scholarly journals Simultaneous Mastopexy Explantation With a Vertical Bipedicle and Novel Open Pattern Marking Technique

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Elliot M Hirsch
Keyword(s):  
Plastic Surgery ◽  
Breast Implant ◽  
Implant Removal ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Depth Analysis ◽  
Safe Technique ◽  
Marking Technique ◽  
Technical Considerations

Abstract There are limited studies in the plastic surgery literature that detail technical considerations in simultaneous breast implant removal and mastopexy procedures. These procedures are difficult, with significant potential for complications and poor cosmesis. The current plastic surgery literature describes a limited number of techniques that address these concerns, virtually all of which are variants of superior or superior medial pedicle vertical pattern mastopexy. This paper details a safe technique for simultaneous explantation and mastopexy with a novel open marking pattern and vertical bipedicle, which can restore breast cosmesis following implant removal. The study will briefly retrospectively review the results of a consecutive series of 86 patients who underwent this procedure from November 2018 to November 2019, with no incidence of partial or total nipple-areola complex necrosis. Thus, the technique is safe and allows the flexibility for intraoperative adjustments that are necessary for these procedures. A future study will conduct a more in-depth analysis of the results. Level of Evidence: 4

scholarly journals A multi-center, retrospective, preliminary observational study to assess the safety of BellaGel® after augmentation mammaplasty

2020 ◽  
Vol 43 (5) ◽  
pp. 577-582
Author(s):  
Moon Seop Choi ◽  
Jae Hoon Chang ◽  
Chul Hwan Seul
Keyword(s):  
Plastic Surgery ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Augmentation Mammaplasty ◽  
The Body ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Kaplan Meier ◽  
Clinical Series ◽  
Surgery Center

Abstract Background BellaGel® is the only cohesive silicone gel-filled breast implant from a Korean manufacturer, and it was first developed in 2005. It was approved by the CE in 2008, thus becoming the first Asian breast implant available in the EU. We conducted this study to assess the safety of BellaGel® in patients receiving augmentation mammaplasty. Methods We evaluated a consecutive series of 239 patients (478 breasts) who received esthetic augmentation mammaplasty using the BellaGel® (round smooth, round textured, round nanotextured, and anatomical textured types of implant) (HansBiomed Co. Ltd., Seoul, Korea) at three clinics in Korea (JW Plastic Surgery Center, BS The Body Plastic Surgery Clinic and Grace Plastic Surgery Clinic) during a period from December 1, 2015 to January 31, 2018. Results A total of 239 patients with a mean age of 33.1 ± 8.5 years old were followed up during a mean period of 399.58 ± 232.71 days, where there were no cases of capsular contracture in our clinical series of the patients. Other complications include one case (0.4%) of seroma, three cases (1.3%) of hematoma, and one case (0.4%) of infection. Moreover, there were no significant differences in the cumulative incidences of complications between the four types of the BellaGel® (χ2 = 2.322, df = 3, P = 0.508). Furthermore, the cumulative Kaplan-Meier survival rate was estimated at 0.979 (95% CI 0.961–0.997). Conclusions Our results indicate that the BellaGel® is such a safe breast implant that surgeons might consider using it for esthetic augmentation mammaplasty. Level of evidence: Level III, risk/prognostic study.

Composite Breast Remodeling After Implant Removal by Tissue Recruitment and Loops Fixation With Power-Assisted Liposuction and Lipofilling (PALLL)

2021 ◽  
Author(s):  
Marwan H Abboud ◽  
Ayush K Kapila ◽  
Svetlana Bogaert ◽  
Nicolas M Abboud
Keyword(s):  
Breast Implant ◽  
Capsular Contracture ◽  
Patient Characteristics ◽  
Fat Grafting ◽  
Implant Removal ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Aesthetic Results ◽  
And Migration ◽  
The Aesthetic

Abstract Background An increasing number of women wish breast implant removal whilst maintaining an acceptable projection and form were possible. Objectives The authors propose a technique to remodel the breast after implant removal utilizing internal suture loops to project the breast, recruit abdominal and axillary tissue cranially and medially, and provide a matrix for lipofilling. Methods A prospective analysis was performed of consecutive patients undergoing implant extraction followed by power-assisted liposuction loops and lipofilling. Patient characteristics were measured. The aesthetic results were evaluated by 2 independent raters. Patient-reported satisfaction was measured by standardized questionnaires. Results Implants in 52 patients with an average age of 55 and body mass index of 23.7 were extracted followed by breast remodeling. A total of 73% of patients had implants for aesthetic reasons, 41% were smokers, and 43% of the reconstruction cases received radiotherapy. A total of 28% had implant extraction for rupture, 58% for capsular contracture, and 14% due to pain and migration. The average volume of the implants removed was 292 cc, followed by an average lipofilling of 223 cc, yielding a ratio of 0.76 to 1. The average tissue recruited by loops was 82.5 cc. Independent raters measured 79% of results as good, 13% as acceptable, and 8% as requiring improvement; 80% of patients were satisfied to very satisfied. Conclusions The authors propose implant extraction followed by power-assisted liposuction loops and lipofilling can provide footprint definition, sustained projection, and high patient satisfaction. Moreover, the recruitment of a vascularized adipo-cutaneous flap by loops allows a reduced ratio of fat grafting to implant volume. Level of Evidence: 4

Evaluation of the Vertical Movement of Ribeiro’s Dermolipoglandular Mammary Flap One Year After Mammaplasties in Post-Bariatric Patients

2019 ◽  
Vol 40 (1) ◽  
pp. NP21-NP31 ◽  
Author(s):  
Rodrigo P Sizenando ◽  
Marco Túlio C Diniz ◽  
Paulo Roberto da Costa ◽  
Luiz Gustavo S Manhães
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Plastic Surgery ◽  
Breast Tissue ◽  
Vertical Movement ◽  
Level Of Evidence ◽  
Significance Level ◽  
Areola Complex ◽  
Ptotic Breast ◽  
One Year

Abstract Background In 1971, Ribeiro isolated a segment in the inferior pole of the ptotic breast, nourished by muscular perforating vessels, and moved it cranially to the posterior region of the remaining detached breast tissue, where it was fixed to the pectoral fascia. This maneuver created a flap with autologous implant function, independent from the rest of the breast’s support, that maintained long-term mammary projection. Objectives The objectives of this study were to measure the vertical movement of this flap 1 year after mammaplasty and to evaluate the factors involved. Methods The sample included 13 patients who had previously undergone bariatric surgery. The position of a titanium marker attached to the Ribeiro flap was compared on chest radiographs taken 1 day and 1 year after the mammaplasty. The significance level was set at 5%. Results All of the titanium markers moved 0.6 cm to 4.1 cm caudally during the study period (average, 2.4 cm ± 1.02 cm). The greater the weight loss after the plastic surgery, the further the marker’s descent. Weight loss between bariatric surgery and plastic surgery, the vertical dimension of the ptotic breast tissue immediately before plastic surgery, the vertical extent of the nipple-areola complex elevation during mammaplasty, the Ribeiro flap thickness and volume, and the breast volume after mammaplasty were not associated with the vertical movement of the flap. Conclusions The Ribeiro flap employed in mammaplasty of patients who previously underwent bariatric surgery undergoes ptosis that is exacerbated by weight loss after mammaplasty. Level of Evidence: 4

scholarly journals Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Carlos A. Higuera ◽  
Juan C. Suarez ◽  
Preetesh D. Patel ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Retrospective Chart Review ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Exact Test ◽  
Total Hip ◽  
Discharge Disposition ◽  
The Mean

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis

2015 ◽  
Vol 41 (3) ◽  
pp. 322-327 ◽  
Author(s):  
J. K. Thillemann ◽  
T. M. Thillemann ◽  
B. Munk ◽  
K. Krøner
Keyword(s):  
Rating Scale ◽  
Revision Rate ◽  
Numerical Rating Scale ◽  
Elevated Serum ◽  
Consecutive Series ◽  
Dash Score ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Thumb Carpometacarpal

We retrospectively evaluated a consecutive series of 42 Motec thumb carpometacarpal total joint arthroplasties. The primary endpoint was revision with implant removal and trapeziectomy. At follow-up the disability of the arm shoulder and hand (DASH) score, pain on numerical rating scale at rest and with activity and serum chrome and cobalt concentrations were assessed for both unrevised and revised patients. At a mean follow-up of 26 months, 17 patients had been revised. The 2 year cumulative revision rate was 42% (95% CI, 28–60%). The DASH score and pain scores at rest and with activity were comparable between the patients whose thumbs remained unrevised and those revised. Patients with elevated serum chrome and cobalt levels had significantly higher DASH and pain scores, but elevated levels were not associated with revision. The revision rate in this study is unacceptably high. However, pain and DASH scores after revision are acceptable and comparable with patients with non-revised implants. Level of evidence: IV

scholarly journals Granzyme B Is a Biomarker for Suspicion of Malignant Seromas Around Breast Implants

2020 ◽  
Author(s):  
Marshall E Kadin ◽  
John Morgan ◽  
Haiying Xu ◽  
Caroline Glicksman ◽  
David Sieber ◽  
...  
Keyword(s):  
Early Detection ◽  
Tumor Cells ◽  
Breast Implant ◽  
Granzyme B ◽  
Breast Implants ◽  
Large Cell ◽  
Target Cells ◽  
Cytotoxic Lymphocytes ◽  
Tumor Cell Death ◽  
Level Of Evidence

Abstract Background Granzyme B (GrB) is a serine protease secreted, along with pore-forming perforin, by cytotoxic lymphocytes to mediate apoptosis in target cells. GrB has been detected in tumor cells associated with systemic and breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) but its potential use for detection of early BIA-ALCL has not been fully investigated. Objectives Prompted by the increased incidence of BIA-ALCL, the aim of this study was to assess GrB as a new biomarker to detect early disease in malignant seromas and to better understand the nature of the neoplastic cell. Methods A Human XL Cytokine Discovery Magnetic Luminex 45-plex Fixed Panel Performance Assay was used to compare cytokine levels in cell culture supernatants of BIA-ALCL and other T-cell lymphomas, as well as malignant and benign seromas surrounding breast implants. Immunohistochemistry was employed to localize GrB to cells in seromas and capsular infiltrates. Results Differences in GrB concentrations between malignant and benign seromas were significant (P &lt; 0.001). GrB was found in and around apoptotic tumor cells, suggesting that the protease may be involved in tumor cell death. Conclusions GrB is a useful marker for early detection of malignant seromas and to identify tumor cells in seromas and capsular infiltrates. Because there is an overlap between the lowest concentrations of soluble GrB in malignant seromas and the highest concentrations of GrB in benign seromas, it is recommended that GrB be used only as part of a panel of biomarkers for the screening and early detection of BIA-ALCL. Level of Evidence: 5

scholarly journals Applications of Medical Tattooing: A Systematic Review of Patient Satisfaction Outcomes and Emerging Trends

2021 ◽  
Author(s):  
Stacie J Becker ◽  
Jeffrey E Cassisi
Keyword(s):  
Patient Satisfaction ◽  
Medical Condition ◽  
Case Series ◽  
Outcome Data ◽  
Future Research ◽  
Health Service Provider ◽  
Level Of Evidence ◽  
Case Examples ◽  
Areola Complex ◽  
Clinical Series

Abstract Background Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome. Objectives This article reviews various conditions that medical tattooing have been empirically studied in terms of patient satisfaction outcomes; makes practice recommendations; and suggests future directions for research. Methods This review was performed following the PRISMA guidelines. Studies were included if the tattooing application was associated with a medical condition and if outcome data was provided using at least a case series methodology. Where no cohort or clinical series exist, case examples are used from the literature and the author’s practice to illustrate emerging medical tattooing applications that need further evaluation. Results Eighteen studies met the inclusion criteria and were applied to the following conditions: baldness, vitiligo, scars from incisions, lacerations or burns, and nipple areola complex reconstruction following breast surgery. Conclusions The application of medical tattooing has shown high levels of patient satisfaction across various conditions. The practice recommendation grade is “B” or recommend since the level of evidence for these interventions ranged from III to IV according to the ASPS guidelines. This means clinicians can consider this treatment alternative, but they should be alert to new information and be sensitive to patient preferences. Recommendations are made for reporting future research including clearly describing procedural details, identifying the professional performing the procedure, increased use of standardized outcome measures, and that satisfaction ratings be assessed by someone independent of the health service provider. Further research using RCT methodology with waitlist controls is needed.

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