ABSTRACT
The surgical approach to breast asymmetry depends on several factors, including the surgeon's experience, the anatomy of the patient, and several methods that may help to choose a technique and define the size of the implant or the amount of breast tissue to be excised. The aim of this study is to assist in evaluation of breast volumes with the Quantra™ software application, intended for use with Hologic™ digital mammography systems. Twenty-eight women were studied with full-field digital mammography (FFDM) with the Quantra™ software application, for use with Hologic™ digital mammography systems preoperatively. The case diagnoses were as follows: breast hypertrophy, ptosis, hypoplasia, and reconstruction, and the surgeries included breast reduction, mastopexy, mastopexy and breast reduction, mastoplasty and breast augmentation, breast augmentation, and immediate or delayed breast reconstruction. Patients were evaluated from 6 to 18 months after surgery. Volumetric mammogram studies help to decide the amount of tissue to be excised, the size of the implants, and the combination of both. The results of this study were evaluated by surgeons and patients and found to be highly satisfactory. The use of full-field digital mammography with adequate software should be considered as another tool to assist in making decisions regarding the correction of breast asymmetries. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Subject(s)
Breast/abnormalities , Breast/surgery , Mammaplasty/methods , Patient Satisfaction/statistics & numerical data , Adult , Age Factors , Argentina , Cohort Studies , Esthetics , Female , Humans , Middle Aged , Retrospective Studies , Risk Assessment , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Late capsular contraction around breast implants is one of the most difficult complications to prevent or resolve. The authors studied the mechanisms that control the fibrotic process in an animal model. Using angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonist, the authors previously described a significant reduction in fibrosis in different experimental models. METHODS: Four groups of six rats each had a mini breast implant, 12 with a smooth surface and 12 with a textured surface. In two groups, the angiotensin-converting enzyme inhibitor enalapril was administered in drinking water, ad libitum, to determine its effect on both implant types. Two control groups were given plain drinking water. Three months postoperatively, all of the rats were killed and the capsule sections were cut and stained with hematoxylin and eosin and Masson's trichrome. Immunolabeling of collagen III and transforming growth factor (TGF)-beta1 was performed using monoclonal antibodies. RESULTS: Significant differences were found between smooth and textured implants, with a uniformly low inflammatory response found on textured implants. For both surfaces, the enalapril-treated group had a significant reduction of the inflammatory process that was especially marked in the textured implants. Immunostaining for collagen III and TGF-beta1 showed a consistent reduction in both fibrous tissue and cytokine mediator. CONCLUSIONS: Enalapril lowers the expression of fibrotic mediators, TGF-beta1, inflammatory markers, anti-ED1, anti-collagen III monoclonals, and the periprosthetic fibrosis process. The reduction of TGF-beta1 indicates that the probable main cytokine mediator of the fibrotic cascade is attenuated. This hypothesis may provide the basis for a safe and cheap therapeutic strategy with which to modify the capsular contracture that sometimes affects women with mammary implants.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Breast Implants , Enalapril/therapeutic use , Implants, Experimental , Postoperative Complications/prevention & control , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Animals , Collagen Type III/biosynthesis , Collagen Type III/genetics , Down-Regulation/drug effects , Drug Evaluation, Preclinical , Enalapril/pharmacology , Equipment Design , Female , Fibrosis/etiology , Fibrosis/prevention & control , Granuloma, Foreign-Body/etiology , Granuloma, Foreign-Body/pathology , Granuloma, Foreign-Body/prevention & control , Mammary Glands, Animal/pathology , Mammary Glands, Animal/surgery , Postoperative Complications/etiology , Postoperative Complications/pathology , Random Allocation , Rats , Rats, Sprague-Dawley , Transforming Growth Factor beta1/biosynthesis , Transforming Growth Factor beta1/geneticsSubject(s)
Breast Implantation/adverse effects , Breast Implants/adverse effects , Models, Animal , Prosthesis Failure , Animals , Breast Implantation/methods , Contracture/etiology , Contracture/physiopathology , Female , Humans , Postoperative Complications , Rabbits , Risk Assessment , Sensitivity and SpecificityABSTRACT
El objetivo de este estudio es comparar la durabilidad de la plicatura de los rectos abdominales con técnica convencional versus plicatura con sección de la hoja anterior de la vaina de los rectos y sutura en dos planos (técnica de San Martín). Para ello se realizó el seguimiento de 20 pacientes a quienes se les practicó dicha plicatura como parte de una dermolipectomía convencional
Subject(s)
Comparative Study , Lipodystrophy/classification , Lipodystrophy/diagnosis , Lipectomy/methods , Anesthesia, General , Surgical Flaps , Suture TechniquesABSTRACT
El objetivo de este estudio es comparar la durabilidad de la plicatura de los rectos abdominales con técnica convencional versus plicatura con sección de la hoja anterior de la vaina de los rectos y sutura en dos planos (técnica de San Martín). Para ello se realizó el seguimiento de 20 pacientes a quienes se les practicó dicha plicatura como parte de una dermolipectomía convencional
Subject(s)
Anesthesia, General , Lipectomy , Lipodystrophy , Surgical Flaps , Suture TechniquesABSTRACT
Se presenta la xperiencia del autor en más de 26 años de utilización del bolsillo subpectoral y se realiza la comparación con el bolsillo subglandular, evaluando ventajas y desventajas de cada uno de ellos. Como síntesis si bien es más sencilla la confección de un bolsillo subglandular, no se descarta el uso del subpectoral para los casos que así lo requieran. También pone énfasis en la zona entre el borde inferior del Pectoral y el surco submamario, ya que coincidentemente en ambos bolsillos se suscitan algunos inconvenientes para mantener el implante a la altura deseada
Subject(s)
Humans , Female , Breast Implantation/methods , Pectoralis MusclesABSTRACT
Se presenta la xperiencia del autor en más de 26 años de utilización del bolsillo subpectoral y se realiza la comparación con el bolsillo subglandular, evaluando ventajas y desventajas de cada uno de ellos. Como síntesis si bien es más sencilla la confección de un bolsillo subglandular, no se descarta el uso del subpectoral para los casos que así lo requieran. También pone énfasis en la zona entre el borde inferior del Pectoral y el surco submamario, ya que coincidentemente en ambos bolsillos se suscitan algunos inconvenientes para mantener el implante a la altura deseada
Subject(s)
Humans , Female , Breast Implantation/methods , Pectoralis MusclesABSTRACT
En esta investigación se observa experimentalmente el efecto de la progesterona sobre la envoltura fibrosa en torno a los implantes de mama. En 2 grupos de conejos insertados miniprótesis llenas de gel y sometidas a observación durante períodos de 15, 30, 45 y 60 días. Fue encontrada una diferencia significativa entre ambos grupos mostrando un desplazamiento de la prótesis y fácil movimiento en el grupo tratado con progesterona. Histológicamente los resultados no fueron concluyentes
Subject(s)
Rabbits , Animals , Female , Breast/surgery , Progesterone/pharmacology , Prostheses and ImplantsABSTRACT
En esta investigación se observa experimentalmente el efecto de la progesterona sobre la envoltura fibrosa en torno a los implantes de mama. En 2 grupos de conejos insertados miniprótesis llenas de gel y sometidas a observación durante períodos de 15, 30, 45 y 60 días. Fue encontrada una diferencia significativa entre ambos grupos mostrando un desplazamiento de la prótesis y fácil movimiento en el grupo tratado con progesterona. Histológicamente los resultados no fueron concluyentes (AU)
