ABSTRACT
BACKGROUND: Despite being the cosmetic procedure most performed worldwide, there are still few objective measurements of postoperative volumetric analysis of breast augmentation available in the literature. OBJECTIVE: The aim of this study was to evaluate volumetric changes in the breast parenchyma after the placement of silicone implants in the subglandular plane. METHODS: Thirty-four women were randomly allocated to the intervention group (n = 24), who underwent breast augmentation in the subglandular plane, or to the control group (n = 10), who received no intervention. Volumetric magnetic resonance imaging was performed at inclusion, and after 6 and 12 months in all participants. The non-parametric Friedman's test was used for statistical analysis. RESULTS: There was a significant reduction in glandular volume (mean, 22%) at 12 months postoperatively in patients who underwent breast augmentation. CONCLUSIONS: Breast augmentation caused reduction in the volume of the breast parenchyma. LEVEL OF EVIDENCE: 3 Therapeutic.
Subject(s)
Breast Implantation/methods , Breast Implants/adverse effects , Breast/anatomy & histology , Silicone Gels/pharmacology , Adolescent , Adult , Brazil , Breast Implantation/adverse effects , Female , Follow-Up Studies , Humans , Longitudinal Studies , Magnetic Resonance Imaging/methods , Mammography/methods , Organ Size/physiology , Preoperative Care/methods , Prospective Studies , Prosthesis Design , Prosthesis Failure , Reference Values , Risk Assessment , Silicone Gels/adverse effects , Time Factors , Tomography, X-Ray Computed/methods , Treatment Outcome , Young AdultABSTRACT
INTRODUÇÃO: As sequelas de mastectomia se apresentam de formas variadas exigindo, do cirurgião, experiência e criatividade para obter o melhor resultado na reconstrução de uma nova mama. Dentre as dificuldades para que este objetivo seja alcançado, está o desafio de um melhor preenchimento do polo superior da mama. O objetivo deste trabalho é apresentar uma opção terapêutica alternativa para correção do polo superior dentre as técnicas já existentes com este propósito. MÉTODO: A técnica cirúrgica utilizou o retalho de músculo grande dorsal com extensão gordurosa para preenchimento do polo superior da neomama durante sua reconstrução. A técnica descrita foi utilizada em 8 pacientes durante a reconstrução mamária tardia, com idades variando entre 39 e 70 anos. O tamanho desta extensão gordurosa variou entre 4,0 × 10,0 e 7,0 × 13,0 cm. O componente gorduroso do retalho foi avaliado após 3 meses através de ressonância magnética. RESULTADOS: Foram usados implantes mamários que variavam entre 270 e 435 ml. O acompanhamento pós operatório variou entre 3 meses a 1 ano. Ocorreram 2 casos de epidermólise (28%) na junção do retalho cutâneo com a área receptora. Não houve perda ou sofrimento do retalho. Os resultados demonstram clinicamente ou visualmente que a correção da depressão do polo superior da neomama foi alcançada adequadamente, bem como a viabilidade do retalho gorduroso, observada nos exames de imagem (ressonância magnética). CONCLUSÃO: A técnica proposta é uma alternativa adequada para o tratamento da maioria dos casos de reconstrução mamária em que se busca o preenchimento da depressão existente no polo superior da mama.
INTRODUCTION: The sequelae of mastectomy presents in numerous ways, requiring the experience and creativity of the surgeon to achieve the best result in the reconstruction of a new breast. One of the difficulties in achieving this objective is the challenge of adequately filling the upper pole of the breast. The objective of this work was to present an alternative therapeutic option for correction of the upper pole of the neobreast. METHODS: In our surgical technique, a latissimus dorsi muscle flap with fat extension is used for filling the upper pole of the neobreast during its reconstruction. The described technique was used in 8 patients during late breast reconstruction. The patients' ages ranged from 39 and 70 years. The size of the fat extension ranged from 4.0 × 10.0 cm to 7.0 × 13.0 cm. The fat component of the flap was evaluated after 3 months by using magnetic resonance imaging (MRI). RESULTS: Breast implants that varied in volume between 270 and 435 mL were used. The follow-up period after surgery ranged from 3 months to 1 year. Two patients had epidermolysis (28%) at the junction of the cutaneous flap and the receiver area. No graft loss or other complications occurred. Our results demonstrate clinically or visually that correction of the depression in the upper pole of the neobreast was satisfactorily achieved. The viability of the fat flap, as observed on MRI, was adequate. CONCLUSION: The proposed technique is a suitable alternative method for filling the depression in the upper pole of the neobreast in most cases of breast reconstruction.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , History, 21st Century , Radiotherapy , Breast , Adipose Tissue , Mammaplasty , Breast Implants , Plastic Surgery Procedures , Silicone Gels , Mammary Glands, Human , Fats , Superficial Back Muscles , Myocutaneous Flap , Radiotherapy/adverse effects , Radiotherapy/methods , Breast/surgery , Adipose Tissue/surgery , Mammaplasty/adverse effects , Mammaplasty/methods , Breast Implants/adverse effects , Plastic Surgery Procedures/methods , Silicone Gels/therapeutic use , Silicone Gels/pharmacology , Evaluation Study , Mammary Glands, Human/surgery , Fats/therapeutic use , Superficial Back Muscles/surgery , Myocutaneous Flap/surgery , Myocutaneous Flap/adverse effectsABSTRACT
Con la finalidad de prevenir o mejorar la apariencia de las cicatrices hipertróficas, sean éstas de origen quirúrgico o traumático, se ha desarrollado una gran variedad de tratamientos, tanto tópicos como sistémicos. Estas lesiones son notoriamente recurrentes y su manejo es poco satisfactorio. Ninguna medida en forma individual ha probado ser efectiva en evitar el proceso de la cicatrización hipertrófica (CH), con excepción tal vez de la silicona. El presente trabajo tiene como objetivo revisar la evidencia disponible en estudios prospectivos, controlados, descritos en la literatura acerca de la utilidad de la silicona en el tratamiento de las cicatrices hipertróficas