Dual Plane Breast Augmentation: Optimizing Implant-Soft-Tissue Relationships in a Wide Range of Breast Types

AbstractBackgroundBreast augmentation (BA) is a very common procedure performed for a wide range of indications. The short-term and long-term outcomes are strongly correlated with the choice of the correct implant pocket, which should be tailored to the anatomic features of the breast.ObjectivesThe aim of this study was to report the safety and efficacy of the triple-plane technique and Bra-flap modified dual-plane techniques for BA.MethodsFrom January 1995 to January 2016, 605 patients underwent BA procedures that utilized the triple-plane technique or Bra-flap modified dual-plane techniques. Patient evaluation was performed preoperatively and postoperatively at 6 and 12 months and every 5 years thereafter. The occurrence of ptosis and implant malposition, as well as breast animation deformity, were assessed. Patient satisfaction was evaluated with the BREAST-Q Augmentation Module.ResultsThe average patient age was 39.3 years. The follow-up period ranged from 24 months to 20 years. The triple-plane technique was performed in 450 patients, the Bra-flap modified dual-plane technique in 97, and the inverted Bra-flap modified dual-plane technique in 58. No cases of double-bubble deformity or implant bottoming-out were observed. Regarding animation deformity, 209 patients presented with mild to moderate distortion, whereas no patients presented with severe distortion. The BREAST-Q questionnaire reported significant postoperative improvements in all scales.ConclusionsIn over 20 years of experience, the triple-plane technique has proven to be a reliable procedure that offers natural and long-lasting results. The Bra-flap and inverted Bra-flap modified dual-plane techniques are efficient options to expand the range of breast conditions treated.Level of Evidence: 4

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Evaluation of 99mTc-Label led Vitamin K4 as an Agent for Testicular Imaging

Nuklearmedizin ◽

10.1055/s-0038-1629552 ◽

1991 ◽

Vol 30 (01) ◽

pp. 35-39 ◽

Cited By ~ 1

Author(s):

H. S. Durak ◽

M. Kitapgi ◽

B. E. Caner ◽

R. Senekowitsch ◽

M. T. Ercan

Keyword(s):

Soft Tissue ◽

Room Temperature ◽

Normal Subjects ◽

Left Testis ◽

Wide Range ◽

Activity Ratios ◽

The Right ◽

Radioactivity Levels

Vitamin K4 was labelled with 99mTc with an efficiency higher than 97%. The compound was stable up to 24 h at room temperature, and its biodistribution in NMRI mice indicated its in vivo stability. Blood radioactivity levels were high over a wide range. 10% of the injected activity remained in blood after 24 h. Excretion was mostly via kidneys. Only the liver and kidneys concentrated appreciable amounts of radioactivity. Testis/soft tissue ratios were 1.4 and 1.57 at 6 and 24 h, respectively. Testis/blood ratios were lower than 1. In vitro studies with mouse blood indicated that 33.9 ±9.6% of the radioactivity was associated with RBCs; it was washed out almost completely with saline. Protein binding was 28.7 ±6.3% as determined by TCA precipitation. Blood clearance of 99mTc-l<4 in normal subjects showed a slow decrease of radioactivity, reaching a plateau after 16 h at 20% of the injected activity. In scintigraphic images in men the testes could be well visualized. The right/left testis ratio was 1.08 ±0.13. Testis/soft tissue and testis/blood activity ratios were highest at 3 h. These ratios were higher than those obtained with pertechnetate at 20 min post injection.99mTc-l<4 appears to be a promising radiopharmaceutical for the scintigraphic visualization of testes.

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Quantification of assembly forces during creation of head-neck taper junction considering soft tissue bearing: a biomechanical study

Arthroplasty ◽

10.1186/s42836-021-00075-7 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Toni Wendler ◽

Torsten Prietzel ◽

Robert Möbius ◽

Jean-Pierre Fischer ◽

Andreas Roth ◽

...

Keyword(s):

Soft Tissue ◽

Work Experience ◽

Soft Tissues ◽

Force Sensor ◽

Biomechanical Study ◽

Measuring System ◽

Wide Range ◽

Head Neck

Abstract Background All current total hip arthroplasty (THA) systems are modular in design. Only during the operation femoral head and stem get connected by a Morse taper junction. The junction is realized by hammer blows from the surgeon. Decisive for the junction strength is the maximum force acting once in the direction of the neck axis, which is mainly influenced by the applied impulse and surrounding soft tissues. This leads to large differences in assembly forces between the surgeries. This study aimed to quantify the assembly forces of different surgeons under influence of surrounding soft tissue. Methods First, a measuring system, consisting of a prosthesis and a hammer, was developed. Both components are equipped with a piezoelectric force sensor. Initially, in situ experiments on human cadavers were carried out using this system in order to determine the actual assembly forces and to characterize the influence of human soft tissues. Afterwards, an in vitro model in the form of an artificial femur (Sawbones Europe AB, Malmo, Sweden) with implanted measuring stem embedded in gelatine was developed. The gelatine mixture was chosen in such a way that assembly forces applied to the model corresponded to those in situ. A study involving 31 surgeons was carried out on the aforementioned in vitro model, in which the assembly forces were determined. Results A model was developed, with the influence of human soft tissues being taken into account. The assembly forces measured on the in vitro model were, on average, 2037.2 N ± 724.9 N, ranging from 822.5 N to 3835.2 N. The comparison among the surgeons showed no significant differences in sex (P = 0.09), work experience (P = 0.71) and number of THAs performed per year (P = 0.69). Conclusions All measured assembly forces were below 4 kN, which is recommended in the literature. This could lead to increased corrosion following fretting in the head-neck interface. In addition, there was a very wide range of assembly forces among the surgeons, although other influencing factors such as different implant sizes or materials were not taken into account. To ensure optimal assembly force, the impaction should be standardized, e.g., by using an appropriate surgical instrument.

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Dual-Plane Breast Augmentation for Minimal Ptosis Pseudoptosis (the “In-Between” Patient)

Aesthetic Surgery Journal ◽

10.1177/1090820x12469534 ◽

2013 ◽

Vol 33 (1) ◽

pp. 43-65 ◽

Cited By ~ 11

Author(s):

Joe Gryskiewicz

Keyword(s):

Breast Augmentation ◽

Dual Plane

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Revisited Anterolateral Thigh Free Flaps For Reconstructive Microsurgery : One Year Evaluation

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i2.44 ◽

1970 ◽

Vol 1 (2) ◽

Author(s):

Parintosa Atmodiwirjo ◽

Siti Handayani ◽

Shelly Madona Djaprie

Keyword(s):

Soft Tissue ◽

Free Flaps ◽

Soft Tissue Defect ◽

Anterolateral Thigh Flap ◽

Soft Tissue Defects ◽

Anterolateral Thigh ◽

Wide Range ◽

Reconstructive Microsurgery ◽

One Year ◽

Tissue Defects

Extensive soft tissue defects present a dif!cult problem to the plastic surgeon as they are usually associated with exposed important structures such as vessels, nerves, tendons, joint cavity or bone. Reconstruction of soft tissue defects have a wide range of therapeutic options. We reconstructed soft tissue defect in many areas using free anterolateral thigh flap (ALTF). From Februari 2009 - 2010, 9 cases of soft tissue defects in the face, neck, leg and foot of various etiologic factors were admitted to the plastic and reconstructive surgery unit, Cipto Mangunkusumo general hospital. Trauma is the commonest cause of soft tissue defects of the lower extremity, followed by tumours. The cruris was the commonest site (4 cases, 44,4%). Flap success rate was 66,67 %. Failure was reported 1 cases in this study due to vein compromise. In our hospital, we are quite familiar with Anterolateral thigh flap (ALTF) even though the case is limited. Anterolateral thigh flap (ALTF) is used for reconstruction of various simple and complex soft tissue defects, for big and small defects with cavity (orbita).

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