scholarly journals Implants versus Lipograft – Analysis of Long-Term Results after Congenital Breast Asymmetry Procedure

2021 ◽  
Author(s):  
Vanessa Brebant ◽  
Maximilian Weiherer ◽  
Vivien Noisser ◽  
Stephan Seitz ◽  
Lukas Prantl ◽  
...  
Keyword(s):  
Breast Augmentation ◽  
Young Group ◽  
Long Term Results ◽  
Silicone Implants ◽  
Scanning System ◽  
Breast Asymmetry ◽  
Breast Symmetry ◽  
Left And Right ◽  
Volume Difference

Congenital breast asymmetry represents a particular challenge to the classical techniques of plastic surgery due to a young group of patients. This study compares traditional breast augmentation using silicone implants to the more innovative lipograft technique regarding long-term results. To achieve this, we not only captured subjective parameters like satisfaction with outcome and symmetry, but also objective parameters such as breast volume and anthropometric measurements. Objective examination was performed manually and by using the Vectra® H2 photogrammetry scanning system. Patients who underwent implant augmentation and lipograft both showed no significant differences in patient´s satisfaction with surgical outcome (p = 0.55) and symmetry (p = 0.69). Furthermore, a breast symmetry of 93 % in both groups was reported. Likewise, no statistically significant volume difference between left and right breast was observed in both groups (p<0.41). However, on average, lipograft patients needed 1.3 procedures more until the desired result was achieved. In contrast, patients treated with implant-based breast augmentation usually need several implant changes during their life. In conclusion, both methods should be considered for patients with congenital breast asymmetry.

scholarly journals Implant-based multiplane breast augmentation—a personal surgical concept for dynamic implant–tissue interaction providing sustainable shape stability

2021 ◽  
Author(s):  
Peter M. Vogt ◽  
Marian S. Mackowski ◽  
Khaled Dastagir
Keyword(s):  
Breast Augmentation ◽  
Deep Layer ◽  
Standard Procedure ◽  
Long Term Results ◽  
Shape Stability ◽  
Aesthetic Quality ◽  
Term Stability ◽  
Long Term Stability ◽  
Augmented Breast

Abstract Background The aesthetic long-term stability in shape, symmetry, and natural appearance of an aesthetically augmented breast remains a constant challenge. It has become clear that the results depend strongly on the technique applied and the experience of the surgeon. An ongoing controversy concerns the positioning of the implants. Subglandular, submuscular, partial submuscular, and subfascial pockets have different tradeoffs and advantages. However, secondary deformity, unnatural feel, and appearance are not addressed uniformly. The aim of the following study was to establish a standard procedure allowing for the desired and reproducible results to provide long-term stability and aesthetic quality. Methods The authors have developed a standardized dissection of a dynamic implant pocket. In this approach, a submuscular dissection with lower and medial release of the pectoralis muscle is combined with a wide subfascial release of the breast gland and a scoring of the deep plane of the superficial glandular fascia. In the final step, the deep layer of the glandular fascia is sutured tightly and firmly to the deep layer of the abdomino-pectoral fascia. A total of 867 patients received a 4D pocket–based breast implant by the authors. A subset of 33 patients was further analyzed for long-term results. Retrospectively, all data were analyzed from the electronic patient information system and files of patients using GraphPad 8. For comparison of multiple experimental groups, one-way ANOVA was performed where indicated. Results The concept not only addresses the biplanar approach of submuscular implant placement (3D) but adds the 4th dimension (4D) of an aesthetically pleasing dynamic shape of the augmented breast providing long-term stability. Measurements—taken at 3 months, and 1, 2, 3, 5, and ≥ 7 years post augmentation—for SN-N, N-IMF, N-ML, and MC-N distances did not show any significant changes over time. In the patient cohort of 867 patients (1734 implants), the overall complication rate was < 5%. Revisions for bleeding were below 0.5%. Shape stability was observed over 7 years in more than 95% of the patients. Conclusions Our results indicate that our technique of multiplane breast augmentation provides long-term stability and aesthetic quality. It may solve some of the existing tradeoffs of the different methods by combining the benefits of each technique supported by an additional shaping through a controlled deep fasciotomy. Level of evidence: Level IV, therapeutic study.

scholarly journals “Surgery of Congenital Breast Asymmetry – Which Objective Parameter Influences the Subjective Satisfaction With Long-term Results?”

2021 ◽  
Author(s):  
Vivien Noisser ◽  
Andreas Eigenberger ◽  
Maximilian Weiherer ◽  
Stephan Seitz ◽  
Lukas Prantl ◽  
...  
Keyword(s):  
Influencing Factor ◽  
Postoperative Outcome ◽  
Long Term Results ◽  
Breast Asymmetry ◽  
Good Tool ◽  
Subjective Satisfaction ◽  
Patient Reported ◽  
The Difference ◽  
3D Scans

Abstract Purpose: Congenital breast asymmetry is a serious gynaecological malformation for affected patients. The phenotyping hits young women in puberty and is associated with a socio-aesthetic handicap, depression and psychosexual problems. Therefore, the time of therapy is usually early in view of the patient's entire life so that a sustainable solution is important. Although, postoperative outcome has been evaluated in several studies before, this study firstly analyses which objective parameters have the most influence on subjective satisfaction with long-term results.Methods: 34 patients with a diagnosed congenital breast asymmetry that underwent either lipofilling or implant therapy in the years of 2008 - 2019 were examined. On average, our collective was seven years postoperatively. Data was mainly gathered by manual measurements, patient-reported outcome measures (Breast Q™) and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific).Results: Among all analysed parameters, only the areola diameter correlated significantly negative with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of the postoperative satisfaction with similarity of the breasts, again the mean of areola diameter, the difference of areola diameter between right and left breast and the difference of volume assessed with 3D scans correlated significantly negative.Conclusion: The areola diameter was shown to be a significant influencing factor for patient-subjective long-term satisfaction in breast asymmetry patients. Besides, 3D volumetry was shown to be a good tool for objectifying patient subjective assessments. Our findings could lead to further improvement of surgical planning and will be built upon in further studies.

scholarly journals Surgery of congenital breast asymmetry—which objective parameter influences the subjective satisfaction with long-term results

2021 ◽  
Author(s):  
Vivien Noisser ◽  
Andreas Eigenberger ◽  
Maximilian Weiherer ◽  
Stephan Seitz ◽  
Lukas Prantl ◽  
...  
Keyword(s):  
Postoperative Outcome ◽  
Subjective Assessment ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Long Term Results ◽  
Breast Asymmetry ◽  
Subjective Satisfaction ◽  
Patient Reported ◽  
The Right

Abstract Purpose Congenital breast asymmetry is a serious gynecological malformation for affected patients. The condition hits young women in puberty and is associated with socio-esthetic handicap, depression, and psychosexual problems. Surgical treatment is usually early in the patient's lifetime, so a long-term sustainable solution is important. Although postoperative outcome has been evaluated in several studies before, this study is the first to analyze which objective parameters have the greatest influence on subjective satisfaction with long-term results. Methods Thirty-four patients diagnosed with congenital breast asymmetry that underwent either lipofilling or implant therapy between the years of 2008 to 2019 were examined. On average, our collective comprised patients seven years after surgery. Data were mainly gathered through manual measurements, patient-reported outcome measures (Breast Q™), and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific). Results Among all analyzed parameters, only areolar diameter correlated significantly negatively with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of postoperative satisfaction with similarity of the breasts, again the mean areolar diameter, but also the difference in areolar diameter and breast volume between the right and left breasts correlated significantly negatively. Conclusion Areolar diameter was revealed as being a significant factor influencing subjective long-term satisfaction in breast asymmetry patients. Moreover, 3D volumetry proves to be an effective tool to substantiate subjective patient assessments. Our findings may lead to further improvements to surgical planning and will be expanded in further studies.

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 Long Term Volume Survival after Autologous Fat Transplantation to the Breast: A Review

2021 ◽  
Vol 9 (3) ◽  
Author(s):  
C. Herold
Keyword(s):  
Breast Augmentation ◽  
Standard Technique ◽  
Late Complications ◽  
Long Term Results ◽  
Fat Transplantation ◽  
Fat Transfer ◽  
Autologous Fat ◽  
Fat Grafts ◽  
Autologous Fat Transplantation

Importance Autologous fat transplantation for breast augmentation has become a standard technique and is widely applied. The major weak point is that long time results, especially sudies about long term volumetric survival of the fat grafts have not been available yet. Observations We compared the available literature about volume survival after fat transplantation, including recent findings six years after fat transfer to the breast, showing stable results and even volume gain of transplanted fat grafts in patients that gained weight. Conclusions Fat transplantation to the breast for cosmetic breast augmentation offers stable long term results in terms of volume survival of the transplanted fat grafts. The available long term studies do not show any late complications of fat transfer.

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.

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