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

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.

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

International Journal of Clinical & Experimental Dermatology ◽

10.33140/ijced/01/01/00002 ◽

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.

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

British Journal of Surgery ◽

10.1093/bjs/znab134.220 ◽

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.

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Management of Recurrent Symptomatic Macromastia: A Single Surgeon’s Experience

Aesthetic Surgery Journal Open Forum ◽

10.1093/asjof/ojz002 ◽

2019 ◽

Vol 1 (1) ◽

Author(s):

Ali A Qureshi ◽

W Grant Stevens

Keyword(s):

Complication Rate ◽

Breast Reduction ◽

Long Term Results ◽

Inferior Pedicle ◽

Billing Data ◽

Level Of Evidence ◽

Areola Complex ◽

Areolar Complex ◽

Increased Risk ◽

Wise Pattern

Abstract Background Breast reduction for symptomatic macromastia can have excellent long-term results and relief of symptoms. However, patients may require a re-reduction for recurrent symptoms. Previous reports of re-reduction after a primary inferior pedicle reduction have called into question the safety of blood supply to the nipple-areola complex with re-reduction. Objectives To examine a single surgeon’s experience and management of recurrent symptomatic macromastia after inferior pedicle breast reduction. Methods A retrospective review was performed of a single surgeon’s breast reduction experience using billing data to identify cases of breast re-reduction from January 2003 and January 2018. Breast re-reduction was performed either with a Wise pattern, inferior pedicle or with a smile reduction with an inferior pedicle. Liposuction was used in re-reductions only. Results In 15 years, 3530 breast reductions were performed in 1758 patients. In 7 patients, 14 total re-reductions were performed, including 13 secondary breast re-reductions (12 bilateral, 1 unilateral) and 1 tertiary, unilateral breast re-reduction. Seven Wise pattern, inferior pedicle and 7 smile reductions with inferior pedicle procedures were done at the breast level. This translates to a re-reduction incidence of 1 in 250 or 0.4% rate of re-reduction at the patient level in our practice. The minor complication rate was 14% (1 seroma), and the major complication rate was 0%. There were no instances of partial or complete nipple areola necrosis. Conclusions Recurrent symptomatic macromastia can be managed with re-reduction with re-creation of the inferior pedicle or a smile breast reduction as we describe without increased risk to nipple-areolar complex viability. Level of Evidence: 4

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The use of Integra dermal regeneration matrix in the surgical treatment of a recurrent, extensive malignant skin lesion in the temporal region

Orvosi Hetilap ◽

10.1556/oh.2013.29535 ◽

2013 ◽

Vol 154 (6) ◽

pp. 225-227 ◽

Cited By ~ 1

Author(s):

Csaba Halmy ◽

Zoltán Nádai ◽

Krisztián Csőre ◽

Adrienne Vajda ◽

Róbert Tamás

Keyword(s):

Surgical Treatment ◽

Skin Lesion ◽

Surgical Management ◽

Skin Grafting ◽

Skin Tumor ◽

Temporal Region ◽

Aesthetic Result ◽

Malignant Skin ◽

Dermal Regeneration Template ◽

Dermal Regeneration

Authors report on the use of Integra dermal regeneration template after excision of an extended, recurrent skin tumor in the temporal region. The area covered with Integra was 180 cm2. Skin grafting to cover Integra was performed on the 28th day. Both Integra and the skin transplant were taken 100%. Integra dermal regeneration template can provide good functional and aesthetic result in the surgical management of extended skin tumors over the skull. Orv. Hetil., 2013, 154, 225–227.

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