DOCSLIB.ORG

Breast-Augmentation-Techniques.Pdf

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Breast-Augmentation-Techniques.Pdf CME Breast Augmentation David A. Hidalgo, M.D. Learning Objectives: After studying this article , the participant should be able to: Jason A. Spector, M.D. 1. Assess patient physical characteristics that influence implant selection. 2. Adopt New York, N.Y. a system to aid in implant size selection. 3. Become cognizant of the advantages and disadvantages of incision, pocket plane, and implant options. 4. Understand implant positioning concepts and aseptic implant handling methods. 5. Manage untoward postoperative sequelae 6. Understand secondary surgery concepts. Summary: Breast augmentation is the most commonly performed aesthetic surgi- cal procedure. Choices of incisions, pocket plane, and myriad implant character- istics constitute the basis for surgical planning. Analysis of physical characteristics and inclusion of the patient in implant selection contribute to overall satisfac- tion and reduce requests for secondary surgery. Technical expertise in implant positioning and aseptic handling helps to prevent capsular contracture, implant malposition, and other shape problems. Despite the need for secondary surgery in some, patient satisfaction is high. (Plast. Reconstr. Surg. 133: 567e, 2014.) reast augmentation is the most common aes- personality and aesthetics. Anatomic limitations thetic surgical procedure, with more than must be explained to the patient. B300,000 performed in 2011.1 Choices of Height and weight influence implant selec- incisions, pocket plane, and implant characteris- tion. For example, tall patients require larger tics, including shape, texture, filler, and volume, volumes than short patients to achieve a similarly constitute the key decisions in surgical planning. proportioned result. Thin patients are not well Thoughtful analysis of physical characteristics and suited to saline implants. Idiosyncrasies in body patient participation in the process are the most morphology also play a role: patients with wide important factors in size selection. Knowledge of hips or shoulders look better with larger implants implant positioning and aseptic handling concepts compared with those who are narrower.5 contributes to successful outcomes and minimizes Chest wall shape is important to note.6 Pectus the need for secondary surgery. Patient satisfac- excavatum occurs occasionally, whereas pectus cari- tion is high with this procedure, despite significant natum and Poland’s syndrome are rare.7 Central reoperation rates to treat capsular contracture, deformities are typically ameliorated sufficiently by implant deflation, malposition, and other prob- breast augmentation alone. Deep pectus excavatum lems (References 2 and 3: Level of Evidence: deformities can be treated simultaneously with a cus- Therapeutic, IV).2,3 tom solid silicone implant made from a plaster mou- lage, but most patients decline this option. Poland’s ESSENTIALS OF PREOPERATIVE syndrome, when severe, may require adjunctive pro- ASSESSMENT AND MANAGEMENT cedures, such as tissue expansion, fat grafting, and latissimus muscle transfer.7,8 A round thorax shape Patient Evaluation makes the breast axes diverge, causing the breasts Each patient’s psychology, aesthetic sense, and to appear farther apart following augmentation. A anatomy must be critically assessed. Emotional sta- bility is a mandatory prerequisite.4 Style of dress, Disclosure: Neither author has a financial interest makeup, tattoos, piercings, previous aesthetic in any of the products or devices mentioned in this ar- procedures, community, and occupation reflect ticle. This work was not supported by outside funding. From the Division of Plastic Surgery, Weill Cornell Medical Related Video content is available for this arti- College. cle. The videos can be found under the “Related Received for publication April 9, 2012; accepted September Videos” section of the full-text article, or, for 21, 2012. Ovid users, using the URL citations published Copyright © 2014 by the American Society of Plastic Surgeons in the article. DOI: 10.1097/PRS.0000000000000033 www.PRSJournal.com 567e Plastic and Reconstructive Surgery • April 2014 rectangular thorax makes the axes parallel, so that with atrophic tissue and poor skin elasticity make the breasts appear closer together postoperatively.9 visual and tactile implant concealment challeng- Hemithorax asymmetry due to differences in shape ing, and also pose a risk of late lower pole descent. or relative protrusion can create an uneven breast Conservatively sized silicone implants are the best foundation, suggesting different size implants choice in these patients. A concomitant masto- despite equivalent breast volumes (Fig. 1).10 Sco- pexy allows excision of some of the inelastic lower liosis can cause vertical breast asymmetry requiring pole skin and enables placement of a smaller, thoughtful implant positioning to minimize it.11 lighter implant in more extreme cases. Existing breast volume influences implant Nipple hypertrophy and ptosis, common in filler choice. Small volume is not very compat- postpartum patients, may be improved by circum- ible with saline implants, but as volume increases, ferential skin excision at the nipple base. (See there is less difference between saline and silicone. Video, Supplemental Digital Content 1, which Breast shape may limit implant selection. demonstrates a nipple reduction. This video is Vertically short breasts are prone to lower pole available in the “Related Videos” section of the full- deformities as implant diameter increases. Simi- text article on PRSJournal.com or, for Ovid users, larly, breasts with constricted base diameters, at http://links.lww.com/PRS/A952.) Reduction in such as tubular breast deformity, are challenging both height and diameter can be achieved by the to aggressively augment and may require a more top-hat reduction method.16 Treating this condi- complex treatment strategy.12–14 tion is simple and enhances the overall result. Inframammary crease anatomy is also impor- Nipple-areolar position asymmetry is magni- tant. Minimal crease definition imposes little restric- fied by breast augmentation (Fig. 2). A unilateral tion on implant diameter selection, and therefore circumareolar mastopexy or a Y-scar mastopexy size. Glandular ptosis with a sharply defined crease can be considered depending on the severity of located close to the areola represents the oppo- the problem.17 site extreme. This type is prone to double-bubble The larger the areolar diameter, the more deformities as implant diameter increases.15 it tends to stretch following surgery. Conserva- Tissue characteristics and skin quality are tive circumareolar excision should be considered equally important factors. Postpartum patients with diameters approaching 6 cm. Circumareolar Fig. 1. Chest wall shape can affect the axes of the breasts and their relative projection. 568e Volume 133, Number 4 • Breast Augmentation Video 1. Supplemental Digital Content 1, which demonstrates nip- ple reduction, is available in the “Related Videos” section of the full- text article on PRSJournal.com or, for Ovid users, at http://links.lww. com/PRS/A952. excision must be coupled with a periareolar been proven in the subpectoral plane.19 Smooth purse-string suture, typically with nonabsorbable implants are currently used in approximately 90 suture material, in order to provide a lasting result. percent of patients in the United States.21 Round implants are used in 95 percent Implant Selection of patients in the United States today.21 Supe- Size (volume and diameter) is arguably the rior aesthetic results using anatomic implants most critical aspect of implant selection, followed remain unproven. Implant rotation requiring by filler type.Second-tier factors include shape, additional surgery can occur with these devices profile, and surface texture. ( Reference 23: Level of Evidence: Therapeu- The differences between textured and smooth tic, IV).22,23 Unlike in breast reconstruction, a dif- implants have been debated (Reference 19: Level ferent scenario, there is no clear role for anatomic of Evidence: Therapeutic, I).18,19 Current evidence implants in breast augmentation. holds that smooth implants are more prone to Implant profile is a variable that aids in achiev- capsular contracture in the subglandular plane.20 ing maximum volume in patients having narrow A difference between the two types has not chests, breast base diameters, or both. Higher Fig. 2. (Left) Preoperative nipple-areolar position asymmetry. (Right) The asym- metry is magnified following augmentation, but within acceptable limits. 569e Plastic and Reconstructive Surgery • April 2014 Size is usually the most important implant vari- able to the patient. Magazine photographs, cup sizes, and friends’ experiences are not reliable measures for determining size. One recommended method computes optimal size based on breast base width, anterior skin stretch, upper pole pinch thickness, inframammary fold pinch thickness, and stretched nipple-to-fold distance.24–26 This ana- lytic method determines optimal implant dimen- sions based on individual anatomic characteristics. Preoperative sizing is another method that is more subjective in its approach. It consists of plac- ing sample implants in a bra to preview a range of possible results.27 The surgeon first determines a size range suggested by height, weight, and body habitus that is also mindful of breast anatomy restrictions. This process shares ownership of the final decision between the patient and the sur- geon. It has been shown to minimize
Load more

Recommended publications
  • Breast Reconstruction Surgery for Mastectomy in Hospital Inpatient and Ambulatory Settings, 2009–2014
    HEALTHCARE COST AND Agency for Healthcare UTILIZATION PROJECT Research and Quality STATISTICAL BRIEF #228 October 2017 Highlights Breast Reconstruction Surgery for ■ From 2009 to 2014, in 22 Mastectomy in Hospital Inpatient and States, the population rate of Ambulatory Settings, 2009–2014 breast reconstruction for mastectomy increased by 62 Adela M. Miller, B.S., Claudia A. Steiner, M.D., M.P.H., percent, from 21.7 to 35.1 per Marguerite L. Barrett, M.S., Kathryn R. Fingar, Ph.D., M.P.H., 100,000 women aged 18 years and Anne Elixhauser, Ph.D. or older. ■ Increases occurred for all age Introduction groups, but disproportionately so for women aged 65 years After a mastectomy (surgical removal of the breast), a woman and older, those covered by faces a complex and emotional decision about whether to have Medicare, and those who were breast reconstruction or live without a breast or breasts. There uninsured. are usually three main considerations in the decision: medical, sexual, and physical. Medical considerations include concerns ■ In 2014, women who lived in that breast reconstruction surgery lengthens recovery time and rural areas had fewer increases the chance for infection and other postoperative reconstructions (29 per 100 complications. Sexual considerations involve the impact of the mastectomies) compared with mastectomy on future sexual encounters. Physical features urban-dwelling women (41 include how breasts may define femininity and sense of self.1 reconstructions per 100 mastectomies). Several previous studies have shown an increase in breast ■ Growth in breast reconstructive 2,3,4 reconstruction for mastectomy. One study used a 2007 surgery was primarily national surgical database, another study used 2008 claims-based attributable to the following data of women insured through large private employers, and a factors: third study used the Nationwide Inpatient Sample (NIS) for 2005– 2011,5,6,7 part of the Healthcare Cost and Utilization Project o Ambulatory surgeries (HCUP) increased more than 150 percent.
    [Show full text]
  • Breast Reconstruction with Expanders and Implants
    Evidence-Based Clinical Practice Guideline: Breast Reconstruction with Expanders and Implants INTRODUCTION Disclaimer Evidence-based guidelines are strategies for patient management, The American Cancer Society estimates that nearly 230,000 American developed to assist physicians in clinical decision making. This women were diagnosed with invasive breast cancer in 2011.1 Many of guideline was developed through a comprehensive review of the these individuals will require mastectomy and total reconstruction of scientific literature and consideration of relevant clinical experience, the breast. The diagnosis and subsequent process can create signifi- and describes a range of generally acceptable approaches to diagnosis, cant confusion and distress for the affected persons and their families management, or prevention of specific diseases or conditions. This and, consequently, surgical treatment and reconstructive procedures guideline attempts to define principles of practice that should are of utmost importance in the breast cancer care continuum. In generally meet the needs of most patients in most circumstances. 2011, the American Society of Plastic Surgeons® (ASPS) reported an increase in the rate of breast reconstructions, citing nearly 100,000 However, this guideline should not be construed as a rule, nor procedures, of which the majority employed expanders/implants.2 should it be deemed inclusive of all proper methods of care The 3% increase in reconstructions over the course of just one year or exclusive of other methods of care reasonably directed at highlights the significance of maintaining patient safety and obtaining the appropriate results. It is anticipated that it will be optimizing surgical outcomes. necessary to approach some patients’ needs in different ways.
    [Show full text]
  • Surgical Options for Breast Cancer
    The Breast Center Smilow Cancer Hospital 20 York Street, North Pavilion New Haven, CT 06510 Phone: (203) 200-2328 Fax: (203) 200-2075 SURGICAL OPTIONS There are a number of surgical procedures available today for the treatment of breast cancer. You will likely have a choice and will need to make your own decision, in consultation with your specific surgeon, about the best option for you. We offer you a choice because the research on the treatment of breast cancer has clearly shown that the cure and survival rates are the same regardless of what you choose. The choices can be divided into breast conserving options (i.e. lumpectomy or partial mastectomy) or breast removing options (mastectomy). A procedure to evaluate your armpit (axillary) lymph nodes will likely occur at the same time as your breast surgery. This is done to help determine the likelihood that cells from your breast cancer have left the breast and spread (metastasized) to another more dangerous location. This information will be used to help decide about your need for chemotherapy or hormone blocking drugs after surgery. PARTIAL MASTECTOMY (LUMPECTOMY) A partial mastectomy involves removing the cancer from your breast with a rim, or margin, of normal breast tissue. This allows the healthy noncancerous part of your breast to be preserved, and usually will not alter the sensation of the nipple. The benefit of this surgical choice is that it often preserves the cosmetics of the breast. Your surgeon will make a decision about the volume of tissue that needs removal in order to maximize the chance of clear margins as confirmed by our pathologist.
    [Show full text]
  • ASPS Clinical Practice Guideline Summary on Breast Reconstruction with Expanders and Implants
    CME ASPS Clinical Practice Guideline Summary on Breast Reconstruction with Expanders and Implants Amy Alderman, M.D., M.P.H. Learning Objectives: After reading this article, participants should be able to: Karol Gutowski, M.D. 1. Understand the evidence regarding the timing of expander/implant breast re- Amy Ahuja, M.P.H. construction in the setting of radiation therapy. 2. Discuss the implications of a Diedra Gray, M.P.H. patient’s risk factors for possible outcomes and complications of expander/implant Postmastectomy breast reconstruction. 3. Implement proper prophylactic antibiotic protocols. 4. Use Expander/Implant Breast the guidelines to improve their own clinical outcomes and reduce complications. Reconstruction Guideline Summary: In March of 2013, the Executive Committee of the American Society Work Group of Plastic Surgeons approved an evidence-based guideline on breast reconstruc- Arlington Heights, Ill. tion with expanders and implants, as developed by a guideline-specific work group commissioned by the society’s Health Policy Committee. The guideline addresses ten clinical questions: patient education, immediate versus delayed reconstruction, risk factors, radiation therapy, chemotherapy, hormonal therapy, antibiotic prophylaxis, acellular dermal matrix, monitoring for cancer recur- rence, and oncologic outcomes associated with implant-based reconstruction. The evidence indicates that patients undergoing mastectomy should be offered a preoperative referral to a plastic surgeon. Evidence varies regarding the as- sociation between postoperative complications and timing of postmastectomy expander/implant breast reconstruction. Evidence is limited regarding the opti- mal timing of expand/implant reconstruction in the setting of radiation therapy but suggests that irradiation to the expander or implant is associated with an increased risk of postoperative complications.
    [Show full text]
  • Breast Cancer Treatment What You Should Know Ta Bl E of C Onte Nts
    Breast Cancer Treatment What You Should Know Ta bl e of C onte nts 1 Introduction . 1 2 Taking Care of Yourself After Your Breast Cancer Diagnosis . 3 3 Working with Your Doctor or Health Care Provider . 5 4 What Are the Stages of Breast Cancer? . 7 5 Your Treatment Options . 11 6 Breast Reconstruction . 21 7 Will Insurance Pay for Surgery? . 25 8 If You Don’t Have Health Insurance . 26 9 Life After Breast Cancer Treatment . 27 10 Questions to Ask Your Health Care Team . 29 11 Breast Cancer Hotlines, Support Groups, and Other Resources . 33 12 Definitions . 35 13 Notes . 39 1 Introducti on You are not alone. There are over three million breast cancer survivors living in the United States. Great improvements have been made in breast cancer treatment over the past 20 years. People with breast cancer are living longer and healthier lives than ever before and many new breast cancer treatments have fewer side effects. The New York State Department of Health is providing this information to help you understand your treatment choices. Here are ways you can use this information: • Ask a friend or someone on your health care team to read this information along with you, or have them read it and talk about it with you when you feel ready. • Read this information in sections rather than all at once. For example, if you have just been diagnosed with breast cancer, you may only want to read Sections 1-4 for now. Sections 5-8 may be helpful while you are choosing your treatment options, and Section 9 may be helpful to read as you are finishing treatment.
    [Show full text]
  • Breast Lift (Mastopexy)
    BREAST LIFT (MASTOPEXY) The operation for breast lift is aimed at elevation of your normal breast tissue. This operation will not affect back, neck and shoulder pain due to the other problems such as arthritis. It also is not a weight loss procedure for obesity, nor will this operation correct stretch marks which may already be present. Often times this opera- tion is done to recreate symmetry if there is a large discrepancy in the shape of the two breasts. This operation has inherent risks asso- ciated with any surgery including infection, bleeding and the risk associated with the general anesthesia which is necessary. In addi- tion this operation results in scars around the areola and beneath the breast as has been described. It is impossible to lift the breasts with- out obvious scars. Although attempts and techniques will be made to minimize the scarring, this is an area of the body in which scars tend to widen due to location and the weight of the breasts. Revi- sion of these scars may be possible depending on their appearance following a 9-12 month healing period. In addition, these widened scars may be the result of delayed healing resulting from a small area of skin death in the portion where the two incisions come to- gether. This area is prone to a partial separation of the scar due to the tension and often times marginal blood supply in this area. This usually can be treated with local wound care including hydro- gen peroxide washes and application of a antibiotic ointment.
    [Show full text]
  • Therapeutic Mammaplasty Information for Patients the Aim of This Booklet Is to Give You Some General Information About Your Surgery
    Oxford University Hospitals NHS Trust Therapeutic mammaplasty Information for patients The aim of this booklet is to give you some general information about your surgery. If you have any questions or concerns after reading it please discuss them with your breast care nurse practitioner or a member of staff at the Jane Ashley Centre. Telephone numbers are given at the end of this booklet. Author: Miss P.G.Roy, Consultant Oncoplastic Breast Surgeon Oxford University Hospitals NHS Trust Oxford OX3 9DU page 2 Therapeutic mammaplasty This operation involves combining a wide local excision (also known as a lumpectomy) with a breast reduction technique resulting in a smaller, uplifted and better shaped breast. This means that the lump can be removed with a wide rim of healthy tissue. The nipple and areola are preserved with their intact blood supply and the remaining breast tissue is repositioned to allow reshaping of the breast. The scars are either in the shape of a lollipop or an anchor (as shown below). You may have a drain placed in the wound to remove excess fluid; this is usually left in for 24 hours. This procedure can be carried out on one or both of your breasts, as discussed with your surgeon. Vertical mammaplasty Lollipop scar Wise pattern Anchor shaped scar mammaplasty page 3 Your nipple is moved to a new position to suit your new breast shape and size but it may end up in a position different to your wishes. The surgeon will try to achieve a mutually agreed breast size whilst performing the operation; however a cup size cannot be guaranteed and there are likely to be further significant changes to your breast after radiotherapy.
    [Show full text]
  • Silicone-Filled Breast Implants
    Important Information for Women About Breast Reconstruction with INAMED® Silicone-Filled Breast Implants RECON Patient Labeling Rev 11/03/06/06 page 1 TABLE OF CONTENTS Page GLOSSARY ..................................................................................................................................... 4 1. CONSIDERING SILICONE GEL-FILLED BREAST IMPLANT SURGERY ............................ 10 1.1 WHAT GIVES THE BREAST ITS SHAPE? ...................................................................... 11 1.2 WHAT IS A SILICONE GEL-FILLED BREAST IMPLANT? .............................................. 11 1.3 ARE SILICONE GEL-FILLED BREAST IMPLANTS RIGHT FOR YOU? ......................... 12 1.4 IMPORTANT FACTORS YOU SHOULD CONSIDER IN CHOOSING SILICONE GEL-FILLED BREAST IMPLANTS ................................................................. 12 2. BREAST IMPLANT COMPLICATIONS................................................................................... 14 2.1 WHAT ARE THE POTENTIAL COMPLICATIONS? ......................................................... 14 2.2 WHAT ARE OTHER REPORTED CONDITIONS? ........................................................... 19 3. ALLERGAN* CORE STUDY RESULTS .................................................................................. 22 3.1 OVERVIEW OF ALLERGAN’S CORE STUDY................................................................. 22 3.2 WHAT WERE THE 4-YEAR FOLLOW-UP RATES? ........................................................ 22 3.3 WHAT WERE THE BENEFITS? ......................................................................................
    [Show full text]
  • Clinical Guidelines for the Management of Breast Cancer West Midlands Expert Advisory Group for Breast Cancer West Midlands Clinical Networks and Clinical Senate
    Clinical Guidelines for the Management of Breast Cancer West Midlands Expert Advisory Group for Breast Cancer West Midlands Clinical Networks and Clinical Senate Coversheet for Network Expert Advisory Group Agreed Documentation This sheet is to accompany all documentation agreed by the West Midlands Strategic Clinical Network Expert Advisory Groups. This will assist the Clinical Network to endorse the documentation and request implementation. EAG name Breast Cancer Expert Advisory Group Document Clinical guidelines for the management of breast cancer Title Published December 2016 date Document Clinical guidance for the management of Breast cancer to all practitioners, Purpose clinicians and health care professionals providing a service to all patients across the West Midlands Clinical Network. Authors Original Author: Mr Stephen Parker Modified By: Mrs Abigail Tomlins Consultant Breast Surgeon University Hospitals Coventry & Warwickshire NHS Trust References Consultation These guidelines were originally authored by Stephen Parker and Process subsequently modified by Abigail Tomlins for the Coventry, Warwickshire and Worcestershire Breast Group. The West Midlands EAG agreed to adopt these guidelines as the regional network guidelines. The version history reflects changes made by the Coventry, Warwickshire and Worcestershire Breast Group. As the Coventry, Warwickshire and Worcestershire Breast Group update their guidelines, the EAG will discuss whether to adopt the updated version. Review Date December 2019 (must be within three years) Approval Network Clinical Director Signatures: Date: 25/10/2017 \\ims.gov.uk\data\Users\GBEXPVD\EXPHOME25\PGoulding\Data\Desktop\guidelines- 2 for-the-management-of-breast-cancer-v1.doc Version History - Coventry, Warwickshire and Worcestershire Breast Group Version Date Brief Summary of Change 2010v1.0D 12 March 2010 Immediate breast reconstruction criteria Young adult survivors Updated follow-up guidelines.
    [Show full text]
  • Lumpectomy/Mastectomy Patient/Family Education
    LUMPECTOMY/MASTECTOMY PATIENT/FAMILY EDUCATION Being diagnosed with breast cancer can be emotionally challenging. It is important to learn as much as possible about your cancer and the available treatments. More than one type of treatment is commonly recommended for breast cancer. Each woman’s situation is unique and which treatment or treatments that will be recommended is based on tumor characteristics, stage of disease and patient preference. Surgery to remove the cancer is an effective way to control breast cancer. The purpose of this educational material is to: increase the patient’s and loved ones’ knowledge about lumpectomy and mastectomy to treat breast cancer; reduce anxiety about the surgery; prevent post-operative complications; and to facilitate physical and emotional adjustment after breast surgery. THE BASICS There are three primary goals of breast cancer surgery: 1. To remove a cancerous tumor or other abnormal area from the breast and enough surrounding breast tissue to leave a “margin of safety” around the tumor or affected area. 2. To remove lymph nodes from the armpit area (axilla) to check for possible spread of cancer (metastasis) or remove lymph nodes that are already known to contain cancer. 3. Sometimes one or both breasts are removed to prevent breast cancer if a woman is at especially high risk for the disease. Breast cancer surgery can be done before or after chemotherapy (if chemotherapy is recommended). Radiation therapy and hormonal therapy (if recommended) are typically done after surgery. There are several types of breast surgery. The type of surgery best suited for a specific woman depends on the type of breast disease, the size and location of the breast disease/tumor(s) in the breast, and the personal preference of the patient.
    [Show full text]
  • Your Options a Guide to Reconstruction for Breast Cancer
    Your Options A Guide to Reconstruction for Breast Cancer Options In this booklet Introduction to Breast Reconstruction ................................................................ 3 How to Make a Decision .............................................................................. 4 UMHS Team .......................................................................................... 6 Reconstruction Options Implants ........................................................................................... 7 Natural Tissue and Implants ....................................................................... 10 Lat Dorsi (Latissimus Dorsi) Flap Natural Tissue Reconstruction .................................................................... 11 Abdomen • Pedicled TRAM (Transverse Rectus Abdominis Myocutaneous) Flap • Free TRAM (Transverse Rectus Abdominis Myocutaneous) Flap • Free Muscle-Sparing TRAM (Transverse Rectus Abdominis Myocutaneous) Flap • Free DIEP (Deep Inferior Epigastric Perforator) Flap • Free SIEA (Superficial Inferior Epigastric Artery) Flap Alternative Donor Sites ........................................................................... 15 SGAP (Superior Gluteal Artery Perforator) Flap TUG (Transverse Upper Gracilis) Flap Additional Surgeries After Reconstruction ........................................................ 17 • Nipple Reconstruction • Breast Lift, Augmentation, Reduction Terms to Know .................................................................................... 19 “I’m a wife and mother and I
    [Show full text]
  • Transumbilical Breast Augmentation a Practical Review of a Growing Technique
    ORIGINAL ARTICLE Transumbilical Breast Augmentation A Practical Review of a Growing Technique William A. Brennan, MD, and Jacob Haiavy, MD These complication rates were comparable or less than other pub- Background: The transumbilical breast augmentation procedure lished methods of breast prosthesis implantation. has been described in the literature since 1993. This indirect route Conclusions: Transumbilical breast augmentation is a safe and for implant placement has received both criticism and praise over effective method for breast implant placement in selected patients. the years, without a comprehensive assessment of the procedure Patient satisfaction weighs heavily on implant location and postop- from the perspective of the patient. The growing patient demand for erative firmness and less on other variables. The procedure is the procedure, combined with the increased use by surgeons, associated with a complication rate comparable with other methods prompts a review of the procedure and a discussion of its pros and and finds itself growing in demand and popularity secondary to high cons, including tabulated patient satisfaction data. patient satisfaction. Methods: A retrospective chart review of 245 transumbilical breast augmentations performed by the second author from 2002 to 2004, Key Words: transumbilical breast augmentation, breast including the 1-year patient satisfaction surveys, is presented. Ad- augmentation surveys, endoscopic breast surgery ditionally, complications from the procedure are also tabulated and (Ann Plast Surg 2007;59: 243–249) compared with the complications published by our studies’ domi- nant implant manufacturer in their 1-year follow-up published data. The patients were asked to rate their postoperative pain, numbness, firmness, size satisfaction, rippling, and overall satisfaction.
    [Show full text]