scholarly journals 59 Should The ‘Normal’ And ‘Ideal’ Nipple Position in A Male Influence the Surgeon When Planning Severe Gynaecomastia Correction?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
P Tan ◽  
K Dhaliwal ◽  
A Khanna
Keyword(s):  
Chest Wall ◽  
Breast Reduction ◽  
Aesthetic Outcome ◽  
Two Stage ◽  
Minor Variation ◽  
Aesthetic Result ◽  
Nipple Position ◽  
Wise Pattern ◽  
The Ideal

Abstract Background The ideal nipple position of the male chest following gynecomastia surgery is well documented however with increased development of the chest muscles, the NAC placement can change, leading to the medial displacement of the nipple giving a poor aesthetic outcome. Therefore, we feel these measurements need to be applied to the patients build and take into consideration the patient's future fitness goals. Method We have analysed photographs of 3 groups of men: super- athletes, athletes and severe gynaecomastia. We assessed the proportions of the chest in relation to the NAC and the degree of ptosis. Results There is wide variation in the position of the nipple to the chest wall between each group with minor variation within each group. Based on this research we believe that surgeons should be circumspect when considering breast reduction with a Wise pattern in patients with severe gynaecomastia. In patient with increased development of the pectoralis major muscles, the NAC placement can change, leading to medial displacement of the nipple and ptosis and poor aesthetic result. Conclusions We suggest a two-stage procedure, carried out on two separate occasions wound be more ideal than a single stage as this allows better long-term better positioning of the nipple.

Comparing Outcomes of Wise-Pattern, Two-Stage Breast Reduction-Reconstruction with and without Acellular Dermal Matrix

2021 ◽  
Vol 148 (3) ◽  
pp. 511-521
Author(s):  
Ashraf A. Patel ◽  
Hana Kayaleh ◽  
Luke A. Sala ◽  
Dylan J. Peterson ◽  
Prashant K. Upadhyaya
Keyword(s):  
Breast Reduction ◽  
Acellular Dermal Matrix ◽  
Two Stage ◽  
Dermal Matrix ◽  
Acellular Dermal ◽  
Wise Pattern

scholarly journals The Hybrid Breast Reduction; Taking Advantages of from Both the Vertical and Wise Pattern Reductions

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Breast Reduction ◽  
Reduction Mammaplasty ◽  
Skin Incision ◽  
Hybrid Technique ◽  
Vertical Scar ◽  
Aesthetic Result ◽  
Advantages And Disadvantages ◽  
Type Pattern ◽  
Wise Pattern ◽  
Breast Projection

Reduction mammaplasty is one of the most commonly performed procedures by plastic surgeons. The Wise and vertical scar techniques are two of the most commonly published and performed techniques. The superior technique has long been argued. The advantages and disadvantages of each are well documented. We show a technique which combines the best aspects of the Wise and vertical pattern reductions. In this “Hybrid” technique, we use a typical superior medical pedicle that would be typically used in a vertical pattern and use a skin incision and tissue resection pattern of that of a Wise type pattern. By doing using this technique , the surgeon is able to utilize advantages of the two well-known reduction types. The hybrid reduction uses a robust and reliable superior type pedicle which also allows for a quick de epithelization and dissection of the pedicle. By using the Wise type (anchor shaped skin incision) a large amount of tissue is able to be harvested and the breast projection is restored and is aesthetically favorable. This paper outlines several important points which can aid in achieving an optimal aesthetic result when performing the hybrid breast reduction.

Wise-Pattern Superomedial Dermoglandular Pedicle Technique: Improves Breast Upper Pole Fullness and Breast Proportions

2021 ◽  
pp. 229255032110270
Author(s):  
Sinem Eroglu ◽  
Alpay Duran ◽  
Bora Akalın
Keyword(s):  
Chest Wall ◽  
Breast Reduction ◽  
Lateral Position ◽  
Reduction Mammoplasty ◽  
Horizontal Line ◽  
Complication Rates ◽  
Lower Pole ◽  
Line Passing ◽  
Skin Excision ◽  
Wise Pattern

Background: This study aimed to analyze postoperative upper pole fullness, upper/lower pole ratios, bottoming-out deformity, and complication rates for patients who underwent planned bilateral reduction mammoplasty for gigantomastia using the superomedial dermoglandular pedicle technique and Wise-pattern skin excision. Methods: A total of 105 consecutive patients were evaluated postoperatively within a year in full lateral position, and the upper pole was between the lines drawn horizontally from the nipple meridian, where the breast became evident on the chest wall. Flat and slightly convex upper pole slopes were considered well-rounded; the concave ones were evaluated as exhibiting decreased fullness. The lower pole was the height between the horizontal line passing through the level of the inframammary fold and nipple meridian. Bottoming-out deformity was evaluated according to the 45/55% ratio developed by Mallucci and Branford, where the bottom pole was above 55%, at which it was held to be leaning toward bottoming-out deformity. Results: The upper and lower pole ratios were 44.79% ± 2.80% and 55.21% ± 2.80%, respectively. In 4 cases, a lower pole distance of >55% was leaning toward bottoming-out deformity. A minimum of 12 months was required after surgery to detect upper pole fullness and any possible bottoming-out deformity. The upper pole fullness was achieved in 94% of cases that underwent superomedial dermoglandular pedicle Wise-pattern breast reduction. Conclusion: The use of the superomedial dermoglandular pedicle technique with the Wise-pattern in breast reduction operations helps in ensuring upper pole fullness, resulting in less bottoming-out deformity and requiring less revision.

Seat belt breast injury: a reconstructive approach to managing unilateral bisected breast deformity

2021 ◽  
Vol 14 (7) ◽  
pp. e243065
Author(s):  
George Lafford ◽  
Stephen Mulgrew ◽  
Guido Köhler ◽  
Richard Haywood
Keyword(s):  
Surgical Management ◽  
Breast Reduction ◽  
Seat Belt ◽  
Contralateral Breast ◽  
Aesthetic Result ◽  
Scar Revision ◽  
Breast Deformity ◽  
Areola Complex ◽  
Psychosocial Sequelae ◽  
Wise Pattern

Seat belt breast deformity can result in significant aesthetic, functional and psychosocial sequelae. Although seat belt breast deformity is well documented, there is a lack of literature describing their reconstructive management. We describe the surgical management of a 63-year-old woman presenting with stage 2b seat belt breast deformity, who underwent scar revision, repositioning of the nipple–areola complex and contralateral breast reduction using Wise-pattern incisions based on superior pedicles. She made an excellent recovery with an improved aesthetic result.

Improving Long-Term Breast Shape with the Medial Pedicle Wise Pattern Breast Reduction

2005 ◽  
Vol 115 (7) ◽  
pp. 1937-1943 ◽  
Author(s):  
David L. Abramson ◽  
Stephen Pap ◽  
Suzan Shifteh ◽  
Scot B. Glasberg
Keyword(s):  
Breast Reduction ◽  
Breast Shape ◽  
Wise Pattern

scholarly journals Long-term outcomes of two-stage, immediate and delayed breast reconstruction with polyurethane-covered versus textured implants: protocol of a prospective, multicentre randomised controlled trial (TIPI trial)

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044219
Author(s):  
J X Harmeling ◽  
Kevin Peter Cinca ◽  
Eleni-Rosalina Andrinopoulou ◽  
Eveline M L Corten ◽  
M A Mureau
Keyword(s):  
Randomised Controlled Trial ◽  
Breast Reconstruction ◽  
Controlled Trial ◽  
Capsular Contracture ◽  
Tissue Expander ◽  
Complication Rates ◽  
Two Stage ◽  
Randomised Controlled

IntroductionTwo-stage implant-based breast reconstruction is the most commonly performed postmastectomy reconstructive technique. During the first stage, a tissue expander creates a sufficiently large pocket for the definite breast implant placed in the second stage. Capsular contracture is a common long-term complication associated with implant-based breast reconstruction, causing functional complaints and often requiring reoperation. The exact aetiology is still unknown, but a relationship between the outer surface of the implant and the probability of developing capsular contracture has been suggested. The purpose of this study is to determine whether polyurethane-covered implants result in a different capsular contracture rate than textured implants.Methods and analysisThe Textured Implants versus Polyurethane-covered Implants (TIPI) trial is a multicentre randomised controlled trial with a 1:1 allocation rate and a follow-up of 10 years. A total of 321 breasts of female adults undergoing a two-stage breast reconstruction will be enrolled. The primary outcome is capsular contracture at 10-year follow-up which is graded with the modified Baker classification. It is analysed with survival analysis using a frailty model for clustered interval-censored data, with both an intention-to-treat and per-protocol approach. Secondary outcomes are other complication rates, surgical revision rate, patient satisfaction and quality of life and user-friendliness. Outcomes are measured 2 weeks, 6 months, 1, 2, 3, 5 and 10 years postoperatively. Interim analysis is performed when 1-year, 3-year and 5-year follow-up is completed.Ethics and disseminationThe trial has been reviewed and approved by the Medical Research Ethics Committee of the Erasmus MC, University Medical Centre Rotterdam (MEC-2018-126) and locally by each participating centre. Written informed consent will be obtained from each study participant. The results will be disseminated by publication in peer-reviewed journals.Trial registrationNTR7265.

On the long-term strength of metals and the ideal-creep model

2007 ◽  
Vol 52 (7) ◽  
pp. 388-390
Author(s):  
A. M. Kovrizhnykh
Keyword(s):  
Creep Model ◽  
Term Strength ◽  
The Ideal
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