Fat grafting versus implant-based treatment of breast asymmetry, a single surgeon experience over 13 years: a paradigm shift?

Background: Breast asymmetry can result from congenital or traumatic aetiologies. Breast implants, autologous fat grafting, or a combination of both of these techniques are commonly used to achieve symmetry. This study adds critical evaluation of long-term patient outcomes in a large study group, to evaluate pearls and pitfalls of these treatment modalities.

International development and implementation of a core measurement set for research and audit studies in implant-based breast reconstruction: a study protocol.

Introduction: Outcome reporting in research studies of breast reconstruction is inconsistent and lacks standardisation. The results of individual studies therefore cannot be meaningfully compared or combined limiting their value. A core outcome set (COS) has been developed to address these issues and identified 11 key outcomes to be measured and reported in all future research and audit studies in reconstructive breast surgery (RBS).

Chest resurfacing with a reverse abdominoplasty flap for invasive breast cancer recurrence.

We present a patient with recurrent breast cancer requiring massive resection of the upper chest. Management included a reverse abdominoplasty flap to resurface the anterior chest wall, with acceptable aesthetic outcomes, and adjuvant chemotherapy. RA is a simple and versatile coverage option in patients with high risk of disease recurrence.

Functional recovery after bilateral extended autologous latissimus dorsi breast reconstruction: A prospective observational study.

Background: The impact of unilateral extended autologous latissimus dorsi (EALD) flap harvest and axillary surgery on shoulder function has been well described, but the impact of bilateral EALD flap harvest has not been clearly defined nor is it clear whether reconstructions should be synchronous or staged.

Methods: In this prospective observational study, patients undergoing bilateral EALD breast reconstruction (February 2003-December 2009) completed the disability, arm, shoulder and hand (DASH) questionnaire preoperatively and at five post-operative timepoints. Intensive shoulder physiotherapy was offered to those whose DASH score was >30 at 6 weeks or >20 at 12 weeks post-operatively.

A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland - An analysis of 589 patients.

Introduction: Current evidence for oncoplastic breast conservation (OBC) is based on single institutional series. Therefore, we carried out a population-based audit of OBC practice and outcomes in Scotland.

Methods: A predefined database of patients treated with OBC was completed retrospectively in all breast units practicing OBC in Scotland.

Six-year follow-up of patients treated with oncoplastic reduction mammoplasty: A cohort study.

Background: Current evidence for the oncological safety of oncoplastic breast conservation is poor as it is based mostly on short-term follow-up data. Hence, we report long-term recurrence rates in patients treated with oncoplastic reduction mammoplasty (ORM).

Methods: A prospectively maintained database was searched to identify patients who underwent ORM between 2005 and 2010.

Imaging Results Following Oncoplastic and Standard Breast Conserving Surgery.

Background: Oncoplastic breast-conserving surgery (OBCS) requires more complex surgical techniques than standard wide local excision (WLE) and the postoperative complication rate may be higher. Since these can have an impact on postoperative imaging, we compared imaging and biopsy results after OBCS and WLE.

Methods: Findings for patients undergoing OBCS (n = 83) or standard WLE (n = 128) were compared.

[Intraoperative, postoperative and long-term oncosurgical safety of therapeutic mammaplasty].

Introduction: (Pre)malignant lesion in the breast requiring mastectomy conventionally may be treated with breast conservation by using oncoplastic breast surgical techniques, which is called therapeutic mammaplasty. However, no reliable data has been published so far as regards the oncological safety of this method.

Aim: The aim of the authors was to analyse the oncological safety of therapeutic mammaplasty in a series of patients.

[Oncologic safety of skin-sparing mastectomy followed by immediate breast reconstruction: rate and localization of recurrences, and impact of reconstruction techniques].

Introduction: Oncological safety of skin-sparing mastectomy followed by immediate breast reconstruction is widely debated. Current evidence is relatively poor since it is based mostly on short-term follow-up data of highly selected patient populations.

Aim: Recurrence rates of a large cohort of non-selected patients, i.

Idiopathic neonatal ischemia in the upper limb: the role of the microsurgeon.

Idiopathic neonatal limb ischemia remains a rare occurrence. It is a devastating process that leads to complete or partial loss of affected limb or severe deformity. The main treatments over the years have been conservative and nonsurgical, such thrombolysis.

[Oncoplastic approach in breast cancer surgery--a new challenge for the future breast surgeon?].

The future challenge of breast surgery, the so-called oncoplastic approach is reviewed in this article. The authors discuss the most frequently applied surgical techniques as well as their indications. Medline and pubmed search was carried out using the following keywords and cross-references: "oncoplastic breast surgery", "breast reconstruction", "breast conserving surgery" and "reduction mammoplasty".

Idiopathic granulomatous mastitis: surgery, treatment, and reconstruction.

Idiopathic granulomatous mastitis is a rare inflammatory breast disease that mimics breast diseases such as inflammatory breast carcinoma, infective mastitis, and inflammatory breast disease of known cause. It is a diagnosis made only after excluding other causes, and although the disease is nonmalignant it may be both locally aggressive and recurrent. Definitive treatment may require radical excision and adjunctive treatment with immunosuppressants.

Triamcinolone reduces seroma re-accumulation in the extended latissimus dorsi donor site.

Background: The incidence of donor site seroma after autologous latissimus dorsi (ALD) breast reconstruction is in the order of 70%. In the majority of cases the seroma recurs following an initial aspiration. We designed a double-blind randomised controlled trial to test the hypothesis that an intracavity injection of the anti-inflammatory corticosteroid triamcinolone would inhibit seroma re-accumulation.

Perforator flap breast reconstruction.

A perforator flap consists of skin and fat harvested from a donor site nourished by myocutaneous perforators while sparing the donor muscle for function and strength. This flap type has revolutionized microvascular free tissue transfer and the technique has been successfully applied to well-established donor sites for autologous breast reconstruction namely the lower abdomen, upper and lower buttock, the upper back, and the lateral thigh. Although these flaps are technically more demanding than conventional myocutaneous free flaps, their minimal impact on the donor site muscle function significantly reduces local morbidity, postoperative pain and hospital stay.