCULAR BURN OF SKIN WITH UNDERLYING TISSUES COMPLICATED BY COMPARTMENT SYNDROME

2020 ◽  
pp. 28-33
Author(s):  
Teimur Ahaliievich Kurbanov ◽  
O. V. Kravtsov ◽  
M. S. Myroshnychenko ◽  
Yu. I. Isaev
Keyword(s):  
Compartment Syndrome ◽  
Physiological Solution ◽  
Burn Wound ◽  
Local Pressure ◽  
Tissue Pressure ◽  
Surgical Interventions ◽  
Morphological Evaluation ◽  
General Pathology ◽  
Saline Area ◽  
The One

Compartment syndrome is one of the complications of tissue damage of various origins, the basis of which is the compression of blood vessels and disruption of blood supply to tissues due to an increased local pressure in the closed space of the fascial sheath. The consequences of compartment syndrome can be local and general. An effective treatment of compartment syndrome in burns is to perform a necrotomy, which due to decompression helps to reduce intra−tissue pressure and diminish the scale of necrotic changes in tissues. In order to morphologically evaluate the effectiveness of necrofasciotomy, as well as the one in combination with infiltration of ozonated saline area of deep circular skin burns with underlying tissues, complicated by compartment syndrome, an experimental study was conducted. Circular deep burns, complicated by the formation of compartment syndrome, were simulated in 18 WAG rats. To reduce the pressure in the burned and surrounding tissues, surgical interventions such as necrofasciotomy were performed, which provided a notable reduction in pressure. In parallel, infiltration of damaged tissues with ozonated saline was performed, which was bubbled for 15 minutes at a dissolved ozone concentration of 4.0±0.2 mg / l, which improved microcirculation and reduced tissue hypoxia. The findings indicate that the compartment syndrome is characterized by a significant severity of general pathology. Performance of necrofasciotomy of a burn wound with its infiltration by ozonated physiological solution in comparison with just necrofasciotomy has more positive medical effect, and efficiency of these medical measures increases when they are performed at early terms (day 1) of formation of a burn wound in comparison with late terms (day 3). Key words: burns, surgical treatment, compartment syndrome, histological examinations.

Ultrasound predictive criteria for short term benign thyroid nodular volume reduction after ultrasound guided radiofrequency ablation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Fikry Tawfik Shehab ◽  
Ahmed Mohamed Hussein ◽  
Rasha Tolba Khattab
Keyword(s):  
Thyroid Nodules ◽  
Reduction Ratio ◽  
Volume Reduction ◽  
Body Sensation ◽  
Significant Difference ◽  
Noticeable Improvement ◽  
Us Findings ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid ◽  
Ultrasound Features

Abstract Purpose This study evaluates the outcome of patients complaining of compressive& cosmetic problems due to benign thyroid nodules after recieving RF ablation with correlation between some ultrasound features of the nodules and their shrinkage and volume reduction. Methods and material fifteen patients with benign thyroid nodules causing compressive symptoms (foreign body sensation,neck discomfort or pain) and cosmetic problems. Results A total of 15 patients were included with the age rangmg from 22-82 years old the mean was 52.73 years old (SD + 14.37).Among them 12 patients (800 0)were females and 3 patients(20%) were males. There was statistically significant difference between volume of nodules before the procedure with mean volume was 21.13±5.13 and I month after with mean volume I I .96±3.08 and 3 months after the procedure with mean volume 7.70±2.82 with noticeable improvement in nodules with peri and intranodular vascularity showing mean reduction ratio 69.88% after 3 months vs 59.93% and 64 12% of weak peripheral vascularity and intense intra-nodular vasculanty respectively as well as US structure with spongiform nodules showing mean reduction ratio 68.48% at 3 months vs 59.87% and 62.14% for solid &mixed nodules respectively.Mean symptoms and cosmetic score were significantly reduced. Conclusion: This study validated the efficacy and safety of RFA for treatment of benign thyroid nodules and showed correlation between shrinkage and some common US findings.

scholarly journals Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 28-34
Author(s):  
Kumkum Vadehra ◽  
Jennifer Cai ◽  
Rashmi Rekha Bhuyan ◽  
Ping Ji ◽  
Rose Venegas ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Anaplastic Large Cell Lymphoma ◽  
Cell Lymphoma ◽  
Breast Implant ◽  
Fluid Collection ◽  
Breast Implants ◽  
Large Cell ◽  
Silicone Implants ◽  
Axillary Lymph ◽  
Large Cell Lymphoma

Breast implant-associated anaplastic large cell lymphoma (ALCL) is a recently recognized type of T-cell lymphoma that can develop following breast implants, with morphologic and immunophenotypic features indistinguishable from those of ALK-negative ALCL. Here we report a case of a 58-year-old woman with a history of subglandular silicone implants placed for bilateral breast augmentation 25 years ago, who presented with bilateral breast pain and was found to have bilateral Baker Grade III capsular contracture, and heterogenous fluid collection centered near the left third costochondral articulation, a suspicious left chest wall lesion, and left axillary lymphadenopathy on imaging. A left axillary lymph node core biopsy and an aspiration of the fluid were performed, and no malignant cells were identified. The patient underwent bilateral removal of breast implants and total capsulectomies. Microscopic examination of the capsule surrounding the left breast implant revealed large pleomorphic tumor cells in a fibrinous exudate. By immunohistochemistry, the tumor cells were found to be positive for CD3 (subset), CD4, CD7, CD30 (strong and uniform), and CD43, and negative for CD2, CD5, CD8, and ALK1, supporting the diagnosis of breast implant-associated ALCL. No lymphoma cells were identified in the right breast capsule, confirmed by CD30 stain. Breast implant-associated ALCL is a very rare disease that can develop many years after breast implant placement. Proper evaluation with breast imaging and pathologic workup is essential to confirm the diagnosis in suspected cases. Our case highlights that adequate sampling is important in the investigation of patients with suspected breast implant-associated ALCL.

scholarly journals Lung Volume Reduction Surgery in Patients with Heterogenous Emphysema: Selecting Perspective

2019 ◽  
Vol 7 (24) ◽  
pp. 4389-4392
Author(s):  
Nguyen Truong Giang ◽  
Trung Nguyen Ngoc ◽  
Nguyen Van Nam ◽  
Nguyen Viet Nhung ◽  
Ta Ba Thang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Pulmonary Function Tests ◽  
Volume Reduction ◽  
Military Hospital ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Function Tests ◽  
Significant Difference ◽  
Preoperative Factor

BACKGROUND: Lung volume reduction surgery (LVRS) was introduced to alleviate clinical conditions in selected patients with heterogenous emphysema. Clarifying the most suitable patients for LVRS remained unclear. AIM: This study was undertaken to specifically analyze the preoperative factor affecting to LVRS. METHODS: The prospective study was conducted at 103 Military Hospital between July 2014 and April 2016. Severe heterogenous emphysema patients were selected to participate in the study. The information, spirometry, and body plethysmographic pulmonary function tests in 31 patients who underwent LVRS were compared with postoperative outcomes (changing in FEV1 and CAT scale). RESULTS: Of the 31 patients, there was statistically significant difference in the outcome of functional capacity, lung function between two groups (FEV1 ≤ 50% and > 50%) (∆FEV1: 22.46 vs 18.32%; p = 0.042. ∆CAT: 6.85 vs 5.07; p = 0.048). Changes of the FEV1 and CAT scale were no statistically significant differences in three groups residual volume. Patients with total lung capacity < 140% had more improved than others (∆FEV1: 23.81 vs 15.1%; p = 0.031). CONCLUSION: Preoperative spirometry and body plethysmographic pulmonary function tests were useful measures to selected severe heterogenous emphysema patients for LVRS. Patients with FEV1 ≤ 50%, TLC in the range of 100-140% should be selected.

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