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Nipple-sparing mastectomy
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Steven J. Kronowitz, John R. Benson, Maurizio B. Nava
Early publications on nipple-sparing mastectomy1,2 stated that breast ptosis is a contraindication to this procedure, based on an increased risk of nipple necrosis consequent to long, poorly perfused skin flaps, and the inability to control the final nipple position on the breast mound.1 The nipple is such a focal point on the breast that a preserved nipple which is badly positioned may look worse than a correctly positioned, good quality nipple reconstruction.
Should immediate breast reconstruction be performed in the setting of radiotherapy? An ethical analysis
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Emma Hansson, Anna Elander, Håkan Hallberg, Lars Sandman
The severity of outcomes associated with lacking a breast after mastectomy must be considered mild to moderate in relation to other conditions treated in the healthcare system [16]. Utility measurements reveal that a bilateral mastectomy defect [standard gamble (SG): 0.86; and time trade-off (TTO): 0.85] is considered similar to a breast ptosis (SG: 0.90; and TTO: 0.87) [16]. Furthermore, studies show that even women who have had a mastectomy without breast reconstruction adapt quite well in terms of QoL [17,18]. Parker et al. [17] demonstrated similarities in the general patterns of psychosocial adjustment and QoL among women with breast cancer operated on with breast-conserving surgery, mastectomy alone, and mastectomy combined with IBR [17]. Moreover, Harcourt et al. [18] concluded that women who undergo mastectomy with IBR have similar issues involving altered body image as those reported by women undergoing mastectomy alone at 1-year postoperation. Nevertheless, it is difficult to evaluate the significance of these studies, as they likely included women who opted not to undergo reconstruction, as well as those not medically fit to undergo reconstruction, even if this was not reported. Furthermore, patients tend to come to terms with their choice, as long as they feel involved in the decision-making process [19]. Therefore, randomization of patients into groups receiving reconstruction or not receiving reconstruction would likely not provide a more reliable result.
Ligasure™ Impact and Ligasure™ Small Jaw in Body Contouring after Massive Weight Loss: A New Perspective
Published in Journal of Investigative Surgery, 2022
Diletta Maria Pierazzi, Edoardo Pica Alfieri, Roberto Cuomo, Maria Alessandra Bocchiotti, Luca Grimaldi, Aniello Donniacuo, Irene Zerini, Giuseppe Nisi
Mastopexy was performed in patients with Regnault’s grade 2 or grade 3 breast ptosis using superior pedicle technique without breast implants placement.19 The procedure was characterized by Wise pattern drawing, de-epithelialization of the keyhole and skin around nipple-areola complex (NAC), removal of skin excess in the lower part of the Wise pattern, detachment of the gland from pectoralis muscle fascia and back plication of the lower pole of breast parenchyma on itself to improve projection and long-term results. One suction drain for each breast was inserted followed by skin closure and compression dressing.20
Is the transposition of the nipple-areolar complex necessary in Simon grade 2b gynecomastia operations using suction-assisted liposuction?
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Burhan Özalp, Ömer Berköz, Mustafa Aydınol
SNN distance is one of the most important factors for assessing breast ptosis and aesthetic appearance after breast surgery in both male and female patients. It has been reported that NAC 20 cm away from the sternal notch is normal [27]. There is no data in the literature comparing SNN distance and grade 2b patients in the same population. We determined that mean SNN distance was 22.3 cm in the grade 2b gynecomastia patients and 19.9 cm in the control group (p < .05). These measurements showed that grade 2b gynecomastia causes a mean 2.4-cm elongation in SNN distance.