ABSTRACT
BACKGROUND: Oncoplastic surgery (OS) has added plastic surgery concepts and techniques to the breast cancer surgery. However, reports of the impact of OS on cosmesis after breast-conserving surgery (BCS) are limited in the literature. PATIENTS AND METHODS: This cross-sectional prospective study included patients who underwent BCS. The patients self-evaluated the cosmetic outcome of the breasts and had them photographed. The photos were evaluated by BCCT.core software and by 6 breast surgeons (mastologists and plastic surgeons) using the Harvard, Garbay, and Fitoussi scales. Kappa and weighted kappa tests were used to analyze agreement for categorical variables; for continuous variables, the interclass correlation index and the chi-square test to analyze the association between the OS and the symmetrization. RESULTS: A total of 300 patients were evaluated: 228 (76.0%) underwent traditional BCS and 72 (24.0%) underwent OS, and of these, 37 (51.4%) underwent contralateral symmetrization surgery. In the evaluation of the cosmetic result, the correlation between patients and observers (BCCT.core and surgeons) was weak; between the 2 groups of surgeons, the correlation was moderate (Fitoussi scale) and excellent (Garbay scale). Plastic surgeons are more critical for evaluating cosmetic results; they considered it good or excellent in 30.0% whereas patients, mastologists, and BCCT.core results considered it so in 78.8%, 34.0%, and 30.0%, respectively. In terms of cosmesis, OS and symmetrization did not influence the results in this study with long follow-up. CONCLUSION: Patients' self-evaluation reported better cosmesis than surgeons' analyses. Plastic surgeons were the most critical. OS and symmetrization did not influence the results.
Subject(s)
Breast Neoplasms/surgery , Cosmetic Techniques/psychology , Esthetics , Mastectomy, Segmental/psychology , Patient Satisfaction/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Humans , Mastectomy, Segmental/methods , Middle Aged , Prospective Studies , Quality of Life , Surveys and Questionnaires , Treatment OutcomeABSTRACT
BACKGROUND: Rhytidoplasty may cause permanent and unwanted stigmas, such as dislocation of the temporal and cervical hairline. Widened scars inside the hairline may cause considerable social embarrassment. Furthermore, pretrichial incisions, even if well placed, may widen or become hypochromic, thus revealing that an aesthetic procedure has been performed. Various procedures for the correction of these undesirable telltale signs of a face-lift have been published. This report aims to present the results of correction for postrhytidoplasty stigmas using follicular transplantation. Patient assessment is discussed, and relevant technical aspects are detailed and illustrated. METHODS: A prospective study at the Ivo Pitanguy Clinic investigated patients who underwent hair transplantation to correct unaesthetic signs secondary to rhytidoplasty from January 2001 to December 2004. The aesthetic results and complications were evaluated, as well as the patients' satisfaction rate. The patients presented in this series either were referred from another service or had their rhytidoplasty originally performed in the authors' service. RESULTS: A total of 33 female patients were included in this study. Two patients were lost to follow-up evaluation and not included. The complications were minor. In the late follow-up assessment, 24 patients classified the result as excellent, 4 as satisfactory, and 3 as unsatisfactory. Only the patients who classified the results as unsatisfactory requested a second procedure (i.e., another follicular transplantation). CONCLUSIONS: When performed by an experienced surgical team, the follicular unit transplantation technique is a simple, safe, and efficient way to correct stigmas secondary to a rhytidoplasty, such as a visible scar or a displaced hairline, with satisfactory results and a very low complication rate.
Subject(s)
Hair Follicle/transplantation , Rhytidoplasty/adverse effects , Scalp/abnormalities , Scalp/surgery , Adult , Aged , Female , Humans , Middle Aged , Prospective StudiesABSTRACT
Introdução: A elevação da linha de implantação pilosa temporal - a costeleta - é um dos principais estigmas de pacientes submetidos a ritidoplastias. Este deslocamento pode ser inerente ao procedimento, devido à tração súpero-lateral do retalho, ou pode resultar de dano permanente dos folículos pilosos, por um descolamento superficial do retalho facial. O objetivo deste estudo é analisar a correção da elevação da costeleta pós-ritidoplastias através da técnica de transplante folicular. Método: Os autores acompanharam prospecti-vamente os pacientes submetidos a transplante folicular, para a correção do apagamento da costeleta pós-ritidoplastias, realizados no Serviço de Cirurgia Plástica do Professor Ivo Pitanguy, no período de janeiro de 2003 a outubro de 2004. Foram avaliados os resultados estéticos, as complicações, assim como o grau de satisfação dos pacientes. Resultados: Vinte e cinco pacientes do sexo feminino foram analisadas. No acompa-nhamento tardio, realizado seis e doze meses após a cirurgia, todas as pacientes obtiveram melhora estética importante. Como complicações, identificamos 4 per cent de alargamento da cicatriz da área doadora e 28 per cent eflúvio telógeno. Apenas 8 per cent das pacientes foram submetidas a um novo procedimento para aumentar a densidade capilar. Conclusões: Os autores acreditam que o transplante folicular é uma alternativa válida, segura e que apresenta resultados satisfatórios na correção da elevação da costeleta pós¬ritidoplastias.
Subject(s)
Adult , Female , Face , Hair , Rhytidoplasty , Methods , MethodsABSTRACT
Os autores estudaram a incidência de algias de colunaem idosos, baseados em dois questionários aplicados em pessoas de terceira idade na área de abrangência daUnidade Básica de Saúde (UBS) da Vila Casoni, Londrina, Paraná. Foi estudada uma amostra de 83 idosos, envolvendo ambos os sexos. Os resultados comprovaram a alta incidência de problemas de coluna nesse segmento social. Baseando-se em estudos que reforçam a idéia de um tratamento preventivo ou um tratamento paliativopor fisioterapia é mais indicado para os idosos, os autores realizaram um trabalho em grupo que contou coma presença de profissionais especializados. Foram elaborados materiais de fácil leitura sobre algia de coluna para serem distribuídos na própria UBS. O estudo ainda demonstra que a fisioterapia é muito procurada pela populaçäo da regiäo, embora a rede municipal de saúde näo ofereça o serviço desse profissional nas unidades básicas de saúde
