OFFICIAL PROCEEDINGS, Volume XV
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Surgical Approach to the Treatment of Gynecomastia According to Its Classification
ARTIGO ORIGINAL Abordagem cirúrgica para o tratamentoVendraminFranco da T ginecomastia FSet al.et al. conforme sua classificação Abordagem cirúrgica para o tratamento da ginecomastia conforme sua classificação Surgical approach to the treatment of gynecomastia according to its classification MÁRIO MÚCIO MAIA DE RESUMO MEDEIROS1 Introdução: A ginecomastia é a proliferação benigna mais comum do tecido glandular da mama masculina, causada pela alteração do equilíbrio entre as concentrações de estrógeno e andrógeno. Na maioria dos casos, o principal tratamento é a cirurgia. O objetivo deste tra- balho foi demonstrar a aplicabilidade das técnicas cirúrgicas consagradas para a correção da ginecomastia, de acordo com a classificação de Simon, e apresentar uma nova contribuição. Método: Este trabalho foi realizado no período de março de 2009 a março de 2011, sendo incluídos 32 pacientes do sexo masculino, com idades entre 13 anos e 45 anos. A escolha da incisão foi relacionada à necessidade ou não de ressecção de pele. Foram utilizadas quatro técnicas da literatura e uma modificação da técnica por incisão circular com prolongamentos inferior, superior, lateral e medial, quando havia excesso de pele também no polo inferior da mama. Resultados: A principal causa da ginecomastia identificada entre os pacientes foi idiopática, seguida pela obesidade e pelo uso de esteroides anabolizantes. Conclusões: A técnica mais utilizada foi a incisão periareolar inferior proposta por Webster, quando não houve necessidade de ressecção de pele. Na presença de excesso de pele, a técnica escolhi- da variou de acordo com a quantidade do tecido a ser ressecado. A nova técnica proposta permitiu maior remoção do tecido dermocutâneo glandular e gorduroso da mama, quando comparada às demais técnicas utilizadas na experiência do cirurgião. -
Benign Breast Diseases1
BENIGN BREAST DISEASES PROFFESOR.S.FLORET NORMAL STRUCTURE DEVELOPMENTAL/CONGENITAL • Polythelia • Polymastia • Athelia • Amastia ‐ poland syndrome • Nipple inversion • Nipple retraction • NON‐BREAST DISORDERS • Tietze disease • Sebaceous cyst & other skin disorders. • Monder’s disease BENIGN DISEASE OF BREAST • Fibroadenoma • Fibroadenosis‐ ANDI • Duct ectasia • Periductal papilloma • Infective conditions‐ Mastitis ‐ Breast abscess ‐ Antibioma ‐ Retromammary abscess Trauma –fat necrosis. NIPPLE INVERSION • Congenital abnormality • 20% of women • Bilateral • Creates problem during breast feeding • Cosmetic surgery does not yield normal protuberant nipple. NIPPLE INVERSION NIPPLE RETRACTION • Nipple retraction is a secondary phenomenon due to • Duct ectasia‐ bilateral nipple retarction. • Past surgery • Carcinoma‐ short history,unilateral,palpable mass. NIPPLE RETRACTION ABERRATIONS OF NORMAL DEVELOPMENT AND INVOLUTION (ANDI) • Breast : Physiological dynamic structure. ‐ changes seen throught the life. • They are ‐ developmental & involutional ‐ cyclical & associated with pregnancy and lactation. • The above changes are described under ANDI. PATHOLOGY • The five basic pathological features are: • Cyst formation • Adenosis:increase in glandular issue • Fibrosis • Epitheliosis:proliferation of epithelium lining the ducts & acini. • Papillomatosis:formation of papillomas due to extensive epithelial hyperplasia. ANDI & CARCINOMA • NO RISK: • Mild hyperplasia • Duct ectasia. • SLIGHT INCREASED RISK(1.5‐2TIMES): • Moderate hyperplasia • Papilloma -
Breastfeeding After Breast Surgery-V3-Formatted
Breastfeeding After Breast and Nipple Surgeries: A Guide for Healthcare Professionals By Diana West, BA, IBCLC, RLC PURPOSE A satisfying breastfeeding relationship is not precluded by insufficient milk production. When measures are taken to protect the milk supply that exists, minimize supplementation, The purpose of this guide is to provide the healthcare and increase milk production when possible, a mother with professional with an understanding of breast and nipple compromised milk production can have a satisfying surgeries and their effects upon lactation and the breastfeeding relationship with her baby. breastfeeding relationship. The effect of breast and nipple surgery upon lactation functionality and breastfeeding dynamics varies according to the type of surgery performed. This guide has delineated discussion of breastfeeding after PREDICTING LACTATION breast and nipple surgeries according to the three broad CAPABILITY AFTER BREAST AND categories: diagnostic, ablative, and therapeutic breast procedures, cosmetic breast surgeries, and nipple surgeries. NIPPLE SURGERIES The reasons, motivations, issues, concerns, stresses, and physical and psychological results share some The aspect of breast and nipple surgeries that is most likely to commonalities, but are largely unique to the type of surgery affect lactation is the surgical treatment of the areola and performed. For this reason, each type of surgery and its nipple. The location, orientation, and length of the incision effect upon lactation will be discussed independently. directly affect lactation capability by severing the parenchyma Methods to assess milk production and an overview of and innervation to the nipple/areolar complex. An incision feeding options to maximize milk production when near or on the areola, particularly in the lower, outer quadrant supplementation is necessary are presented. -
Breast Uplift (Mastopexy) Procedure Aim and Information
Breast Uplift (Mastopexy) Procedure Aim and Information Mastopexy (Breast Uplift) The breast is made up of fat and glandular tissue covered with skin. Breasts may change with variable influences from hormones, weight change, pregnancy, and gravitational effects on the breast tissue. Firm breasts often have more glandular tissue and a tighter skin envelope. Breasts become softer with age because the glandular tissue gradually makes way for fatty tissue and the skin also becomes less firm. Age, gravity, weight loss and pregnancy may also influence the shape of the breasts causing ptosis (sagging). Sagging often involves loss of tissue in the upper part of the breasts, loss of the round shape of the breast to a more tubular shape and a downward migration of the nipple and areola (dark area around the nipple). A mastopexy (breast uplift) may be performed to correct sagging changes in the breast by any one or all of the following methods: 1. Elevating the nipple and areola 2. Increasing projection of the breast 3. Creating a more pleasing shape to the breast Mastopexy is an elective surgical operation and it typifies the trade-offs involved in plastic surgery. The breast is nearly always improved in shape, but at the cost of scars on the breast itself. A number of different types of breast uplift operations are available to correct various degrees of sagginess. Small degrees of sagginess can be corrected with a breast enlargement (augmentation) only if an increase in breast size is desirable, or with a scar just around the nipple with or without augmentation. -
Phd Thesis Summary
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 Ph.D. CANDIDATE: Radu Claudiu Gabriel CRAIOVA 2013 INTRODUCTION According to statistics, only in the United States in 2012 over 14 million cosmetic surgery of the breasts were made, but only about 3% of these were for surgical breast reconstruction after mastectomy as an interventional oncology treatment, although about 300,000 women are diagnosed each year with mammary tumors and most of them suffer breast surgery that can vary from partial, segmental or total removal of the breast. This creates a major gap between the number of surgeons able to successfully carry out such intervention and the number of patients who would require them, making obvious the need to increase the number of professionals that are able to perform breast reconstruction after mastectomy, especially the aesthetic mastectomy in people diagnosed with breast hypertrophy. Based on medical literature data, in this study we aimed to elucidate, using specific research methods, the impact of clinical and psychological intervention of breast reconstruction in patients suffering from breast hypertrophy and benign tumors. We hope that our study will shade some light on the need of brest reconstruction, its impact on specific pathology (mammary hypertrophy and benign tumors) and to contribut in improving breast reconstruction techniques that can help to avoid any complication that may arise. CHAPTER I Functional anatomy of the mammary gland Adult female mammary gland is located on both side of the anterior chest having it's base stretching from about the second to the sixth rib. -
CASE REPORT Severe Gynaecomastia Associated with Highly Active Antiretroviral Therapy Faith C
Open Access CASE REPORT Severe gynaecomastia associated with highly active antiretroviral therapy Faith C. Muchemwa1,2, Clarice T. Madziyire2 1. Department of Surgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe 2. Department of Immunology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe Correspondence: Dr Faith C. Muchemwa ([email protected]) © 2018 F.C. Muchemwa & C.T. Madziyire. This open access article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), East Cent Afr J Surg. 2018 Aug;23(2):80–82 which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. https://dx.doi.org/10.4314/ecajs.v23i2.6 Abstract The association between gynaecomastia and HIV infection was first reported in 1987; however, there were no subsequent pub- lished reports of gynaecomastia linked to HIV infection until highly active antiretroviral therapy (HAART) was introduced. Although HAART significantly improves the prognosis of HIV infection, its extensive use has resulted in multiple adverse effects, including benign breast enlargement. We present a rare case of severe gynaecomastia in a male patient with vertically transmitted HIV on HAART. He was surgically treated with mastectomy with no nipple-areolar complex reconstruction. The pathology report con- firmed the benign nature of the breast tissue. Surgical intervention resulted in an improvement of daily activities and enhanced psychosocial wellbeing. Benign bilateral breast enlargement of this magnitude in a male patient has never been reported. -
Dinner Theatre in Niagara Falls
Spring, Summer, Fall and Christmas 20182018 Offering Motorcoach Tours and Holidays SINCE 1982 February 2018 Dear Friends, 2018 marks 36 years in business for us (and 1982 doesn’t really seem that long ago!) It has given us the opportunity to know and serve some very nice people over the years, many of whom have travelled with us for a long time. Thank you – it has been a pleasure. We would also like to say thank you and wish a warm welcome to all of our great new customers who have called us over the past while. It is tour time once again, so look over what we have to offer, make your choices and call us. If our lines are busy, please leave us a message – we’ll get back to you! (Don’t leave it too long to book your tours, though – some sell out very quickly.) As always, we look forward to the pleasure of your company. Happy Travels in 2018, Time Of Your Life Tours Going Places … But Not Without You! Call us at 416 224 0684 TABLE OF CONTENTS – 2018 DAY TOURS Dates Page Shuffle Off to Buffalo. Apr. 2018 – Feb. 2019. 5 Showplace…Theatre: St. Patrick’s Day Party. March 16th. 6 Oh Canada Eh…Theatre: The Show Must Go On . March 21st/April 11th . 6 Hamilton Family Theatre: Hairspray . March 28th. 7 St. Jacobs…Playhouse: The Drowsy Chaperone. April 14th. 7 Showplace Dinner Theatre: The Legend in Black. April 18th. 8 Crafters Caravan: A Knitters Jaunt . April 25th/Nov. 7th . 8 A Fun Day in Niagara. -
The Topic of the Lesson “Mastitis and Breast Abscess.”
The topic of the lesson “Mastitis and breast abscess.” According to the evidence-based data from UpToDate extracted March of 19, 2020 Provide a conspectus in a format of .ppt (.pptx) presentation of not less than 50 slides containing information on: 1. Classification 2. Etiology 3. Pathogenesis 4. Diagnostic 5. Differential diagnostic 6. Treatment With 10 (ten) multiple answer questions. Lactational mastitis - UpToDate Official reprint from UpToDate® www.uptodate.com ©2020 UpToDate, Inc. and/or its affiliates. All Rights Reserved. Print Options Print | Back Text References Graphics Lactational mastitis Contributor Disclosures Author: J Michael Dixon, MD Section Editors: Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C), Daniel J Sexton, MD Deputy Editors: Meg Sullivan, MD, Kristen Eckler, MD, FACOG All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Feb 2020. | This topic last updated: Jan 15, 2020. INTRODUCTION Lactational mastitis is a condition in which a woman's breast becomes painful, swollen, and red; it is most common in the first three months of breastfeeding. Initially, engorgement occurs because of poor milk drainage, probably related to nipple trauma with resultant swelling and compression of one or more milk ducts. If symptoms persist beyond 12 to 24 hours, the condition of infective lactational mastitis develops (since breast milk contains bacteria); this is characterized by pain, redness, fever, and malaise [1]. Issues related to lactational mastitis will be reviewed here. Issues related to other breast infections are discussed separately. (See "Nonlactational mastitis in adults" and "Primary breast abscess" and "Breast cellulitis and other skin disorders of the breast".) EPIDEMIOLOGY Lactational mastitis has been estimated to occur in 2 to 10 percent of breastfeeding women [2]. -
2009 Program
ISOQOL 16th Annual Conference of the International Society for Quality of Life Research Integrating HRQOL in Health Care Policy, Research, and Practice October 28-31, 2009 New Orleans, Louisiana, USA Sheraton New Orleans Final Program Table of Contents Table of Contents Schedule-at-a-Glance ......................................................................................................................... 3 Welcome ................................................................................................................................................ 4 Scientific Program Committee .......................................................................................................... 5 ISOQOL Leadership ............................................................................................................................ 6 About ISOQOL/General Information .........................................................................................7 - 8 Program Schedule, Wednesday...................................................................................................9 - 14 Program Schedule, Thursday ................................................................................................... 15 - 21 Program Schedule, Friday ......................................................................................................... 22 - 28 Program Schedule, Saturday .................................................................................................... 29 - 35 Posters ......................................................................................................................................... -
Breast Lift Letter
SACRAMENTO AESTHETIC SURGERY a medical corporation Mastopexy (Breast Lift) and Breast Reduction; a letter to my patients: In some patients requesting Breast Enhancement the tissues of the breast have become lax and saggy. The medical term for this condition is Breast Ptosis. This can occur with advancing age and as a common consequence of pregnancy, nursing and/ or weight fluctuations. Breasts progressively hang lower and lower on the chest with loss of upper breast projection (perkiness), elongation and flattening. In some cases, the nipples point straight down. These changes are also very common in patients with breasts that are very large. Conceptually, the basic problem with ptotic (saggy) breasts is that the supporting elements of the breast are weak and stretchec. There is, as a result, too much skin for the amount of breast tissue present. Along with this problem, the nipple has come to rest lower on the chest wall. With early stages of breast ptosis, a breast implant may be able to make up for the volume deficit in breast tissue. However, in many women, the nipple and remainder of the breast has fallen too far down the chest to allow a simple implant to give an aesthetically pleasing result. In these women, some form of breast lift (Mastopexy) is indicated. In these women, if you only performed breast augmentation, the result would be an implant in the normal breast location with the nipple and breast appearing to have slipped off the front of the normally placed implant. Occasionally the argument is made that you can place the implant above the muscle to minimize this appearance. -
The Effect of Breastfeeding on Breast Ptosis Following Augmentation
Norma Cruz, MD Division of Plastic Surgery University of Puerto Rico Disclosure: Nothing to disclose. Is breast ptosis increased by breastfeeding in women with breast implants? A study was designed n=62 to evaluate the n=57 changes in breast measurements resulting from pregnancy without breastfeeding (control group) vs. pregnancy Control Group with breastfeeding Study Group (study group). Mid-clavicle to nipple Nipple to inframammary fold (IMF) Before pregnancy Measurements were made before pregnancy and one year after pregnancy or one year after completing breastfeeding. After pregnancy without breastfeeding 0 1 2 3 No ptosis (Grade 0): nipples lie above the level of the IMF Grade 1 : mild ptosis, nipples lie at the level of the IMF Grade 2 : moderate ptosis, nipples lie below the level of the IMF but remain above the lower breast contour Grade 3 : severe ptosis, nipples lie below the IMF at the lower contour of the breast Age Body mass index Bra size Duration of breastfeeding The groups were not significantly different regarding age, BMI or mean bra size (p>0.05) Control Group Study Group Age 24±5 25±6 Body mass index 23±3 22±4 Bra size 34-C 34-C The mean duration of breast feeding for the study group was 6±3 months. Control Study P Mean±SD Mean±SD Mid-clavicle to nipple (before) 21±2 cm 21±3 cm >0.05 Mid-clavicle to nipple (after) 23±3 cm 22±4 cm >0.05 Nipple to IMF (before) 6±2 cm 6±3 cm >0.05 Nipple to IMF (after) 8±3 cm 8±2 cm >0.05 Before After Before After Control Group Study Group Breast measurements were not significantly different between the groups 0 1 2 3 Control Study P Regnault’s grade (before) 0.5±1.0 0.5±1.0 >0.05 Regnault’s grade (after) 2.0±1.0 2.0±1.0 >0.05 Before After Before After Control Group Study Group The degree of breast ptosis was not significantly different between the groups. -
National Historic Sites of Canada System Plan Will Provide Even Greater Opportunities for Canadians to Understand and Celebrate Our National Heritage
PROUDLY BRINGING YOU CANADA AT ITS BEST National Historic Sites of Canada S YSTEM P LAN Parks Parcs Canada Canada 2 6 5 Identification of images on the front cover photo montage: 1 1. Lower Fort Garry 4 2. Inuksuk 3. Portia White 3 4. John McCrae 5. Jeanne Mance 6. Old Town Lunenburg © Her Majesty the Queen in Right of Canada, (2000) ISBN: 0-662-29189-1 Cat: R64-234/2000E Cette publication est aussi disponible en français www.parkscanada.pch.gc.ca National Historic Sites of Canada S YSTEM P LAN Foreword Canadians take great pride in the people, places and events that shape our history and identify our country. We are inspired by the bravery of our soldiers at Normandy and moved by the words of John McCrae’s "In Flanders Fields." We are amazed at the vision of Louis-Joseph Papineau and Sir Wilfrid Laurier. We are enchanted by the paintings of Emily Carr and the writings of Lucy Maud Montgomery. We look back in awe at the wisdom of Sir John A. Macdonald and Sir George-Étienne Cartier. We are moved to tears of joy by the humour of Stephen Leacock and tears of gratitude for the courage of Tecumseh. We hold in high regard the determination of Emily Murphy and Rev. Josiah Henson to overcome obstacles which stood in the way of their dreams. We give thanks for the work of the Victorian Order of Nurses and those who organ- ized the Underground Railroad. We think of those who suffered and died at Grosse Île in the dream of reaching a new home.