Abstract:
BACKGROUND:Nipple-sparing mastectomy with immediate prosthetic reconstruction is routinely performed because of excellent aesthetic results and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, caused by pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage. METHODS:A single surgeon's experience with immediate prosthetic reconstruction following nipple-sparing mastectomy from 2012 to 2016 was reviewed. Patient demographics, adjuvant treatment, length and characteristics of the expansion, and incidence of complications during the tissue expander stage were compared between the partial submuscular/partial acellular dermal matrix (dual-plane) cohort and the prepectoral cohort. RESULTS:Fifty-one patients (84 breasts) underwent immediate prepectoral tissue expander placement, compared with 115 patients (186 breasts) undergoing immediate partial submuscular expander placement. The groups had similar comorbidities and postoperative radiation exposure. There was no significant difference in overall complication rate between the two groups (17.9 percent versus 18.8 percent; p = 0.49). CONCLUSIONS:Prepectoral breast reconstruction provides a safe and effective alternative to partial submuscular reconstruction, that yields comparable aesthetic results with less operative morbidity. In the authors' experience, the incidence of acute and chronic postoperative pain and animation deformity is significantly lower following prepectoral breast reconstruction. This technique is now considered for all patients who are safe oncologic candidates and are undergoing nipple-sparing mastectomy and prosthetic reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, III.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Sbitany H,Piper M,Lentz Rdoi
10.1097/PRS.0000000000003627subject
Has Abstractpub_date
2017-09-01 00:00:00pages
432-443issue
3eissn
0032-1052issn
1529-4242pii
00006534-201709000-00002journal_volume
140pub_type
杂志文章abstract:SUMMARY:Gynecomastia, or persistent enlargement of the male breast, is a common occurrence during early sexual development. Typically, two types of tissue can be identified during this period of growth. Initially, a dense fibrous growth of supporting stroma and breast tissue forms directly under the areola, creating a ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181aa2dc7
更新日期:2009-07-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Discuss the critical anatomic structures of the nose that are affected in naso-orbital ethmoid fractures. 2. Discuss the advantages of early, complete nasal reconstruction of these fractures. 3. Apply a clinical algorithm to such nas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000195081.39771.57
更新日期:2006-01-01 00:00:00
abstract::Perfusion of rat groin flaps after 10 and 11 hours of complete ischemia with superoxide dismutase, an oxygen free-radical scavenger, significantly improved the survival of these flaps. This finding provides further evidence for the important role that oxygen-derived free radicals play in ischemic injury. The study als...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198604000-00022
更新日期:1986-04-01 00:00:00
abstract::Apoptosis, or programmed cell death, is a phenomenon that is integral to development and cellular homeostasis. In the last decade, many of the essential molecules and pathways that control this phenomenon have been elucidated. Because apoptosis is involved in almost all physiologic and pathologic processes, the unders...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.PRS.0000049639.64947.EF
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Traditional nonoperative management of stenosing tenosynovitis is limited to one corticosteroid injection, followed by surgery in the case of failure. Recently, nonoperative strategies have been extended to include two or three injections despite the absence of large prospective studies supporting this pract...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000475789.46608.39
更新日期:2016-02-01 00:00:00
abstract::Since the development of smooth silicone breast implants in 1962, more than 1 million women throughout the world have opted for breast augmentation surgery. Although initially successful, smooth implants are prone to develop surrounding scar capsules that may harden and contract, resulting in discomfort, weakening of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199712000-00014
更新日期:1997-12-01 00:00:00
abstract::New upper pedicle reduction mammaplasty and mastopexy techniques are presented. The surgical steps are described point by point. An analysis is made of the results obtained in 25 patients who underwent surgery between November of 1987 and November of 1988 and were examined in December of 1990 with a mean follow-up of ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199305000-00012
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine whether or not prefilled breast implants retain their volume in packaging. METHODS:This study examined 32 Poly Implant Prosthesis prefilled textured saline breast implants. All of these implants were within the manufacturer's expiration date at the time of weighing...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000227674.65284.80
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Today, minimally invasive procedures are becoming more popular because of the fast recovery. Rhinoplasty is a common facial plastic surgery procedure that can be associated with significant postoperative morbidities, especially periorbital edema and ecchymosis. The aim of this review is to summarize the resu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002101
更新日期:2016-05-01 00:00:00
abstract::Traumatic amputation of the lip is a rare yet devastating event affecting both form and function. Considering the available methods for reconstruction, replantation may offer a reasonable solution. We sought to characterize the variables associated with lip replantation and to assess the outcome in a retrospective rev...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199808000-00009
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Age is a frequent consideration for surgical timing in pediatric craniofacial surgery for optimal psychosocial development. However, systematic evaluations of the effects of age in children under active treatment have not been thoroughly evaluated. METHODS:Ninety-nine patients (age, 8 to 17 years; 46.5 perc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003687
更新日期:2017-10-01 00:00:00
abstract::Surgery is a stressful event, with the potential for profound disturbance to the patient's psychological and physiologic homeostasis. Cosmetic surgery is a particularly intense psychological experience because, in addition to the usual concerns about surgical side effects, cosmetic patients bring their hopes and expec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199708000-00046
更新日期:1997-08-01 00:00:00
abstract::A case is reported in which a closed compression capsulotomy for fibrous capsular contracture was followed by rupture of the implant bag with the immediate appearance of silicone gel in the axilla. A possible mechanism, analogous to that of high-pressure injection injuries of the hands, is hypothesized. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197812000-00013
更新日期:1978-12-01 00:00:00
abstract::Based on contemporary social psychological theory and research, the aesthetic appeal of one's physical appearance can have considerable influence on others--on social attraction, attitudes, attributions, and actions, which in turn can affect one's psychosocial experiences and development. From this perspective, the pr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1983-10-01 00:00:00
abstract::Forty axial-pattern skin flaps in 10 pigs were studied, and 50 and 15 mu radioactively tagged microspheres were used to study blood flow at 2 days and 7 days after surgical delay. Blood flow increased during this period. No statistically significant change in the index of non-nutrient flow, an expression of arterioven...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198003000-00008
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:An insidious risk with the use of muscle perforator flaps is the possibility of venous outflow compromise. Congestion in deep inferior epigastric perforator (DIEP) flaps in particular is not infrequent. On an empiric basis, their salvage has been accomplished by augmenting venous drainage through alternative...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000172889.62564.e1
更新日期:2005-08-01 00:00:00
abstract::In a number of congenital, developmental, and postoperative conditions, many patients have a difference in the vertical and anteroposterior position of the ears. On correction of this deformity, the most difficult problem is the low and anterior location of the external auditory canal. To overcome this unyielding limi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199912000-00006
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Perforator flaps are increasingly used in reconstructive surgery. However, the microvascular perfusion pattern within these flaps remains essentially unknown. In perforator flaps, the importance of preserving the skin bridge at the base is still an object of debate. The authors hypothesized that dividing the...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31824423f8
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Reconstruction of the defects of the upper lateral lip is still one of the most difficult challenges for plastic surgeons. No method specific to the superficial and larger defects of the upper lateral lip has been proposed before. Nasolabial rotation flaps based on the upper lateral lip subunit for superfici...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31825dc09f
更新日期:2012-09-01 00:00:00
abstract::This paper discusses a case of congenital leukemia cutis of lymphoblastic type presenting as a solitary frontonasal tumor. The presentation is unusual when compared with other reported cases of neonatal leukemia and represents the only reported case with comparable presenting features to the authors' knowledge. The di...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199712000-00026
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:The free fibular flap has become the workhorse flap for composite mandibular defect reconstruction. As advancements in microsurgery have improved flap survival, greater interest has shifted toward flap refinements to avert donor-site morbidities. METHODS:A total of 27 free fibular flaps used for mandible re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318218fc70
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Since the inception of microvascular free tissue transfer, flap monitoring has been based on clinical signs. Color, capillary refill, and handheld Doppler have been used for monitoring in the postoperative period; however, subjective clinical examination may delay recognition of flap compromise. Tissue oxime...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31820436cb
更新日期:2011-03-01 00:00:00
abstract::Early surgery for isolated craniosynostosis is designed to improve morphology, to prevent functional disturbances, and equally important, to enhance the psychosocial development of the child. As the first of a two-part series, 104 patients with isolated craniofacial synostosis were retrospectively analyzed. Diagnoses ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199508000-00004
更新日期:1995-08-01 00:00:00
abstract::This study was designed to clarify the vascularization of the inner anterior abdominal wall with respect to the novel transversus and rectus abdominis musculoperitoneal (TRAMP) flap, which was introduced recently for vaginal reconstruction. A series of human cadavers was injected with a lead oxide-gelatine mixture by ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199703000-00016
更新日期:1997-03-01 00:00:00
abstract::Spare-part surgery of upper extremity avulsions may facilitate primary soft-tissue healing and prosthetic rehabilitation. This procedure also may be applicable to the management of analogous proximal lower extremity avulsions where a short femoral stump and a shortage of soft tissue exist. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199105000-00027
更新日期:1991-05-01 00:00:00
abstract::Cerebrospinal fluid rhinorrhea, whatever the etiology, is a serious and life-threatening problem. We present a case following rhinoplasty. To our knowledge, this specific complication has not been reported, most likely because it has gone unrecognized, since most cerebrospinal fluid leaks cease spontaneously. Surgeons...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198301000-00025
更新日期:1983-01-01 00:00:00
abstract::Distraction osteogenesis is a well-established method of endogenous tissue engineering. This technique has significantly augmented our armamentarium of reconstructive craniofacial procedures. Although the histologic and ultrastructural changes associated with distraction osteogenesis have been extensively described, t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200102000-00021
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Toxic epidermal necrolysis syndrome is a devastating disease, with mortality rates ranging between 20 and 60 percent. This study evaluated an alternative treatment approach using antishear wound care and compared outcomes using the severity of illness score for toxic epidermal necrolysis syndrome (SCORTEN) s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181773d5d
更新日期:2008-07-01 00:00:00
abstract::The orbital floor is one of the most frequently damaged parts of the maxillofacial skeleton during facial trauma. Unfavorable aesthetic and functional outcomes are frequent when it is treated inadequately. The treatment consists of spanning the floor defect with a material that can provide structural support and resto...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000096704.34065.03
更新日期:2004-01-01 00:00:00
abstract::We have used dacryoscintigraphy to study the efficiency of the lacrimal system following the repair of a divided lower canaliculus in 4 children. This test has been reliable in evaluating lacrimal function and suggests that a canaliculus can be repaired and splinted satisfactorily. Our experience with dacryoscintigrap...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197609000-00016
更新日期:1976-09-01 00:00:00