Which technique for which breast? A prospective study of different techniques of reduction mammaplasty
|
|
- Catherine Richards
- 5 years ago
- Views:
Transcription
1 British Journal of Plastic Surgery (1999), 52, The British Association of Plastic Surgeons Which technique for which breast? A prospective study of different techniques of reduction mammaplasty P. Giovanoli, C. Meuli-Simmen*, V. E. Meyer* and M. Frey Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical School, University of Vienna, Austria; and *Division of Hand, Plastic and Reconstructive Surgery, Department of Surgery, University Hospital Zurich, Switzerland SUMMARY. This study was designed to analyse the outcome of three different techniques of reduction mammaplasty with long-term follow-up. We developed a prospective protocol to record patient satisfaction and complaints as well as to objectively quantify the final result. The techniques used were the B-technique of Regnault, the Eren technique and the Frey technique. The technique was chosen according to a preoperatively applied protocol. Eighty-one women, all of whom exhibited physical symptoms of macromastia, were followed up postoperatively for 12 months to 5.4 years (mean 31.8 months). The relief of chronic back pain, improvement of mastodynia and overall satisfaction were rated by the patients subjectively and were reduced with all three techniques. Long-term stability of the postoperative result, especially of the vertical inframammary distance, was achieved in the techniques using a central pedicle and dermis suspension, namely the Eren and the Frey techniques. In smaller and medium-size reductions a medial submammary scar can be avoided using the Frey techniques. Complications, secondary scar and dog-ear revisions were significantly less frequent in the techniques with B-shaped skin incisions. For reductions with nipple transpositions up to 10 cm we prefer the Frey technique. In reduction mammaplasties with nipple transpositions more than 10 cm the Eren technique should be performed. The free nipple areola graft is the procedure of choice in the treatment of gigantomastia. Keywords: breast reduction, superior pedicle, central pedicle, dermis suspension, prospective study. Reduction mammaplasty is one of the more frequent procedures in plastic surgery with a large number of technical variations and modifications proposed in the literature. This study was designed to evaluate the longterm efficacy of the three different techniques used in our unit during the last 6 years. Many authors have investigated the outcome of reduction mammaplasty by addressing symptom resolution, morbidity and patient satisfaction. Only a few have focussed on objective assessment of the final result by measurements and comparison of different techniques. 1,2 In an attempt to address this, we developed a prospective protocol to record patients satisfaction and complaints as well as to objectively quantify parameters of shape of the reduced breast. The reduction technique was chosen according to a preoperatively applied protocol. The patients were treated by three different techniques: 1. Initially, for smaller and medium-size reductions, the B-technique of Regnault was used. This technique with a superior pedicle offers the advantage of preventing a medial submammary scar For larger reductions the Eren technique, which is based on a central pedicle principle and includes the advantage of dermis suspension, was performed. 4,5 3. Finally, the advantages of both techniques, i.e. prevention of a medial scar and long-term stability by dermis suspension, were combined in the Frey technique, applicable for smaller and medium-size reductions. 5 The outcome was tested by standardised check ups to evaluate the development of the long-term result. Patients and methods Since 1990, all women who underwent reduction mammaplasty for macromastia and ptosis at the University Hospital of Zurich, Switzerland were included in a prospective documentation protocol. Patients treated for gigantomastia by reduction mammaplasty with free nipple transfer were excluded from the study. A nipple transposition distance of up to 10 cm was treated by the B-technique (n = 20), or by the Frey technique (n = 30). Nipple transpositions of over 10 cm were treated by the Eren technique (n = 31). Preoperatively, each patient rated their symptoms back pain, shoulder pain, painful bra strap grooves, mastodynia from absent (0) to severe (5). Using a 6-grade scale for subjective ratings (ranging from 0 to 5) the patients were not allowed to give a median value. With regard to limitations of activity, the women were asked to describe their physical limitations (jogging, running, aerobic exercise and even walking) on a scale of 0 5, corresponding to the level of limitation. 52
2 Prospective study of different breast reduction techniques 53 Finally, the patients were asked to give a personal ranking of their appearance on a scale of 0 5. Preoperative height, weight, body mass index (BMI) and the sternal notch-to-nipple distance were recorded for each patient. In addition, we measured the vertical inframammary distance (the distance between the inferior border of the areola and the inframammary fold), the horizontal distance between the sternal midline and the nipple, the distance between the inframammary scar and inframammary fold postoperatively and, finally, the horizontal and vertical areolar diameter for objective, quantitative evaluation of the breast shape. Chest form, breast asymmetry and the presence of scars and dog-ears were documented. The shape of the breast, the degree of ptosis, the form and the shape, and the sensibility of the nipple areola complex (NAC) were subjectively ranked on a scale from 0 to 5 by the patient. Standardised photographs were taken of the breasts. The women were interviewed and examined at least 3, 6 and 12 months postoperatively, some up to 5.4 years after surgery. Statistical calculations were performed using StatView 4.5 TM on Macintosh (Abacus Concepts, Berkeley, CA, USA). Non-parametric tests, the Wilcoxon signed-rank test and the Mann Whitney U-test, were used to determine the statistical significance. Results are displayed either as bar or line charts with error bars (standard error). Figure 1 Improvement in the limitation in sporting activities (scale 0 5). Results Check ups were scheduled at 3, 6 and 12 months after the operation, and late check ups up to 5.4 years. We present a selection of results showing the preoperative state, the postoperative change and the long-term result. The mean follow-up was 28.8 months for the Regnault group, 30.3 months for the Eren group and 33.5 months for the Frey group. The average age of the patients, their height and weight and the preoperative sternal notch-to-nipple distance are listed in Table 1; the average reduction as well as the hospital stay are Figure 2 Reduction in back pain by reduction mammaplasty (scale 0 5). shown in Table 2. The mean weight decreased slightly in all three groups, but there was no significant longterm change. A significant improvement in the physical and social activity was noted in the short- and long-term follow-up for all three groups (Fig. 1). Back pain was significantly reduced in the Eren and Frey groups (Fig. 2). Table 1 Patient data 1 B-technique (Regnault) Eren technique Frey technique n = 20 n = 31 n = 30 Age [y] 23.4 (SD 4.0) 31.6 (SD 10.1) 29.4 (SD 12.0) Height [cm] (SD 6.3) (SD 7.4) (SD 7.6) Weight [kg] 61.9 (SD 7.9) 69.1 (SD 9.5) 60.1 (SD 8.9) BMI [kg/m 2 ] 22.8 (SD 2.8) 25.3 (SD 2.7) 22.3 (SD 2.8) Sternal notch nipple [cm] 26.4 (SD 3.4) 30.5 (SD 3.1) 26.4 (SD 2.6) (preoperative) Mean follow-up [months] 28.8 (SD 19.2) 30.3 (SD 12.9) 33.5 (SD 6.8) Table 2 Patient data 2 B-technique (Regnault) Eren technique Frey technique Reduced breast tissue [g/side] (SD 143.7) (SD 271.7) (SD 180.5) n = 40 n = 62 n = 60 Hospital stay [days] 6.5 (SD 0.8) 6.6 (SD 1.3) 5.8 (SD 1.3) n = 20 n = 31 n = 30
3 54 British Journal of Plastic Surgery Figure 3 Improvement in mastodynia (scale 0 5). Figure 5 Improvement in patient satisfaction with size (scale 0 5). Figure 4 Improvement in patient satisfaction with shape (scale 0 5). Figure 6 Improvement in patient satisfaction with degree of ptosis (scale 0 5). Mastodynia was significantly reduced by the reduction mammaplasty in the Eren and Frey groups. The drop in the B-technique group was statistically not significant (Fig. 3). In the long-term follow-up, there was a significant subjective improvement concerning shape and size of the breast and degree of ptosis for each of the three groups. There was no statistically significant difference between the groups (Figs 4 6). The postoperative increase of the sternal notch-tonipple distance ranged from 0.8 to 1.3 cm in the two techniques with dermis suspension, the Eren and Frey techniques, compared to an increase of cm on average for the B-technique group. The vertical inframammary distance, intraoperatively fixed to 5 cm, was in the long-term follow-up 7.1 cm (SD 1.0) for the B- technique group, 7.5 cm (SD 1.5) in the Eren group and 6.7 cm (SD 1.1) in the Frey group. The mean diameter of the areola at the time of surgery was 42 mm (range mm). Postoperative changes of horizontal and vertical diameter as a parameter of irregularity are illustrated in Figure 7. Persistent periareolar wrinkling was found in 15% of the B-technique cases, in 3.2% of the Eren cases and in 13.3% of the Frey cases in the long-term follow-up. A persistent sensory deficit of the NAC in the Figure 7 Postoperative increase of horizontal and vertical diameter of the areola. n = number of breasts. postoperative course was documented for all three techniques. The nipple sensibility (scale 0 5) decreased from 4.8 preoperatively to 3.8 one year postoperatively in the B-technique group (statistically significant), from 4.2 to 3.6 in the Eren group (P = N.S.) and from
4 Prospective study of different breast reduction techniques 55 Table 3 Complications B-technique (Regnault) Eren technique Frey technique n = 20 n = 31 n = 30 Minor complications 41.6% 65.6% 41.4% Major complications 4.7% 6.7% 3.4% Correction of dog-ears/scar 14.2% 26.6% 8.2% Figure 8 Nipple sensibility pre- and postoperatively (scale 0 5). n = number of breasts. 4.7 to 4.5 in the Frey group (P = N.S.) (Fig. 8). We critically listed all the complications including the minor ones, minimal fat necrosis, delayed wound healing or infection. The incidence was 41.6% in the B-technique cases, 65.6% in the Eren cases and 41.4% in the Frey cases. Revisions were necessary in 4.7% of the B-technique group, in 6.7% of the Eren group and in 3.4% of the Frey group. Some (14.2%) of the B- technique cases, 26.6% of the Eren cases and 8.2% of the Frey cases required secondary revisions of scars, of dog-ears and of the NAC (Table 3). Discussion Patients seeking a breast reduction are usually motivated by a desire to get rid of the physical symptoms. Many women are embarrassed by comments related to their breasts. Younger patients do not incorporate their large breasts into their body image. 6 Poor posture associated with macromastia is a symptom of the increased load on the skeletal system, but also a way to hide large breasts. Patients requiring primary correction of ptosis often seek improvement of their aesthetic appearance and are more worried about scars than patients with large breasts. The goal of this prospective study was to focus on both the subjective view and the objective assessment before and after breast reduction. We felt it important to apply the protocol preoperatively, because the shape of the breast and the quality of the tissue might influence the postoperative long-term result. We tried to analyse both aspects of breast hyperplasia, the physical symptoms as well as the aesthetic appearance of the breast, by prospective subjective ranking and objective measurements before and after reduction mammaplasty. We studied 81 women whose breasts were reduced using three different techniques: the B- technique, the Eren technique and the Frey technique. The latter was developed on the basis of unsatisfying hypertrophic medial scar formation of the Eren technique and secondary sagging of the B-technique (Figs 9, 10). Combining the B-shaped skin incision of the Regnault technique and the advantage of dermis suspension for long-term stability was the basis of this new technique (Fig. 11). The mean average breast tissue removed was similar in the B- and Frey technique groups, whereas in the Eren group nearly double the amount of the former two was resected, as expected in those patients with nipple transposition distances of more than 10 cm. Whereas most women did have an initial decrease in weight, the longterm results did not include a significant stable weight loss. The relief of the most common symptom, chronic back pain, was confirmed by Strömbeck. 7 In his study 83% of patients with back pain had improvement or relief of their symptoms following reduction mammaplasty. Berg et al reported also that 47% became painfree and 35% of the patients had improvements in more than 50% of their initial symptoms. 8 Our patients experienced considerable improvement in back pain independent of the technique of the surgical procedure. This observation is most simply explained by the decrease of breast weight 9 but may have a postural component. It is widely agreed that reduction mammaplasty significantly improves symptoms associated with macromastia. 8,10,11 The limitation in physical activity decreased significantly for all three groups in the long-term follow-up. Boschert et al reported a significant increase in exercise and other sporting and social activities in their outcome analysis of reduction mammaplasty. 12 However, Davies et al found that exercise and activity levels were not related to breast size and that the activity level of women did not increase following breast reduction. 13 Mastodynia was not improved in the B-technique group. Symptoms of breast pain were markedly reduced by the Eren and Frey techniques. Dermis suspension might lead to some pain relief by reducing the vertical tension of the remaining breast tissue. Satisfaction about shape and size of the breast was high. The reduction of volume and weight seems to be the primary goal for the patient, who might not judge the postoperative result as critically as the surgeon. 14,15 However, the subjective results of both techniques using a central pedicle and dermis suspension, the Eren and Frey techniques, were rated higher than the
5 56 British Journal of Plastic Surgery A B C D Figure 9 (A) A 26-year-old patient 24 months after reduction mammaplasty with the Regnault B-technique, frontal view. Flattening of the superior poles of the breast caused by sagging of the breast tissue. Lateral view (B) 6 months, (C) 12 months and (D) 24 months postoperatively. Visible sagging of the breast tissue behind the submammary fold and upwards projection of the nipple areola complex in the postoperative course. A B C D Figure 10 A 38-year-old patient with breast hyperplasia. (A) Preoperative sternal notch-to-nipple distance 30 cm (right side) and 28 cm (left side), frontal view. (B) Twelve months after reduction mammaplasty with the Eren technique, frontal view. Visible hypertrophic medial scar formation and oblique distortion of the nipple areola complex. (C) Preoperative lateral view. (D) Postoperative lateral view. Good stability of the vertical inframammary distance.
6 Prospective study of different breast reduction techniques 57 A B C D Figure 11 A 22-year-old patient with breast hyperplasia. (A) Preoperative sternal notch-to-nipple distance 26 cm (right side) and 27.5 cm (left side), frontal view. (B) Twenty-nine months after reduction mammaplasty with the Frey technique, frontal view. Slight oblique distortion of the nipple areola complex visible, absent medial scar. (C) Preoperative lateral view. (D) Postoperative lateral view. Good longterm stability of the shape of the breast. result in the B-technique group. A predictive model for successful operation has not been developed so far. 16 Nevertheless, reduction mammaplasty is an effective procedure and the treatment of choice for symptomatic mammary hyperplasia. 17 The sternal notch-to-nipple distance was a stable value measured in the postoperative course for all three techniques of breast reduction. Sagging of the breast is defined as an increase in length of the vertical inframammary distance and not in a change of the sternal notch-to-nipple distance. In all our cases the vertical inframammary distance was fixed to 5 cm intraoperatively. Both techniques used for smaller reductions, the B- and the Frey techniques, showed better long-term stability of the vertical inframammary distance. Berg et al place the new submammary fold less than 7 cm distant from the nipple, which is identical to less than 5 cm from the inferior border of the areola. 18 In his series he found a mean inframammary distance of 11.5 cm (range 7 14 cm) for the Lejour technique and 8.2 cm (range 5 13 cm) for the Strömbeck technique in an early follow-up 12 months postoperatively. This corresponds to a vertical inframammary distance of 9.5 cm and 6.2 cm, respectively. In another series, Pickford and Boorman reported (again for the Lejour technique) a mean length of the vertical inframammary scar of 10 cm, ranging from 7 to 13 cm. However, only one was noted to extend below the breast onto the chest wall. 1 A slight oblique distortion of the areola was found in all three groups. The asymmetry was more pronounced in patients who underwent reduction mammaplasty by the Eren technique. These women were mostly overweight and the remaining breast was larger than in the other groups. Also, the quality of the skin and its aptitude for retraction was reduced in this group. Secondary enlargement of the areola in the B- technique group was due to the fact that, in this series, in some of the earlier patients we did not use a nonabsorbable periareolar purse string suture to prevent this phenomenon. Periareolar wrinkling, particularly in the upper part of the areola, generally resolves over a period of months. Excessive puckering of the skin due to large reductions with nipple transposition distances over 10 cm should be avoided using an inverted- T skin incision (Fig. 12). Preoperative nipple sensibility was rated higher in small-breasted women undergoing reduction mammaplasty either by the B- or by the Frey technique. This difference illustrates the different chronic traction injury to the fourth, fifth and sixth intercostal nerves. 19 Preservation of sensory branches, namely of the fourth intercostal nerve, may be possible to a higher extent in techniques using a central pedicle Further advantages of the central pedicle are the vascular security of the NAC and the conservation of lactiferous ducts. 23 The overall complication rate seems to be high for all groups, because all minor wound healing problems were cited. As expected the highest complication rate was found in obese patients in the Eren group. Complications for large (up to 50%) breast reductions are reported by different authors. 1,10,18,24 Most of these complications resolved conservatively with or without administration of oral antibiotics. Major revisions had to be performed in only a few cases in all groups
7 58 British Journal of Plastic Surgery Figure 12 A 22-year-old patient with breast hyperplasia. (A) Preoperative sternal notch-to-nipple distance 32 cm, frontal view. (B) Postoperative result 16 months after reduction mammaplasty with the Frey technique, frontal view. Puckering of the skin particularly in the upper part of the areola and slight secondary widening of the areola. (3.4 to 6.7%). Secondary scar revisions of the inverted-t skin incision and corrections of dog-ears in the Eren technique were significantly more frequent than in the other two techniques with B-shaped skin incisions. As a result of this study we now use the following therapeutic strategy to treat breast hyperplasia: For reductions with nipple transposition up to 10 cm we prefer the Frey technique. It provides 1. A good long-term stability of breast shape, especially of the submammary distance. 2. Absence of a medial scar. 3. Preservation of sensibility and conservation of vascularity and lactiferous ducts by the central pedicle. 4. A low incidence of revision procedures. In reduction mammaplasties with nipple transpositions greater than 10 cm we use the Eren technique: 1. Long-term stability is achieved by dermal suspension of the breast tissue. 2. The medial scar cannot be avoided in larger reductions because its absence would result in a permanent periareolar wrinkling. 3. Nipple sensibility, lactation and vascularity are preserved by the central pedicle. References 1. Pickford MA, Boorman JG. Early experience with the Lejour vertical scar reduction mammaplasty technique. Br J Plast Surg 1993; 46: Kurtay M. Standardization in reduction mammaplasty: a comparison of techniques. Plast Reconstr Surg 1993; 92: Regnault P. Reduction mammaplasty by the B technique. Plast Reconstr Surg 1974; 53: Eren S. Personal communications, Frey M. A new technique of reduction mammaplasty: dermis suspension and elimination of medial scars. Br J Plast Surg 1999; 52: Goin MK, Goin JM, Gianini MH. The psychic consequences of a reduction mammaplasty. Plast Reconstr Surg 1977; 59: Strömbeck JO. Macromastia in women and its surgical treatment: a clinical study based on 1042 cases. Acta Chir Scand Suppl 1964; 341: Berg A, Stark B, Malec E. Reduction mammaplasty: a way helping females with neck, shoulder and back pain symptoms. Eur J Plast Surg 1994; 17: Letterman G, Schurter M. The effects of mammary hypertrophy on the skeletal system. Ann Plast Surg 1980; 5: Dabbah A, Lehman JA Jr, Parker MG, Tantri D, Wagner DS. Reduction mammaplasty: an outcome analysis. Ann Plast Surg 1995; 35: Gonzalez F, Walton RL, Shafer B, Matory WE Jr, Borah GL. Reduction mammaplasty improves symptoms of macromastia. Plast Reconstr Surg 1993; 91: Boschert MT, Barone CM, Puckett CL. Outcome analysis of reduction mammaplasty. Plast Reconstr Surg 1996; 98: Davis GM, Ringler SL, Short K, Sherrick D, Bengtson BP. Reduction mammaplasty: long-term efficacy, morbidity, and patient satisfaction. Plast Reconstr Surg 1995; 96: Hughes LA, Mahoney JL. Patient satisfaction with reduction mammaplasty: an early survey. Aesth Plast Surg 1993; 17: Raispis T, Zehring RD, Downey DL. Long-term functional results after reduction mammaplasty. Ann Plast Surg 1995; 34: Miller AP, Zacher JB, Berggren RB, Falcone RE, Monk J. Breast reduction for symptomatic macromastia: can objective predictors for operative success be identified? Plast Reconstr Surg 1995; 95: Schnur PL, Schnur DP, Petty PM, Hanson TJ, Weaver AL. Reduction mammaplasty: an outcome study. Plast Reconstr Surg 1997; 100: Berg A, Palmer B, Stark B. Early experience with Lejour vertical scar reduction mammaplasty technique. Eur J Plast Surg 1995; 18: Slezak S, Dellon AL. Quantitation of sensibility in gigantomastia and alteration following reduction mammaplasty. Plast Reconstr Surg 1993; 91: Gonzalez F, Brown FE, Gold ME, Walton RL, Shafer B. Preoperative and postoperative nipple-areola sensibility in patients undergoing reduction mammaplasty. Plast Reconstr Surg 1993; 92: Sarhadi NS, Soutar DS. Nerve supply of the nipple: only from the fourth or from several intercostal nerves? A clinical experiment and an anatomical investigation. Eur J Plast Surg 1997; 20: Jaspars JJP, Posma AN, van Immerseel AAH, Gittenberger-de Groot AC. The cutaneous innervation of the female breast and nipple-areola complex: implications for surgery. Br J Plast Surg 1997; 50: Palmer JH, Taylor GI. The vascular territories of the anterior chest wall. Br J Plast Surg 1986; 39: Lejour M. Invited commentary. Eur J Plast Surg 1995; 18:
8 Prospective study of different breast reduction techniques 59 The Authors Pietro Giovanoli MD, Senior Registrar, Manfred Frey MD, Professor of Plastic and Reconstructive Surgery, Director, Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical School, University of Vienna, A-1090 Vienna, Austria. Correspondence to: Dr Pietro Giovanoli, Abt. f. Plastische und Wiederherstellungschirurgie, Universitätsklinik für Chirurgie, Währinger Gürtel 18 20, A-1090 Vienna, Austria. Paper received 2 February Accepted 9 September 1998, after revision. Claudia Meuli-Simmen MD, Senior Registrar, Viktor E. Meyer MD, Professor of Plastic and Reconstructive Surgery, Director, Department of Surgery, Division of Hand, Plastic and Reconstructive Surgery, Medical School, University of Zurich, CH-8091 Zurich, Switzerland.
Medial Pedicle Reduction Mammaplasty for Severe Mammary Hypertrophy
Medial Pedicle Reduction Mammaplasty for Severe Mammary Hypertrophy Maurice Y. Nahabedian, M.D., Bernard M. McGibbon, M.D., and Paul N. Manson, M.D. Baltimore, Md. Current options in reduction mammaplasty
More informationA comparison of the patient and surgeon opinion on the long-term aesthetic outcome of reduction mammaplasty
British Journal of Plastic Surgery (1998), 51,444M49 9 1998 The British Association of Plastic Surgeons BRITISH JOURNAL OF \ ~ ) PLASTIC SURGERY A comparison of the patient and surgeon opinion on the long-term
More informationBreast Reduction By Dr. Tarek Ahmed Said Professor of Plastic Surgery Cairo University 2017
Breast Reduction By Dr. Tarek Ahmed Said Professor of Plastic Surgery Cairo University 2017 Reduction Mammaplasty SAFE Good Size Reduction Minimal Scar Aesthetic & Long Lasting Breast Shape Reduction Mammaplasty
More informationPlastic Surgery of the Breast: Keeping the Nipple Sensitive
Plastic Surgery of the Breast: Keeping the Nipple Sensitive Charles A. Riccio, MS, Matthew R. Zeiderman, BA, Saeed Chowdhry, MD, Ronald M. Brooks, MD, Shahrooz S. Kelishadi, MD, John Paul Tutela, MD, Joshua
More informationVertical mammaplasty has been developed
BREAST Y-Scar Vertical Mammaplasty David A. Hidalgo, M.D. New York, N.Y. Background: Vertical mammaplasty is an effective alternative to inverted-t methods. Among other benefits, it results in a significantly
More informationAESTHETIC SURGERY OF THE BREAST: MASTOPEXY, AUGMENTATION & REDUCTION
CHAPTER 18 AESTHETIC SURGERY OF THE BREAST: MASTOPEXY, AUGMENTATION & REDUCTION Ali A. Qureshi, MD and Smita R. Ramanadham, MD Aesthetic surgery of the breast aims to either correct ptosis with a mastopexy,
More informationCarpal Tunnel Syndrome in Women Undergoing Reduction Mammaplasty
Carpal Tunnel Syndrome in Women Undergoing Reduction Mammaplasty Luis R. Pernia, M.D., Daniel N. Ronel, M.D., F.A.A.P., James D. Leeper, Ph.D., and Howard L. Miller, Ph.D., M.P.H. Tuscaloosa, Ala., and
More informationReduction mammaplasty is a surgical procedure designed to remove a variable proportion of breast tissue.
Last Review Status/Date: March 2014 Page: 1 of 7 Description Reduction mammaplasty is a surgical procedure designed to remove a variable proportion of breast tissue. Background Macromastia, or gigantomastia,
More informationDespite breast reduction being one of the BREAST. Does Knowledge of the Initial Technique Affect Outcomes after Repeated Breast Reduction?
BREAST Does Knowledge of the Initial Technique Affect Outcomes after Repeated Breast Reduction? Jamil Ahmad, M.D. Sarah M. McIsaac, M.D. Frank Lista, M.D. Mississauga and Ottawa, Ontario, Canada Background:
More informationUniversity of Medicine and Pharmacy of Craiova DOCTORAL SCHOOL. PhD Thesis
University of Medicine and Pharmacy of Craiova DOCTORAL SCHOOL PhD Thesis BREAST RECONSTRUCTION AFTER SURGERY FOR BREAST HIPERTROPHY AND BENIGN TUMORS Summary Ph.D. SUPERVISOR: Prof. univ. dr. Mihai Brăila
More informationAutoaugmentation Mastopexy with an Inferior-Based Pedicle
Aesth Plast Surg (2009) 33:302 307 DOI 10.1007/s00266-009-9310-7 ORIGINAL ARTICLE Autoaugmentation Mastopexy with an Inferior-Based Pedicle Johannes Franz Hönig Æ Hans Peter Frey Æ Frank Michael Hasse
More informationSafe Plastic Surgery of the Breast II: Saving Nipple Sensation
Safe Plastic Surgery of the Breast II: Saving Nipple Sensation Steven Schulz, MD, a,b Matthew R. Zeiderman, MD, c J. Stephen Gunn, MD, a Charles A. Riccio, MD, d Saeed Chowdhry, MD, a,e Ronald Brooks,
More informationBreast Augmentation and Mastopexy Using a Pectoral Muscle Loop
Aesth Plast Surg (2011) 35:333 340 DOI 10.1007/s00266-010-9612-9 ORIGINAL ARTICLE Breast Augmentation and Mastopexy Using a Pectoral Muscle Loop André Auersvald Luiz Augusto Auersvald Received: 28 April
More informationSuperomedial Pedicle Reduction with Short Scar
Superomedial Pedicle Reduction with Short Scar Scott L. Spear, M.D., F.A.C.S., 1 Steven P. Davison, M.D., D.D.S., F.A.C.S., 1 and Ivan Ducic, M.D., Ph.D. 1 ABSTRACT Reduction mammaplasty combining a superomedial
More informationCircumareolar Mastopexy
Circumareolar Mastopexy and Moderate Reduction drien iache n mastopexy the problems created by the doughnut-type excision and scarring are relatively minimal, because the breast tissue is not excised and
More informationThe ideal reduction mammaplasty should produce. Eliminating the Vertical Scar in Breast Reduction Boston Modification of the Robertson Technique
Eliminating the Vertical Scar in Breast Reduction Boston Modification of the Robertson Technique Kiya Movassaghi, MD, DMD; Eric C. Liao, MD, PhD; Vivian Ting, MD; Evan Matros, MD; Donald J. Morris, MD;
More informationSuperior Pedicle Vertical Scar Mammaplasty: Surgical Technique
Superior Pedicle Vertical Scar Mammaplasty: Surgical Technique 4 Foad Nahai A man honours himself by not displaying all the knowledge he has acquired. Folk Tradition Introduction I first tried the vertical
More informationReduction Mammaplasty for Breast-Related Symptoms. Original Policy Date
MP 7.01.16 Reduction Mammaplasty for Breast-Related Symptoms Medical Policy Section Surgery Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013 Return
More informationEvolution of the Vertical Reduction Mammaplasty
CME Evolution of the Vertical Reduction Mammaplasty Scott L. Spear, M.D., and Michael A. Howard, M.D. Washington, D.C. Learning Objectives: After studying this article, the participant should be able to:
More informationMacromastia (large breasts): request for breast reduction
Practice 10 Minute Consultation Macromastia (large breasts): request for breast reduction BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c5408 (Published 13 October 2010) Cite this as: BMJ 2010;341:c5408
More informationONCOPLASTIC SURGERY. Dr. Sadir Alrawi Director of Surgical Oncology Services. Dr. Humaa Darr Surgical Oncology Fellow
Hessa St ONCOPLASTIC SURGERY Dr. Sadir Alrawi Director of Surgical Oncology Services Dr. Humaa Darr Surgical Oncology Fellow Al Sufouh Rd AL SUFOUH AL SUFOUH Sharaf DG Mall of the Emirates Mall Of the
More informationReduction mammoplasty techniques in post-bariatric patients: our experience
Acta Biomed 2017; Vol. 88, N. 2: 156-160 DOI: 10.23750/abm.v88i2.5085 Mattioli 1885 Original article Reduction mammoplasty techniques in post-bariatric patients: our experience Susanna Polotto 1, Michele
More informationThe vertical reduction mammaplasty was first
Special Topic Technical Refinements of the Vertical Mammaplasty: A Modified Lejour Approach Steven G. Wallach, MD Dr. Wallach is Assistant Clinical Professor of Plastic Surgery, Albert Einstein College
More informationReduction Mammaplasty for Breast-Related Symptoms
Reduction Mammaplasty for Breast-Related Symptoms Policy Number: 7.01.21 Last Review: 7/2014 Origination: 7/2005 Next Review: 7/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide
More informationModified ''Lejour Technique'': A Safe Option for Large Breasts Reductions
Egypt, J. Plast. Reconstr. Surg., Vol. 34, No. 1, January: 1-7, 2010 Modified ''Lejour Technique'': A Safe Option for Large Breasts Reductions KARIM KHALIL EL-LAMIE, M.D. The Department of Plastic Surgery,
More informationEssential Anatomy for oncoplastic surgery. Omar Z. Youssef M.D Professor of surgical oncology NCI- Cairo University
Essential Anatomy for oncoplastic surgery Omar Z. Youssef M.D Professor of surgical oncology NCI- Cairo University Introduction Rationale for anatomical basis for OPS Anatomical considerations: 1. Surface
More informationMayo Clin Proc, May 2001, Vol 76 Clinical Outcomes in Reduction Mammaplasty 504 bursement regardless of the patient s physical or psychosocial complai
Mayo Clin Proc, May 2001, Vol 76 Clinical Outcomes in Reduction Mammaplasty 503 Review Clinical Outcomes in Reduction Mammaplasty: A Systematic Review and Meta-analysis of Published Studies ELENIE B. CHADBOURNE,
More informationThe Effect of Breast Hypertrophy on Patient Posture
The Effect of Breast Hypertrophy on Patient Posture Oren Lapid, E Joline de Groof, Leonard UMC Corion, Mark JC Smeulders, Chantal MAM van der Horst Department of Plastic, Reconstructive and Hand Surgery,
More informationBreast reduction surgery is a popular procedure. BREAST Outcomes Article
BREAST Outcomes Article Analysis of Satisfaction and Well-Being following Breast Reduction Using a Validated Survey Instrument: The BREAST-Q Michelle Coriddi, M.D. Meghan Nadeau, M.D. Maakan Taghizadeh,
More informationAugmentation of the Ptotic Breast: Simultaneous Periareolar Mastopexy/Breast Augmentation By: Laurence Kirwan, M.D., F.R.C.S
Augmentation of the Ptotic Breast: Simultaneous Periareolar Mastopexy/Breast Augmentation By: Laurence Kirwan, M.D., F.R.C.S Background: Submusculofascial augmentation of the ptotic breast can result in
More informationAn estimated 40,000 breast reduction procedures were performed in the United. The Common Principles of Effective Breast Reduction Techniques
Special Topic Alexandre de Souza, MD; and Renato Saltz, MD Background: The evolution of breast reduction surgery is discussed to shed light on the various principles and techniques used in this 4-step
More informationPseudoptosis Correction With the 270 Pedicle Reduction Mammoplasty: An Anatomic and Clinical Study
Pseudoptosis Correction With the 270 Pedicle Reduction Mammoplasty: An Anatomic and Clinical Study Matthew R. Zeiderman, BA, a Steven Schulz, MD, b Charles A. Riccio, MS, a Jonathan Nguyen, BS, a Saeed
More informationDefining Pseudoptosis (Bottoming Out) 3 Years After Short-Scar Medial Pedicle Breast Reduction
Aesth Plast Surg (2011) 35:357 364 DOI 10.1007/s00266-010-9615-6 ORIGINAL ARTICLE Defining Pseudoptosis (Bottoming Out) 3 Years After Short-Scar Medial Pedicle Breast Reduction Michelle Quan Ahmed Fadl
More informationThe Vertical Scar Reduction Mammaplasty: a Review of 50 Cases Using Hall Findlay s Technique
The Vertical Scar Reduction Mammaplasty: a Review of 50 Cases Using Hall Findlay s Technique Waleed Haddaden MD*, Muhammad Abo-Samin MD*, Maher Al-Khateeb MD*, Awni Abo-Lail MD*, Khalid El-Maaytah MD*,
More informationPeriareolar Augmentation Mastopexy with Interlocking Gore-Tex Suture, Retrospective Review of 50 Consecutive Patients
Periareolar ugmentation Mastopexy with Interlocking Gore-Tex Suture, Retrospective Review of 50 Consecutive Patients Original rticle Johnny Franco 1, Emma Kelly 2, Michael Kelly 1 1 Miami Plastic Surgery,
More informationName of Policy: Reduction Mammaplasty
Name of Policy: Reduction Mammaplasty Policy #: 056 Latest Review Date: November 2013 Category: Surgery Policy Grade: D Background/Definitions: As a general rule, benefits are payable under Blue Cross
More informationBREAST AUGMENTATION TECHNIQUES
BREAST AUGMENTATION TECHNIQUES Breast Augmentation Top Surgical Procedure in 2015 (Worldwide) Surgical Procedure : Breast Augmentation Rank : 1 Total : 1,488,992 Percent of Total Surgical Procedures :
More informationF ORUM. Horizontal or Vertical? An Evaluation of Patient Preferences for Reduction Mammaplasty Scars
Horizontal or Vertical? An Evaluation of Patient Preferences for Reduction Mammaplasty Scars Amy M. Sprole, MD; Ife Adepoju; Jeffrey Ascherman, MD; Lloyd B. Gayle, MD; Robert T. Grant, MD; and Mia Talmor,
More informationPlastic surgery of the breast includes; augmentation, reduction, Plastic Surgery of the Breast. Abstract. Continuing Education Column
Plastic Surgery of the Breast Keuk Shun Shin, M.D. Keuk SHUN SHIN s Asthetic Plastic Surgery E mail: drsks@drsks.co.kr Abstract Plastic surgery of the breast includes; augmentation, reduction, reconstruction
More informationSelective salvage of zones 2 and 4 in the pedicled TRAM flap: a focus on reducing fat necrosis and improving aesthetic outcomes
DOI 10.1186/s40064-016-1714-7 RESEARCH Open Access Selective salvage of zones 2 and 4 in the pedicled TRAM flap: a focus on reducing fat necrosis and improving aesthetic outcomes Chi Sun Yoon and Kyu Nam
More informationPeriareolar Extra-Glandular Breast Augmentation
Original Article 93 Periareolar Extra-Glandular Breast Augmentation Muhammad Humayun Mohmand 1 *, Muhammad Ahmad 2 1. Cosmetic Plastic Surgeon, La Chirurgie, Islamabad Cosmetic Surgery Centre, Islamabad,
More informationHow To Make a Good Mastectomy for Reconstruction Based on the Anatomy. Zhang Jin, Ph.D MD
How To Make a Good Mastectomy for Reconstruction Based on the Anatomy Zhang Jin, Ph.D MD Deputy Director and Professor Tianjin Medical University Cancer Institute and Hospital People s Republic of China
More informationApplication of the Lalonde (horizontal-only scar) breast reduction technique for correction of gynaecomastia in dark skinned patients
Case Report Application of the Lalonde (horizontal-only scar) breast reduction technique for correction of gynaecomastia in dark skinned patients Fawz Kazzazi 1, Charles M. Malata 2,3,4 1 School of Clinical
More informationIntra-Capsular Versus Extra-Capsular Breast Mastopexy of Previously Augmented Breast
Original Hela Article et al. 301 Intra-Capsular Versus Extra-Capsular Breast Mastopexy of Previously Augmented Breast Hesham A. Helal*, Asser El-Hilaly, Nahed Samir Boughdadi Department of Plastic and
More informationReduction Mammaplasty is not Associated with a Decrease in BMI for Overweight or Obese Women
Research Article imedpub Journals http://www.imedpub.com Vol. 3 No.1: 2 DOI: 10.4172/2472-1905.100025 Reduction Mammaplasty is not Associated with a Decrease in BMI for Overweight or Obese Women Paige
More informationReduction Mammoplasty Operative Techniques for Improved Outcomes in the Treatment of Gigantomastia
Reduction Mammoplasty Operative Techniques for Improved Outcomes in the Treatment of Gigantomastia Brent R. DeGeorge, Jr., MD, PhD, David L. Colen, MD, Alexander F. Mericli, MD, and David B. Drake, MD
More informationActa Medica Okayama OCTOBER Mastectomy in Female-to-male Transsexuals. Yuzaburo Namba Toshiyuki Watanabe Yoshihiro Kimata
Acta Medica Okayama Volume 63, Issue 5 2009 Article 4 OCTOBER 2009 Mastectomy in Female-to-male Transsexuals Yuzaburo Namba Toshiyuki Watanabe Yoshihiro Kimata Department of Plastic and Reconstructive
More informationAll efforts to reduce the size of the breast or to improve the shape of the ptotic
Reduction Mammaplasty and Mastopexy with Shorter Scar and Better Shape Ruth Maria Graf, MD; André Auersvald, MD; Afranio Bernardes, MD; and Thomas M. Biggs, MD Background: Efforts to reduce the size or
More informationBased on patient satisfaction, breast reduction is one of the most successful operations. Breast Reduction Techniques and Outcomes: A Meta-analysis
Special Topic Breast Reduction Techniques and Outcomes: A Meta-analysis Stephen P. Daane, MD a ; and W. Bradford Rockwell, MD b Background: Although sequelae such as visible scarring often are an expected
More informationA long term review of augmentation mastopexy in muscle splitting biplane
Topic: Aesthetic Surgery of the Breast A long term review of augmentation mastopexy in muscle splitting biplane Umar Daraz Khan Aesthetic Plastic Surgeon, Reshape House, West Malling, Kent ME19 6QR, UK.
More informationThe number of breast reduction procedures COSMETIC. Liposuction Breast Reduction: A Prospective Trial in African American Women.
COSMETIC Liposuction Breast Reduction: A Prospective Trial in African American Women Martin J. Moskovitz, M.D. Sherwood A. Baxt, M.D. Aridaman K. Jain, Ph.D. Robert E. Hausman, Ph.D. Paramus, N.J. Background:
More informationF ORUM. Laser-Assisted Breast Reduction: A Safe and Effective Alternative. A Study of 367 Patients
Laser-Assisted Breast Reduction: A Safe and Effective Alternative. A Study of 367 Patients W. Grant Stevens, MD; Robert Cohen, MD; Steven A. Schantz, MD; David A. Stoker, MD; Steven D. Vath, MD; Elliot
More informationChapter 1 SURGICAL ANATOMY OF THE BREAST
Chapter 1 SURGICAL ANATOMY OF THE BREAST Mahmoud El-Tamer and Sunny Mitchell Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA Women s Breast Center,
More informationAesthetic surgery techniques after excision of dermatofibrosarcoma protuberans: a case report
British Journal of Plastic Surgery (2005) 58, 556 560 CASE REPORT Aesthetic surgery techniques after excision of dermatofibrosarcoma protuberans: a case report G. Dagregorio a, *, V. Darsonval b a Department
More informationFrom ancient times to the present day, the aesthetic female breast has been portrayed. A Classification and Algorithm for Treatment of Breast Ptosis
lassification and lgorithm for Treatment of reast Ptosis Laurence Kirwan, M ackground: The Regnault classification of breast ptosis is insufficient for determining surgical strategies for different stages
More informationTechniques for Reduction of Larger Breasts
Techniques for Reduction of Larger Breasts Tolbert S. Wilkinson s discussed earlier, circumareolar surgery was initially performed only for smaller mastopexies; in time its use gradually expanded to include
More informationCurrent Strategies in Breast Reconstruction
Current Strategies in Breast Reconstruction Hani Sbitany, MD Assistant Professor of Surgery University of California, San Francisco Division of Plastic and Reconstructive Surgery 12 th Annual School of
More informationA mammometric comparison of modified Robertson versus Wise pattern inferior pedicle reduction mammoplasty
Plast Aesthet Res 2016;3:284-90 DOI: 10.20517/2347-9264.2016.48 Original Article Plastic and Aesthetic Research www.parjournal.net Open Access A mammometric comparison of modified Robertson versus Wise
More informationPolicy #: 056 Latest Review Date: March 2017
Name of Policy: Reduction Mammaplasty Policy #: 056 Latest Review Date: March 2017 Category: Surgery Policy Grade: D Background/Definitions: As a general rule, benefits are payable under Blue Cross and
More informationPostreduction Breast Augmentation
Postreduction Breast Augmentation Original Article Breast David A. Hidalgo, MD Melissa A. Doft, MD Background: Most breast reduction patients are highly satisfied after surgery. However, there is a subset
More informationReduction Mammaplasty for Breast-Related Symptoms
Reduction Mammaplasty for Breast-Related Symptoms Policy Number: Original Effective Date: MM.06.012 11/12/2002 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 09/01/2017 Section:
More informationcomplicanze in chirurgia senologica ricostruttiva Tecniche per la prevenzione delle complicanze nelle mastectomie conservative
Il trattamento delle complicanze in chirurgia senologica ricostruttiva Tecniche per la prevenzione delle complicanze nelle mastectomie conservative Dr. Christian Rizzetto UOC Chirurgia Senologica - Breast
More informationJPRAS Open 3 (2015) 1e5. Contents lists available at ScienceDirect. JPRAS Open. journal homepage:
JPRAS Open 3 (2015) 1e5 Contents lists available at ScienceDirect JPRAS Open journal homepage: http://www.journals.elsevier.com/ jpras-open Case report The pedicled transverse partial latissimus dorsi
More informationSuccessful Excision of Gynecomastia with Nipple Repositioning Technique Utilizing the Dermoglandular Flap
Case Report 163 Successful Excision of Gynecomastia with Nipple Repositioning Technique Utilizing the Dermoglandular Flap Sadrollah Motamed 1, Seyed Esmail Hassanpour 1, Seyed Mehdi Moosavizadeh 1, Ataollah
More informationA New Reduction Mastopexy Design for Young Women: Snowman Pattern
110 Original Article A New Reduction Mastopexy Design for Young Women: Snowman Pattern Yakup Cil1, Atacan Emre Kocman2 1. 2. Diyarbakır Military Hospital, Department of Plastic Surgery 000 Diyarbakır,
More informationReduction Mammaplasty and Mastopexy in Previously Irradiated Breasts
Breast Surgery Reduction Mammaplasty and Mastopexy in Previously Irradiated Breasts Scott L. Spear, MD; Samir S. Rao, MD; Ketan M. Patel, MD; and Maurice Y. Nahabedian, MD The combination of lumpectomy
More informationPrevention of Implant Malposition in Inframammary Augmentation Mammaplasty
Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty Yoon Ji Kim, Yang Woo Kim, Young Woo Cheon Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center,
More informationBreast cancer reconstruction surgery (immediate and delayed) across Ontario: Patient indications and appropriate surgical options
A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Breast cancer reconstruction surgery (immediate and delayed) across Ontario: Patient indications and appropriate
More informationCosmetic Surgery: Breast Reduction
PROCEDURE FACT SHEET PLASTIC SURGERY Cosmetic Surgery: Breast Reduction This guide is for women who are considering having an operation to lift their breasts. We advise that you talk to a plastic surgeon
More informationh a n d s o m e reduction & an overview
BREAST reduction & Breast lift an overview b r e a s t r e d u c t i o n Having been since ancient times an outstanding symbol for femininity and fertility the female breast has always been a central part
More informationBreast reduction surgery reduction mammaplasty Is it right for me? What to expect during your consultation Be prepared to discuss:
This guide is for women who are considering having an operation to lift their breasts. We advise that you talk to a plastic surgeon and only use this information as a guide to the procedure. Breast reduction
More informationBreast Reduction
Breast Reduction Breasts that are excessively large in proportion to body size are a frequent cause of back and neck pain as well as shoulder irritation from bra straps. Additionally, sleep and participation
More informationNipple-Areolar Complex Reconstruction: A Review of the Literature and Introduction of the Rectangle-to-Cube Nipple Flap
Nipple-Areolar Complex Reconstruction: A Review of the Literature and Introduction of the Rectangle-to-Cube Nipple Flap Joshua T. Henderson, BA, a ThomasJ.Lee,MD, b Andrew M. Swiergosz, BS, a Andrea R.
More informationNipple Sparing Mastectomy: Tips & Tricks. Rebecca Nelson, MD MSc FRCSC Plastic & Reconstructive Surgeon, Burnaby Hospital
Nipple Sparing Mastectomy: Tips & Tricks Rebecca Nelson, MD MSc FRCSC Plastic & Reconstructive Surgeon, Burnaby Hospital Nipple Sparing Mastectomy (NSM) Introduction & Technique Safety Evidence Indications/Contraindications
More informationReduction Mammaplasty for Breast- Related Symptoms
Reduction Mammaplasty for Breast- Related Symptoms Policy Number: 7.01.21 Last Review: 7/2018 Origination: 7/2005 Next Review: 7/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide
More informationBreast Reconstruction: Current Strategies and Future Opportunities
Breast Reconstruction: Current Strategies and Future Opportunities Hani Sbitany, MD Assistant Professor of Surgery University of California, San Francisco Division of Plastic and Reconstructive Surgery
More informationA simple classification and a simplified treatment s algorithm for ptotic breasts
Kotti. Plast Aesthet Res 2018;5:16 DOI: 10.20517/2347-9264.2018.11 Plastic and Aesthetic Research Original Article Open Access A simple classification and a simplified treatment s algorithm for ptotic
More informationOncoplastic Breast Surgery
Disclosures Oncoplastic Breast Surgery Newfoundlander OAGS 2016 Dr Renee Hanrahan General Surgeon Oncologic and Reconstructive Breast Surgeon Objectives What is Oncoplastic Surgery Define Oncoplastic Surgery
More informationTackling challenging revision breast augmentation cases
the BREAST Careful preoperative consultations can reduce the need for revision breast surgery. Second Time Around Tackling challenging revision breast augmentation cases By Adam D. Schaffner, MD, FACS
More informationCOSMETIC SURGERY: BREAST LIFT (MASTOPEXY)
PROCEDURE FACT SHEET PLASTIC SURGERY COSMETIC SURGERY: BREAST LIFT (MASTOPEXY) This guide is for women who are considering having an operation to lift their breasts. We advise that you talk to a plastic
More informationUNDERSTANDiNG THE BREAST AUGMENTATION PROCEDURE
UNDERSTANDiNG THE BREAST AUGMENTATION PROCEDURE Having fuller more voluptuous breasts is a very important part of feeling feminine and more confident for women. The breasts give the female body more proportion,
More informationONCOLOGIC AND COSMETIC CHALLENGES DO NOT ROUTINELY OPPOSE BREAST CONSERVING SURGERY IN RETRO-AREOLA PRIMARY LESIONS
ONCOLOGIC AND COSMETIC CHALLENGES DO NOT ROUTINELY OPPOSE BREAST CONSERVING SURGERY IN RETRO-AREOLA PRIMARY LESIONS SURGERY SYMPOSIUM Ines Buccimazza Breast Unit Department of Surgery Nelson R. Mandela
More informationF ORUM. Is One-Stage Breast Augmentation With Mastopexy Safe and Effective? A Review of 186 Primary Cases
Is One-Stage Breast Augmentation With Mastopexy Safe and Effective? A Review of 186 Primary Cases W. Grant Stevens, MD; David A. Stoker, MD; Mark E. Freeman, MD; Suzanne M. Quardt, MD; Elliot M. Hirsch,
More informationBreast Reconstruction with Superficial Inferior Epigastric Artery Flaps: A Prospective Comparison with TRAM and DIEP Flaps
Breast Reconstruction with Superficial Inferior Epigastric Artery Flaps: A Prospective Comparison with TRAM and DIEP Flaps Pierre M. Chevray, M.D., Ph.D. Houston, Texas Breast reconstruction using the
More informationMitchell Buller, MEng, a Adee Heiman, BA, a Jared Davis, MD, b ThomasJ.Lee,MD, b Nicolás Ajkay, MD, FACS, c and Bradon J. Wilhelmi, MD, FACS b
Immediate Breast Reconstruction of a Nipple Areolar Lumpectomy Defect With the L-Flap Skin Paddle Breast Reduction Design and Contralateral Reduction Mammoplasty Symmetry Procedure: Optimizing the Oncoplastic
More informationImplant selection in the setting of prepectoral breast reconstruction
Review Article Implant selection in the setting of prepectoral breast reconstruction Allen Gabriel, G. Patrick Maxwell Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA,
More informationTips for using shaped implants in breast augmentation
Tips for using shaped implants in breast augmentation Sientra would like to thank Dr. Patricia McGuire of St. Louis, MO for her significant contributions to Sientra s educational efforts. Dr. McGuire has
More informationLancashire Teaching Hospitals NHS Foundation Trust Information for Patients having a Breast Reduction Operation
Lancashire Teaching Hospitals NHS Foundation Trust Information for Patients having a Breast Reduction Operation Plastic Surgery Department Leaflet Number 2 Produced: October 2007 Review date: October 2010
More informationMotiva Implant Matrix Silicone Breast Implants Summary of Clinical Data 5-Year Follow Up
Motiva Implant Matrix Silicone Breast Implants Summary of Clinical Data 5-Year Follow Up October 21 - February 216 Motiva Implant Matrix Silicone Breast Implants Prospective Clinical Evaluation: 5-Year
More informationBREAST AUGMENTATION WITH ANATOMICAL SHAPED IMPLANTS
BREAST AUGMENTATION WITH ANATOMICAL SHAPED IMPLANTS Please note that breast augmentation surgery is often not easy as there are a number of factors to consider including: 1. Chest wall/rib cage shape this
More informationSurgical Treatment Of Major Gynecomastia: A Report Of 2 Cases
ISPUB.COM The Internet Journal of Plastic Surgery Volume 13 Number 1 Surgical Treatment Of Major Gynecomastia: A Report Of 2 Cases A Ndiaye, A Sankalé, L Ndiaye, M Foba Citation A Ndiaye, A Sankalé, L
More informationIncrease of Visible Veins After Breast Augmentation. Yuri Andonakis, MD,* and Berend van der Lei, MD, PhD*
BREAST SURGERY A Retrospective Analysis of 78 Consecutive Breast Augmentation Patients Yuri Andonakis, MD,* and Berend van der Lei, MD, PhD* Abstract: A retrospective study was undertaken to determine
More informationDiagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer. Oncoplastic and Reconstructive Surgery
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Oncoplastic and Reconstructive Surgery Plastic-reconstructive aspects after mastectomy Versions 2002 2017: Audretsch / Bauerfeind
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Reduction Mammaplasty for Breast-Related Symptoms Page 1 of 10 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Reduction Mammaplasty for Breast-Related Symptoms
More informationClinical Accuracy of Portrait 3D Surgical Simulation Platform in Breast Augmentation. Ryan K. Wong MD, David T Pointer BS, Kamran Khoobehi MD FACS
Clinical Accuracy of Portrait 3D Surgical Simulation Platform in Breast Augmentation Ryan K. Wong MD, David T Pointer BS, Kamran Khoobehi MD FACS Division of Plastic, Reconstructive & Reconstructive Surgery,
More informationChampagne Groove Lipectomy: A Safe Technique to Contour the Upper Abdomen in Abdominoplasty
Champagne Groove Lipectomy: A Safe Technique to Contour the Upper Abdomen in Abdominoplasty Ron Brooks, MD, Jonathan Nguyen, MD, Saeed Chowdhry, MD, John Paul Tutela, MD, Sean Kelishadi, MD, David Yonick,
More informationMeasuring quality of life in women undergoing surgery for breast hypertrophy
ORIGINAL ARTICLE Measuring quality of life in women undergoing surgery for breast hypertrophy Carolyn L Kerrigan MD 1, Gaston Schwarz MD 2, Roland Charbonneau MD 2 1 Section of Plastic Surgery, Dartmouth
More informationBREAST AUGMENTATION WITH CONICAL SHAPED IMPLANTS
BREAST AUGMENTATION WITH CONICAL SHAPED IMPLANTS Please note that breast augmentation surgery is often not easy as there are a number of factors to consider including: 1. Chest wall/rib cage shape this
More informationBREAST REDUCTION. Based on my discussions with Dr Gutowski, I understand and agree to the following:
INFORMED CONSENT FOR BREAST REDUCTION PLEASE REVIEW AND BRING WITH YOU ON THE DAY OF YOUR PROCEDURE PATIENT NAME Based on my discussions with Dr Gutowski, I understand and agree to the following: Dr. Gutowski
More informationcally, a distinct superior crease of the forehead marks this spot. The hairline and
4 Forehead The anatomical boundaries of the forehead unit are the natural hairline (in patients without alopecia), the zygomatic arch, the lower border of the eyebrows, and the nasal root (Fig. 4.1). The
More information