Breast reconstruction using a staged nipple-sparing mastectomy following mastopexy or reduction.

Background: To address those patients who do not meet anatomical criteria for nipple-sparing mastectomy, the authors use a staged approach: (1) mastopexy or breast reduction, (2) nipple-sparing mastectomy through the mastopexy incisions after a minimum of 3 to 4 weeks, and (3) the final reconstruction.

Methods: Fifteen patients underwent nipple-sparing mastectomy at Georgetown University Hospital between 2007 and 2010 after planned or unrelated mastopexy or reduction. An institutional review board-approved retrospective chart review recorded demographic information and outcomes such as skin necrosis and device failure.

Nipple-sparing mastectomy for prophylactic and therapeutic indications.

Background: Nipple-sparing mastectomy remains controversial and its adoption has been slow because of oncologic and surgical concerns.

Methods: A retrospective study evaluated all nipple-sparing mastectomies performed at a single institution for therapeutic or prophylactic indications for which records were available.

Results: Between 1989 and 2010, 162 nipple-sparing mastectomies were performed in 101 women.

Chronic postoperative breast pain: danger zones for nerve injuries.

Background: Postoperative breast pain is a frequent complaint, reported by 50 percent of women following a breast procedure. Breast pain interferes with sexual activity, as reported by 48 percent of patients, exercise (36 percent), social activity (13 percent), and employment (6 percent).

Methods: To define neurogenic causes of chronic postoperative breast pain, the authors performed a retrospective review of consecutive patients from a single surgeon and performed 10 anatomical bilateral dissections.

Posttraumatic maxillomandibular reconstruction: a treatment algorithm for the partially edentulous patient.

Maxillofacial injuries in the partially edentulous patient present unique challenges that are best treated in conjunction with appropriate dental specialists. Many surgeons who treat complex maxillofacial injuries are not involved in the process of reconstruction of the occlusion and alveolus; however, dental rehabilitation is an important and often overlooked component of treatment of the partially edentulous patients. Working with dental specialists and understanding the role they play in perioperative planning, the plastic surgeon is in a position to optimize reconstruction and rehabilitation of these injuries.

Utility of PET/neck MRI digital fusion images in the management of recurrent or persistent thyroid cancer.

Background: Approximately 30% of thyroid cancer patients present with reappearing disease within 40 years of initial diagnosis. Hence, sensitive postsurgical monitoring techniques are imperative to successful long-term care. The objective of this study was to assess the added clinical utility of a combined positron emission tomography/magnetic resonance imaging (PET/MRI) of the neck in conjunction with standard imaging in the detection of recurrent thyroid carcinoma.