Subject(s)
Breast/pathology , Mammaplasty/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Adult , Body Image , Female , Humans , Hypertrophy/pathology , Hypertrophy/psychology , Hypertrophy/surgery , Mammaplasty/psychology , Physical Examination/methods , Referral and Consultation , Risk FactorsABSTRACT
Pinnaplasty using the Mustardé and Furnas techniques is increasingly popular. One adjunctive technique that is often used involves the elevation of a fascial flap beneath which sutures are placed for additional cover, potentially reducing the risk of complications and possibly recurrence. This flap is traditionally raised with a proximal base, but it can be raised distally with a number of advantages as we illustrate. More significantly, we demonstrate the potential for an entirely new operation to correct prominent ears with benefits including a natural end result, simplicity, reduced operative time, less tissue trauma and the use of a single buried knot. We illustrate the use of this procedure adjunctively to reinforce suture-based techniques in a series of 15 patients.
Subject(s)
Ear, External/abnormalities , Ear, External/surgery , Plastic Surgery Procedures/methods , Adolescent , Child , Fasciotomy , Female , Humans , Surgical Flaps , Suture TechniquesABSTRACT
AIMS: To assess local and systemic recurrence rates and factors predicting for recurrence in patients treated for ductal carcinoma of the breast (DCIS). METHODS: Patients with DCIS treated between January 1986 and January 1997 were identified. All pathology specimens were reviewed. DCIS type, lesion size, nuclear grade and margin clearance were assessed. Mammograms were reviewed and mammographic patterns, size, type of lesion and distance from the nipple were measured. Treatments and subsequent outcomes were established by case note review. Factors predicting for recurrence were analysed by both univariant and multivariant analysis. RESULTS: Of the 220 patients, 153 (70%) had breast-conserving surgery. Sixty-seven (30%) had a mastectomy. Ninety-seven patients had adjuvant therapy of which 22 had radiotherapy alone, 54 had tamoxifen alone and 21 had radiotherapy and tamoxifen. Following mastectomy, two patients developed axillary recurrences. Following breast-conserving surgery 20 (13%) patients developed local recurrences, of which one developed systemic disease and died from breast cancer. CONCLUSIONS: Mammographic nipple to lesion distance of <40 mm and high/intermediate nuclear grade were the only factors found to increase the likelihood of recurrence.
