Mastopexy

2020 ◽  
Author(s):  
Aska Arnautovic ◽  
Justin M. Broyles
Keyword(s):  
Breast Surgery ◽  
Surgical Approaches ◽  
Hormonal Changes ◽  
Breast Ptosis ◽  
Skin Envelope ◽  
Breast Shape ◽  
Ptotic Breasts ◽  
Patient Concerns ◽  
Periareolar Mastopexy ◽  
Wise Pattern

Mastopexy and mastopexy-augmentation are commonly performed surgeries to lift ptotic breasts while improving breast shape and volume. Factors that cause breast ptosis include aging, hormonal changes, and weight loss. Common surgical approaches for mastopexy utilize the periareolar, vertical, and wise techniques. All of these techniques incorporate parenchymal rearrangement in addition to skin envelope resection in order to achieve the patient’s aesthetic goals. A plastic surgeon should carefully select the appropriate mastopexy technique based on a patient’s preoperative grade of ptosis, breast shape/volume, and aesthetic goals. Many of these mastopexy techniques can be combined with implant augmentation, either as a single or two-stage procedure in appropriate patients with volume concerns. Revisions tend to be more common after implant-augmentations and may be necessary based on patient concerns and surgeon discretion.  This review contains 5 figures, 5 tables, and 14 references Keywords: mastopexy, mastopexy-augmentation, breast lift, breast ptosis, vertical mastopexy, periareolar mastopexy, wise pattern mastopexy, breast surgery

Surgical Approaches to the Irradiated Breast

2020 ◽  
Author(s):  
Megan Fracol ◽  
Neil Fine
Keyword(s):  
Radiation Therapy ◽  
Breast Surgery ◽  
Surgical Approaches ◽  
Autologous Reconstruction ◽  
Breast Irradiation ◽  
Surgery Complications ◽  
Number Of Patients ◽  
Operative Complications ◽  
Salvage Mastectomy ◽  
Post Operative Complications

The use of radiation therapy for treatment of breast cancer has steadily increased since the 1990s. Plastic surgeons must be prepared to reconstruct patients with prior lumpectomy and radiation now needing salvage mastectomy, as well as the growing number of patients who will go on to need post mastectomy radiation therapy. Operating in the irradiated field presents unique challenges, including but not limited to intra-operative difficulties such as friable vessels when performing autologous-based reconstruction and higher rates of post-operative complications when performing implant-based reconstruction. Reconstructed outcomes are often inferior to the non-irradiated patient and as such the plastic surgeon should be prepared to perform further revision as necessary. This chapter will review indications for radiation therapy, both autologous- and implant-based approaches to reconstructing the irradiated breast and how to manage post-operative complications. This review contains 3 figures, 5 tables, and 75 references. Keywords: radiation, breast irradiation, breast reconstruction, radiation therapy, autologous reconstruction, implant-based reconstruction, revisionary breast surgery, complications

Treatment of large and ptotic breasts

2021 ◽  
pp. 1367-1372
Author(s):  
Adam Searle ◽  
Albert de Mey ◽  
Christophe Zirak
Keyword(s):  
Surgical Techniques ◽  
Point Of View ◽  
Vertical Scar ◽  
Areolar Complex ◽  
Psychological Point ◽  
Ptotic Breasts ◽  
Almost All ◽  
Normal Sensitivity ◽  
Wise Pattern

The breasts have always been considered a sign of femininity. The correction of breast deformities is therefore important from a physical and psychological point of view, improving greatly the quality of life. Many surgical techniques have been proposed to correct the shape and volume of the breast, and in recent decades techniques have been proposed to preserve the nipple sensitivity and increase the vascular safety of the procedure. Templates (such as the Wise pattern) have been proposed to improve planning and different pedicles for the areola have been described. During the last 20 years, new techniques have been introduced to minimize scars, leaving normal sensitivity in almost all cases, the possibility of lactation, and a pleasing shape. The periareolar scar is, unfortunately, always necessary to reposition the nipple–areolar complex. The vertical scar is necessary to resect the excess of skin of the lower pole of the breast. Effort has been directed to reduce or eliminate the horizontal submammary scar, leading to a vertical scar only, even in large reductions.

scholarly journals No-Scar Breast Reduction Utilizing Power-Assisted Liposuction Mammaplasty, Loops, and Lipofilling

2020 ◽  
Author(s):  
Marwan H Abboud ◽  
Hiba N El Hajj ◽  
Nicolas M Abboud
Keyword(s):  
Breast Reduction ◽  
Minimally Invasive Procedures ◽  
Lower Pole ◽  
Oral Antibiotics ◽  
Invasive Procedures ◽  
Safe Alternative ◽  
The Third ◽  
Skin Envelope ◽  
Breast Shape ◽  
Breast Projection

Abstract Background In the context of continuous interest to develop and refine minimally invasive procedures, recent publications reported a scarless approach in breast lifting. Objectives The authors describe a power-assisted lipomodeling technique combined with surgical loops to achieve breast reduction and reshaping with minimal scars. Methods Between 2014 and 2018, a total of 94 patients underwent breast reduction by combined liposuction and loops. Following infiltration of the breasts, liposuction of the outer quadrants and the lower pole was achieved to reduce the breast footprint and the lateral and inferior heaviness of the breast. After multiaxial multiplanar tunnelization, three types of loops were taken around the breast to suspend and elevate the breast skin envelope and parenchyma. Each loop was guided through a 3 mm, three-hole cannula passed through skin stab incisions. The first loop was designed to reduce the breast footprint and enhance the breast projection, whereas the second loop is designed to achieve breast conus remodeling and can be performed three to five times. The third loop was passed circumferentially around the areola and then cephalad along the breast axis and pulled until the desired NAC elevation was reached. Each loop was pulled to achieve the desired breast projection and shape. Results The authors achieved breast reduction with a mean nipple elevation of 7.3 cm, and 88% of patients were satisfied with their breast shape. The total complication rate was 1%, including mild cellulitis in one breast, treated efficiently with oral antibiotics. Conclusions The proposed technique is a novel, simple, and safe alternative to achieve breast reduction and reshaping without a scar.

scholarly journals Oncoplastic Approaches to Breast Conservation

2011 ◽  
Vol 2011 ◽  
pp. 1-16 ◽  
Author(s):  
Dennis R. Holmes ◽  
Wesley Schooler ◽  
Robina Smith
Keyword(s):  
Breast Cancer ◽  
Multidisciplinary Approach ◽  
Breast Surgery ◽  
Breast Conservation ◽  
Surgical Techniques ◽  
Tumor Location ◽  
Surgical Approaches ◽  
Oncoplastic Breast Surgery ◽  
Body Habitus ◽  
Skill Sets

When a woman is diagnosed with breast cancer many aspects of her physical, emotional, and sexual wholeness are threatened. The quickly expanding field of oncoplastic breast surgery aims to enhance the physician commitment to restore the patient's image and self-assurance. By combining a multidisciplinary approach to diagnosis and treatment with oncoplastic surgery, successful results in the eyes of the patient and physician are significantly more likely to occur. As a way to aid oncoplastic teams in determining which approach is most suitable for their patient's tumor size, tumor location, body habitus, and desired cosmetic outcome we present a review of several oncoplastic surgical approaches. For resections located anywhere in the breast, theradial ellipse segmentectomy incisionandcircumareolar approach for segmental resectionare discussed. For resections in the upper or central breast,crescent mastopexy, thebatwing incision, thehemibatwing incision,donut mastopexy,B-flap resection, and thecentral quadrantectomyare reviewed. For lesions of the lower breast, thetriangle incision,inframammary incision, andreduction mastopexyare discussed. Surgeons who are interested in adding oncoplastic breast conserving therapies to their skill sets are encouraged to implement these surgical techniques where applicable and to seek out breast fellowships or enhanced training when appropriate.

Performing combined breast and gynecologic surgery does not increase the rate of surgical site infections: A NSQIP database analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18093-e18093
Author(s):  
Paul Mayor ◽  
John Etter ◽  
James Brian Szender ◽  
Emese Zsiros ◽  
Peter Jonathan Frederick ◽  
...  
Keyword(s):  
Breast Surgery ◽  
Surgical Site Infections ◽  
Laparoscopic Hysterectomy ◽  
Gynecologic Surgery ◽  
Surgical Approaches ◽  
Improvement Program ◽  
Surgical Quality ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Significant Difference ◽  
Laparoscopic Assisted

e18093 Background: The purpose of this study is to determine and compare the overall rates of surgical site infections (SSI) in patients undergoing breast surgery, hysterectomy and combined breast surgery and hysterectomy. Methods: We inspected the National Surgical Quality Improvement Program (NSQIP) Participant Use Files from 2005-2014 for subjects undergoing breast surgery (CPT codes 19300-19307, 19340, 19342, 19350, 19357, 19361, 19364, 19366-19369, 19380, 19396), Gynecologic surgery ( CPT Codes 58150, 58152, 58180, 58200, 58210, 58240, 58260, 58262, 58263, 58267, 58270, 58275, 58280, 58285, 58290-58294, 58541-58544, 58548, 58550, 58552-58554, 58570-58573), or a combined surgery (the NSQIP databased was queried for encounters that contained both a breast surgery code and hysterectomy procedure code). We then queried the database for SSI rates within 30 days of surgery. SSI rates were compared using a χ2 test with a nominal value of p < 0.05 as a test for significance. Results: We identified a total of 174,605 patients who underwent a breast surgery and found a SSI rate of 2.59%. We identified a total of 137,121 patients who underwent hysterectomy and found a SSI rate of 2.58%. We identified 383 patients who underwent a combined breast surgery and hysterectomy and found a SSI rate of 2.87%. When comparing SSI rates of combined breast surgery and hysterectomy, to breast surgery or hysterectomy alone, we found no significant difference in the rates of SSI between these groups (p = .7304). We analyzed SSI rates in patients by different surgical approaches including combined breast surgery and open hysterectomy and found an SSI rate of 4.35% (p = .357), combined breast surgery and laparoscopic hysterectomy and found an SSI rate of 2.38% (p = .931), and combined breast surgery and laparoscopic assisted vaginal hysterectomy and found an SSI rate of 2.75% (p = .916). Conclusions: The rates of SSI in patients undergoing combined breast surgery and hysterectomy is not significantly different from breast surgery or hysterectomy alone. Gynecologic oncologist should coordinate with breast surgeons to perform a combined procedure in patients who require both breast surgery and hysterectomy.

THE USE OF THE ORIGINAL METHOD OF RESTORING THE INFRAMAMMARY FOLD DURING TWO-STAGE BREAST RECONSTRUCTION

2017 ◽  
Vol 63 (4) ◽  
pp. 598-605
Author(s):  
Artur Ismagilov ◽  
Ilnur Kamaletdinov ◽  
Zinaida Afanaseva
Keyword(s):  
Breast Reconstruction ◽  
Original Method ◽  
Inframammary Fold ◽  
Reconstruction Technique ◽  
Two Stage ◽  
Normal Appearance ◽  
Breast Ptosis ◽  
Breast Shape ◽  
Methods Of Reconstruction ◽  
The Imf

The Inframammary fold (IMF) is an important component of attractive and esthetically normal appearance of the breast and one of the most important elements of natural breast ptosis. It plays a significant role in the formation and maintenance of breast shape as well as it provides support for the implants placed subpectoral that prevent their malposition. It is necessary to restore the IMF during breast reconstruction and it allows achieving results similar to their natural breasts. The IMF reconstruction existing methods on a row with the advantages have some disadvantages: visible scars and contour irregularities in case of the external access, indentations at the site of IMF, little ptosis improvement or small projection, therefore it is impossible to choice a particular method of its reconstruction. Considering certain shortcomings of the existing methods of reconstruction Prof. A. Ismagilov et al. have developed a new IMF reconstruction technique using the posterior sheet of the expander capsule. This article presents our 4-year experience of performing this original technique during two-stage breast reconstruction.

scholarly journals Application of Periareolar Mammaplasty with the Tissue Folding Technique in Breast Reshaping following Polyacrylamide Hydrogel Removal

Breast Care ◽  
2019 ◽  
Vol 15 (2) ◽  
pp. 157-162
Author(s):  
Yantao Cai ◽  
Bin Liu ◽  
Mingjuan Liao ◽  
Liu He ◽  
Chenfang Zhu
Keyword(s):  
Augmentation Mammoplasty ◽  
Polyacrylamide Hydrogel ◽  
Breast Ptosis ◽  
Degree Of Satisfaction ◽  
Breast Reshaping ◽  
Breast Shape ◽  
A New Technique ◽  
Periareolar Mammaplasty ◽  
Implantation Method

Background: Polyacrylamide hydrogel (PAAG) was used as an injectable implant for augmentation mammoplasty for over 30 years, but its use was ceased due to various related complications. The only way to treat these complications is PAAG removal, but this causes breast ptosis, nipple retraction, breast asymmetry, and skin laxity. Objectives: This article reports a new technique for breast reshaping after PAAG removal without prosthesis implantation. Method: From January 2015 to June 2018, twenty-three patients underwent periareolar mammoplasty with the tissue folding technique (PMTFT) for breast reshaping after PAAG removal. Postoperative breast shape and the degree of satisfaction of the patients were evaluated during follow-up. Results: All patients recovered well without severe complications. All patients were satisfied with their postoperative breast shape and their symptoms were relieved after surgery. Conclusions: PMTFT provides satisfactory postoperative breast shape results. Economical, practical, and technical advantages were found over traditional prosthesis-mediated breast reconstruction. PMTFT can be an ideal surgical choice in appropriate cases.

Sign in / Sign up

Export Citation Format

Share Document