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The incidence of breast carcinoma is reportedly the second highest among all carcinomas in Indian women. Depending on the extent of resection, age, general health, and economic condition of the patient, various methods of breast reconstruction using surgery have been reported with success and a superior cosmesis. When the patient is unwilling to opt for surgical reconstruction due to various constraints, an alternative technique must be employed. In such cases, nonsurgical prosthetic reconstruction using maxillofacial silicones is considered the only viable option. This prevents the need for a second surgery and rehabilitates the patient during the decision-making phase for considering a delayed reconstructive surgery. The prosthesis mimics the natural texture, feel, weight, and appearance as its natural counterpart enabling the patient to go about her routine social activities. This case report illustrates an indigenous method of rehabilitation of a unilateral mastectomy case using hollow breast form/prosthesis
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Objective To investigate the effect of ultrasound-guided serratus anterior plane (SAP) block on postoperative pain in patients undergoing breast prosthesis implantation. Methods Fifty patients scheduled for breast prosthesis implantation under general anesthesia, aged 18-40 years, BMI 18-24 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups (n = 25 each) : SAP block group (group N) and control group (group C). Ultrasound-guided bilateral SAP block was performed before induction of anesthesia, and 0.375％ ropivacaine 20 ml was injected bilaterally in group N, while the equal volume of normal saline was used instead in group C. The visual analogue scale (VAS) in resting state was evaluated at 2, 6, 12 and 24 h after surgery. Also, the perioperative opioid consumption, the numbers of PCIA pressing attempts and rescue analgesia, adverse effects and patients′ satisfaction degree within 24 h postoperatively were recorded. Results Compared to group C, the scores of VAS at postoperative 2, 6, 12 and 24 hand the perioperative consumption of opioid were significantly lower, the numbers of PCIA pressing attempts and rescue analgesia were decreased, while patients′ satisfaction degree was increased in group N (P ＜ 0.05).There were no significant differences in adverse reactions between these two groups. Conclusion Ultrasound-guided SAP block reduces the postoperative pain in patients undergoing breast prosthesis implantation.
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Objetivo Determinar los cambios en calidad de vida en mujeres sometidas a mamoplastia de aumento o mastopexia con prótesis, usando el instrumento validado Breast-Q®. Materiales y métodos Estudio de cohortes prospectivo. Se incluyeron todas las pacientes operadas de mamoplastia de aumento o mastopexia de aumento en el Hospital Clínico de la Universidad de Chile entre octubre de 2013 y mayo de 2014. La calidad de vida (CdV) se midió con el instrumento validado Breast-Q®. Se realizó estadística descriptiva y analítica para evaluar el cambio global en CdV y por dominios considerando estadísticamente significativo un valor p < 0,05. Resultados En el periodo estudiado se operaron 58 pacientes, 33 (56,9%) completaron el instrumento Breast-Q® en el preoperatorio y 25 (75,7%) de ellas en el postoperatorio. La CdV subió de un 49,7% a un 82,5% (p < 0,001); analizando por dominio hubo mejoría en autoestima (52% a 88%, p < 0,001), autoimagen (22% a 80%, p < 0,001) y vida sexual (31% a 86%, p < 0,001). Los síntomas físicos empeoraron desde un 94% a 75% (p < 0,001). Conclusiones El aumento mamario mejora la CdV, específicamente la autoestima, la autoimagen y la vida sexual, pero las molestias físicas aumentan. La satisfacción global fue alta.
Objective To determine the changes in the quality of life of women subjected to augmentation mammoplasty or a prosthesis mastopexy, using the validated tool Breast-Q®. Materials and methods A prospective cohorts study was conducted that included operated on for augmentation mammoplasty or augmentation mastopexy in the Hospital Clínico de la Universidad de Chile (HCUCH) between October 2013 and May 2014. The quality of life (QoL) was measured using the Breast-Q® validated tool. Descriptive and analytic statistics were performed to evaluate the overall change in QoL and by domains, considering a p<.05 as statistically significant. Results A total of 58 patients were operated on, of whom 33 (56.9%) completed the Breast-Q® questionnaire before surgery, and 25 (75.7%) of them in the post-operative period. The quality of life increased from 49.7% to 82.5% (p<.001). When analysed by domain, there was an improvement in Self-esteem (52% to 88%, p<.001), Self-image (22% to 80%, p<.001) and Sex Life (31% to 86%, p<.001). The physical symptoms increased from 75% to 94% (p<.001). Conclusions Breast augmentation improves the quality of life, in particular, self-esteem, self-image, and sex life, but physical discomforts increased. The overall satisfaction was high.
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Humans , Female , Adolescent , Adult , Middle Aged , Quality of Life , Breast Implants/psychology , Breast Implantation/psychology , Self Concept , Activities of Daily Living/psychology , Prospective Studies , Surveys and Questionnaires , Follow-Up Studies , Patient SatisfactionABSTRACT
Objective When implantation of a prosthesis is performed for patients with a local defect of the breast after the removal of polyacrylamide hydrogel,incomplete coverage of the surface of the prosthesis occurs in these cases.The aim of this study was to explore the effectiveness of acellular allogeneic dermis in the repair of defects after prosthesis implantation.Methods Breast prosthesis implantation together with acellular allogeneic dermis repair was performed in 46 cases.Acellular allogeneic dermis was applied to cover the surface of the prosthesis,and interrupted suture was used between the margin of the dermis and the incisional margin of the gland,while appropriate tension was maintained.Results There were no complications occurred postoperatively.Correction of local depression in the breast was excellent in all cases.Histological examination showed the implanted acellular allogeneic dermis was integrated into the peripheral tissue.Conclusions Acellular allogeneic dermis can be used for repairing breast and muscle defects,in order to cover the prosthesis.Although it cannot significantly increase the thickness of the subcutaneous tissue,it can maintain the integrity of the peripheral tension around the prosthesis.In this way,it can avoid bulging of the prosthesis caused by a sudden reduction of local tension.Moreover,donor site injury is avoided.Acellular allogeneic dermis is an effective method for the repair of local breast defects.
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PURPOSE: The purpose of this study was to examine the experiences of the use of external breast prostheses among breast cancer survivors in Korea. METHODS: A qualitative descriptive study was conducted, using focus groups. Data were collected from breast cancer survivors who were patients of C women's hospital in Seoul, Korea. Data were analyzed using content analysis in order to identify significant themes. RESULTS: Participants included forty breast cancer survivors who had mastectomy as a surgical treatment. Four themes emerged from the collected data were: 1) concern over the high price of external breast prosthesis, 2) irregular use of external breast prosthesis, 3) unsatisfied with mastectomy bra, and 4) wanting to hide or not to talk about using breast prosthesis openly. CONCLUSION: Since most participants reported irregular use and negative experiences related to external breast prosthesis or mastectomy bra use, healthcare workers should allow more time for proper fitting and counseling and consulting with breast cancer survivors. In addition, health care providers as well as family and friends should keep in mind that cancer survivors need support that can help them cope by using positive reframing. Furthermore, improvements in the coverage of costs and services are needed for these women. This would be helpful for breast prosthesis users.
Subject(s)
Female , Humans , Breast , Breast Neoplasms , Counseling , Delivery of Health Care , Focus Groups , Friends , Health Personnel , Korea , Mastectomy , Phosphatidylethanolamines , Prostheses and Implants , SurvivorsABSTRACT
Objective To compare the curative effects of two different approaches in the surgical treatmentof small breast.Methods Fourty-seven patients with small breast were treated at our department.Twenty-eight sides of patients adopted an approach of prosthesis while the nineteen sides of patients were treated in the approach of autologous fat granules injection.Clinical assessment was done by analyzing operation time,blood loss volume,hospitalization duration and recent and long-term complications in breasts.All the pa-tients were followed up for thirty-two months on average.Results During follow-up period the appearance ofbreast was satisfied.Silicone gel breast prosthesis was well tolerated and the whole operation time was about (35±5 )min,the amount of blood loss was (35±5 ) mL,hospitalization duration was (2±1 ) days,during thefollow-up period prosthesis capsular contracture after hematoma occurred in one patient.The use of autolo-gous fat granules injection to breast augmentation was found limited,and the whole operate time was about (35±5 ) rain,the amount of blood loss was (15±5 ) mL,hospitalization duration was (1±1 ) days.With in-jection(2±l)times.During the follow-up period,one patient had infection,one patient liquefied fat,andone patient the induration.Conclusion Each treatment approach has its own advantages and disadvanta-ges.The approprite one should be selected according to the special situation of patients.
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Objective To explore the treatment of capsular contr ac ture after augmentation mammaplasty with mammary prostheses. Method Through primary incision (axillary or inframammary) and minor capsu le incision, patients with capsular contracture after augmentation mammoplasty w ere treated by preserving the contractive capsule and repositing of the breast p rosthesis anterior to the primary capsule. Results Total ly 12 cases (14 breasts) of capsular contracture were achieved satisfactory res ults since 2001. Conclusion The method of capsule preser vation and reposting of the breast prosthesis anterior to the capsule present n umerous advantages: little trauma, less bleeding, simple surgical procedure, saf e, less possibility of recrudescence, and can be finished through a small primar y axillary incision. It is a preferable method to treat capsular contracture.