Outcomes of smooth round implant-based immediate breast reconstruction: Long-term follow-up results.

The issue of breast implant-associated anaplastic large cell lymphoma in 2019 has resulted in the discontinuation of textured breast implants and resumption in the use of smooth round implants. However, in the field of breast reconstruction, long-term follow-up data for direct-to-implant reconstruction using smooth round implants is insufficient. This retrospective study aimed to evaluate the long-term outcomes of breast reconstruction using smooth round implants.

Loss to follow-up after direct-to-implant breast reconstruction.

Loss to follow-up is inevitable in retrospective cohort studies, and patients are lost to follow-up after direct-to-implant reconstruction despite annual follow-up recommendation. We analyzed more than 500 patients to analyze the rate of loss to follow-up to plastic surgery and to investigate the factors affecting it. A retrospective review of patients who underwent direct-to-implant reconstruction between July 2008 and August 2016 was performed.

Geometric Measurements of Nipple Position in Breasts Reconstructed with Transverse Rectus Abdominis Musculocutaneous Flap: A 5-Year Prospective Study.

Background: After breast reconstruction, nipple position and other long-term changes in the reconstructed breast relative to the contralateral breast remain poorly understood. In this prospective cohort study, the authors performed serial nipple position measurements over 5 years in patients who had undergone breast reconstruction with a transverse rectus abdominis musculocutaneous (TRAM) flap. The effects of adjuvant radiotherapy on nipple position over time were also investigated.

Long-Term Serial Measurement of Muscle Volume in TRAM Flaps Using the Eclipse Treatment Planning System.

Background: Muscle flaps used in reconstructive surgery are known to lose volume over time because of denervation and disuse atrophy. However, there is currently no agreement on a quantitative approach to evaluating volume changes. Here, long-term serial measurement of muscle volume in transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction has been conducted using the Eclipse treatment planning system.

Oncologic safety of skin-sparing mastectomy followed by immediate reconstruction in young patients with breast cancer.

Backgrounds: This study aimed to compare the oncologic outcomes of nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM) followed by immediate reconstruction with those of conventional mastectomy (CM) in young patients aged under 35 years old with breast cancer.

Methods: We analyzed retrospectively 2889 patients who underwent mastectomy for breast cancer at Asan Medical Center from January 2003 to December 2008. We compared NSM/SSM followed by immediate reconstruction with CM in patients under 35 years old by analyzing clinicopathologic features, breast cancer specific survival rate (BCSS), distant metastasis free survival rate (DMFS), and local recurrence rate (LRR).

Long-term outcomes of patients with breast cancer after nipple-sparing mastectomy/skin-sparing mastectomy followed by immediate transverse rectus abdominis musculocutaneous flap reconstruction: Comparison with conventional mastectomy in a single center study.

To evaluate the oncological outcomes of patients with breast cancer after nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM), followed by immediate reconstruction, as compared to conventional mastectomy (CM).SSM/NSM has been increasingly used to treat women with breast cancer who wish to preserve the overlying breast skin, but concern exist regarding its oncological safety due to the potential for residual breast tissue. We report our experience performing SSM/NSM for breast cancer treatment compared to CM with a long follow-up period.

Does the Sequence of Tattooing and Nipple Reconstruction Affect Nipple Projection?

Background: In nipple reconstruction, the maintenance of adequate projection is one of the most important and challenging aspects. However, no reports have evaluated whether tattooing after nipple reconstruction affects nipple projection. This study aimed to test our hypothesis that tattooing after reconstruction adversely affects nipple projection.

Augmentation of the Nipples Reconstructed with Modified Top-Hat Flap Using Dermal Grafts in Implant-Based Breast Reconstruction: A Comparative Study.

Background: Nipple reconstruction in implant-based breast reconstruction remains challenging, as the remaining thin skin envelope results in a less projected neo-nipple with a reduced volume. This study presents a modified top-hat flap technique with rolled dermal grafts from the dog-ears of lateral wings for augmenting reconstructed nipples during implant-based breast reconstruction.

Methods: Between April 2011 and December 2014, among 34 patients who underwent immediate post-mastectomy reconstruction with a direct silicone implant, nipple reconstruction was performed using the modified top-hat flap technique in only 21 patients (group A), whereas 13 patients underwent the modified top-hat flap technique with rolled dermal grafts from the dog-ears of lateral wings (group B).

Enhanced biglycan gene expression in the adipose tissues of obese women and its association with obesity-related genes and metabolic parameters.

Extracellular matrix (ECM) remodeling dynamically occurs to accommodate adipose tissue expansion during obesity. One non-fibrillar component of ECM, biglycan, is released from the matrix in response to tissue stress; the soluble form of biglycan binds to toll-like receptor 2/4 on macrophages, causing proinflammatory cytokine secretion. To investigate the pattern and regulatory properties of biglycan expression in human adipose tissues in the context of obesity and its related diseases, we recruited 21 non-diabetic obese women, 11 type 2 diabetic obese women, and 59 normal-weight women.

Risk factors of mastectomy skin flap necrosis in immediate breast reconstruction using low abdominal flaps.

Background: The purpose of this study was to determine the risk factors associated with mastectomy skin flap necrosis during immediate reconstruction with TRAM or DIEP flaps.

Methods: This study reviewed 1116 cases of immediate breast reconstruction over 10 years. Patients ranged in age from 29-76 years (average = 45.

The Low DIEP Flap: An Enhancement to the Abdominal Donor Site.

Background: A serious drawback of the deep inferior epigastric perforator (DIEP) flap is an abdominal scar that is too high. Because the umbilicus should be incorporated into the flap territory, lowering the scar is very difficult. This report describes a new DIEP flap design where the flap is placed in the lowermost part of the abdomen, well below the umbilicus, similar to a mini-abdominoplasty.

Intraoperative venous congestion in free transverse rectus abdominis musculocutaneous and deep inferior epigastric artery perforator flaps during breast reconstruction: A systematic review.

Background: Even with patent deep inferior epigastric vein anastomoses, venous congestion can occur during free transverse rectus abdominis musculocutaneous (TRAM) or deep inferior epigastric artery perforator (DIEP) flap surgery and lead to flap compromise if not recognized and managed.

Objectives: To identify the incidence of intraoperative venous congestion and describe the best available prevention and treatment methods.

Methods: Systematic electronic searches of the PubMed database including Medline were performed to identify studies published until 2014.

Outcomes of Take-Back Operations in Breast Reconstruction with Free Lower Abdominal Flaps.

Background: Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period.

Inverted Nipple With Nipple-Sparing Mastectomy.

Background: The inverted nipple is a relatively common aesthetic problem seen by plastic surgeons. The etiologies of an inverted nipple include insufficiency of supporting tissues, hypoplasia of the lactiferous ducts, and retraction caused by fibrous bands at the base of the nipple. Many different surgical techniques have been described, either individually or in combination, but none represents a landmark strategy.

Patients' Aesthetic Concerns After Horizontally Placed Abdominal Free Flap Breast Reconstruction.

Purpose: The present study aimed to analyze patients' aesthetic concerns after breast reconstruction with abdominal free flap by reporting secondary cosmetic procedures performed based on the patients' request, and analyzed the effect of adjuvant therapies and other variables on such outcomes.

Methods: All patients who underwent unilateral immediate reconstruction were enrolled prospectively. Free abdominal flaps were placed horizontally with little manipulation.

Histologic comparison between the internal mammary artery and the deep inferior epigastric artery and clinical implications for microsurgical breast reconstruction.

Background: The internal mammary artery (IMA) is one of the most popular recipients for microsurgical breast reconstruction. However, it is often separated into sleeve-like layers when it is handled. This study tried to explain this unique behaviour of the IMA through histologic observation.

Topical EMLA Cream as a Pretreatment for Facial Lacerations.

Background: Topical anesthetics, such as eutectic mixture of local anesthetics (EMLA) cream, can be applied to reduce pain before minor procedure. This trial evaluated EMLA as pretreatment for facial lacerations and compared pain, discomfort and overall satisfaction.

Methods: This trial included consecutive emergency department patients ≥16 years of age who presented with simple facial lacerations.

The influence of pfannenstiel incision scarring on deep inferior epigastric perforator.

Background: Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction.

Local recurrence of breast cancer in reconstructed breasts using TRAM flap after skin-sparing mastectomy: clinical and imaging features.

Objectives: To evaluate clinical and imaging features of cancer recurrence in reconstructed breasts following skin-sparing mastectomy (SSM) or nipple areolar skin-sparing mastectomy (NASSM).

Methods: This study was approved by our Institutional Review Board. In this retrospective study, we included patients with pathologically confirmed recurrent cancer who had transverse rectus abdominis myocutaneous (TRAM) flap reconstruction after SSM or NASSM and whose follow-up radiological studies were available.

Enhanced survival of transplanted human adipose-derived stem cells by co-delivery with liposomal apoptosome inhibitor in fibrin gel matrix.

To improve the survival of transplanted human adipose-derived stem cells (ADSCs), a liposome preparation containing the apoptosome inhibitor, NS3694, was formulated and co-delivered with ADSCs in fibrin gel scaffolds. Liposomes provided enhanced effect on ADSC proliferation in vitro as compared to free drug. Exposure of ADSCs to liposomal NS3694 for 7 days did not affect the surface marker expression profile.

Immediate transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction in underweight Asian patients.

Background: TRAM breast reconstruction is commonly thought to be inadequate for underweight patients and LD flap with implant is usually recommended. However, it is often difficult to find an appropriate implant for thin Asian women with small breasts. The authors present the results of using TRAM flap alone for immediate breast reconstruction in underweight Asian patients.

Adjuvant chemotherapy reduces the incidence of abdominal hypertrophic scarring following immediate TRAM breast reconstruction.

Among the many factors that affect the degree of completion and satisfaction of breast reconstruction, the scarring is one issue that a surgeon cannot completely control. We hypothesized that the administration of cytotoxic drugs following the immediate breast reconstruction using transverse rectus abdominis musculocutaneous (TRAM) flap might affect the process of scarring, thus resulting in reduced incidence of hypertrophic scarring at the donor site. Data have been collected from 1,000 consecutive patients between July 2001 and December 2009.

Midfacial degloving approach for resectioning and reconstruction of extensive maxillary fibrous dysplasia.

Objective: The traditional unilateral or bilateral buccogingival or bicoronal approach often seems to impose limitations on achieving complete resection and reconstruction of the extensive midfacial fibrous dysplasia. Therefore, we hypothesized that the midfacial degloving approach could be used for the correction of maxillary fibrous dysplasia, which has been primarily used for paranasal sinus lesions or nasopharyngeal tumor.

Methods: The study involved 5 maxillofacial fibrous dysplasia patients who underwent a midfacial degloving surgical procedure.