A study of postural changes after abdominal rectus plication abdominoplasty.

PURPOSE: Factors such as body masses and humour are known to influence human posture. Abdominoplasty, which causes a sudden change in body masses, significantly improves body image and self-esteem. The aim of this study was to assess postural changes after abdominoplasty by studding the position and orientation through space of the body and the centre of pressure. METHODS: Patients affected by excess abdominal skin and/or significant abdominal muscular anterior wall laxity due to undergo an abdominoplasty were enrolled. Posture was evaluated both before and for 1 year after surgery by quantifying the centres of mass, using the Fastrak™ system, and the centre of pressure, using stabilometry. The Wilcoxon signed-rank sum test was used to compare changes. RESULTS: Forty-six patients were enrolled. A retro-positioning of the pelvis with a compensatory advancement of the head and shoulders, confirmed by the baropodometric analysis, was evident in the early post-operative period. The biomechanical system subsequently stabilized, achieving a state of equilibrium 1 year after surgery. CONCLUSIONS: We believe that the change in posture following abdominoplasty is a consequence of both surgery (changes in body masses) and psychological factors that influence posture. Indeed, redundant abdominal skin and abdominal muscular anterior wall weakness are often associated with kyphosis since patients try to hide what they consider to be a source of embarrassment. The discovery of a new body image eliminates dissatisfaction, reduces anxiety and increases self-esteem, which provide psychological and physical benefits that improve the quality of life.

[Infiltrating ductal breast carcinoma after radiotherapy and chemotherapy for non-Hodgkin's lymphoma in a young woman. Case report]. / Carcinoma duttale infiltrante della mammella dopo radioterapia e chemioterapia per linfoma non Hodgkin in una giovane donna. Case report.

Lymphoma was one of the first cancers curable by radiotherapy and/or chemotherapy. However the increased risk of second malignancies in lymphoma survivors appeared to be the price of success of modern treatment modalities. In particular, breast cancer has been a major concern among women irradiated for lymphoma at a young age. There are several reports of breast cancer after Hodgkin's lymphoma, but few after non-Hodgkin's lymphoma. Owing to the particularity of this condition and the difficulties in its diagnosis and treatment, we wish to report the case of ductal infiltrant carcinoma of the breast in a young woman survived to a non-Hodgkin's lymphoma. Women who are survivors of pediatric lymphoma have a significantly increased risk of subsequent breast cancer compared with the general population and are at a high risk of developing bilateral disease within a short interval. Several studies have shown that the relative risk for secondary breast cancer becomes significantly increased between 5 and 9 years and rises dramatically between 15 and 19 years after lymphoma treatment. Screening programs to detect breast cancer should be initiated early after Hodgkin's and non-Hodgkin's lymphomas. Screening have to include breast self examinations every month, clinical breast examinations every 6 months, and mammography every 2-3 years. The patients should start breast self-examination at puberty. In these high-risk patients, "aggressive" biopsy is appropriate for suspicious lesions.

[Surgical approach and indications in aesthetic treatment of body dysmorphic disorder]. / Approccio chirurgico e indicazioni ai trattamenti estetici nel dismorfismo da eccesso.

INTRODUCTION: patients with body dysmorphic disorder often go to the plastic surgeon to correct what they consider a physical deformity or defect, although their appearance falls within normal aesthetic standards. The aim of our study was to evaluate the real need for aesthetic treatments in such patients. PATIENTS AND METHODS: we included patients who practised an intense sport activity and believed they had body deformities ascribable to their sport activity. We evaluated whether the deformities described by the patients were real or exaggerated. The patients who did have a deformity underwent surgery to correct it; their level of satisfaction was evaluated at a 6-month follow-up examination. The patients with subjective deformities underwent a psychiatric examination. RESULTS: we enrolled 51 patients who practised an intense sport activity and reported body deformities. Forty-one of these patients were found to have a body deformity upon examination and underwent surgery. Surgery was considered to be unnecessary in the remaining 10 patients. Thirty-two of the 41 patients who did undergo were highly satisfied with the outcome. DISCUSSION: the plastic surgeon often sees patients with minor body deformities that do not require treatment but are a major cause of psychological disorders. A thorough psychiatric examination is necessary in such patients to rule out psychiatric diseases. The plastic surgeon should make every effort to identify patients with subjective body dysmorphic disorder to avoid the negative consequences due to the patient's insatisfaction for the outcome of surgery.

Breast desmoid tumor after augmentation mammoplasty: two case reports.

Desmoid tumor of the breast is a rare fibroblastic disease, a slow-growing and histologically benign lesion that accounts for 0.2% of all breast tumors. It can arise either primarily from the breast parenchyma or, by secondary invasion, from the muscolo-aponeurotic layer of the pectoral muscles. These tumors do not metastatize, have no capsule but do have the propensity to aggressively invade local tissues and organs. It has been suggested that these tumours are associated with surgical and non-surgical tissue trauma, certain hormones and genetic susceptibility. We describe two cases of breast desmoid tumor after breast augmentation. A 52-year-old caucasian woman and 38-year-old caucasian woman presented for a breast implant change. During surgery an inelastic, soft, capsulated mass, arising from the periprosthetic capsula in the area of pectoralis major muscle was found. The mass was removed en bloc together with a portion of the periprosthetic capsula, the resection including a portion of the pectoralis major muscle fascia in both cases. The results of this histological examination suggested an extra-abdominal desmoid tumor. To date both the local and the general conditions of the two patients are good, with no signs of recurrence of the lesion.